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ELECTRICAL-INSPECTOR RECORD <br />DATE tD/stG.COMMENTS Owrs-Build.r D.cleIon <br />I h.rcby .ilim undd Fn.lty of p.rJury fi.i I m .x@p( aom fi. CmtB.toE' Li6!. Lrw fo. tnc followirs lwo Ge.703 I 5 BainB <br />ed Prof6sion co&) Ary Ciry d Couity ehich GquirB a pmit $ @nflNci, alrd, imprcv., d.molish or r.p.ir , 3r^crurc. priq ro ils <br />i$!ec., .lio rcquiB d. lpplidr ror iuch pmt lo filc a li8i.d llal.lMr lhar h. or sh? is lic..rcd pusuur ro tE p.ovisions or ttg <br />Co'ra.toir Lictu.d lrw (Ct.Fa 9, CmmacinS si$ Scti@ ,OO0 of Dvisim 3 of rh! Buinqs &d Profsiom Cod.) or tur h. d <br />shc is crdpr thcrcfM ed th. bat fd tc allcscd qcmptioi Any lolstion ol Sation 70r l.5 by dy applicut fd 6 pcmn subj@t, rh. <br />spplicel to a civil pcnalty of not m@ $d fiv. hundrcd doll&s (1500) <br />_I, a own.rof il'. Fop.rry. or my 6doy.6 wiln wlEB 6 $cir sol. comrcnsation. sill do rhc work lnd in. rl'!ct@ r notinra.t d <br />tr oiI@d ad s.i. ( S€ 7044, B6inBs ed Proa6sion. co.L: Tn. Contretor'E Licm!. Law dG nd apply 6 d o*n.r of $. proplny <br />who buil.ls or imprcv6lhd@n, advho dod such *ork hiN.lfor hd.laqlhrcugh his or hcr own cmploy.s, providcd ll)al tuch <br />inplovco.nri sc nor i.rodcd or olTs.d fd s.lc Ii ho*.tcr, thc buildiis d improtchdt is sold wnhin o.. ycdofcompl{n, ih. <br />O*ncFBuildcr villhdv. thc bu.din of proving that hc o. sh. nol build d impDv. fs thc purpc. ofsal.) <br />_1, ao*ndof $c proF.ny, m *clsivcly contr&tiDg ynh liccns.dconE 106 to .onsrud lh. pbjat ( Sd. 704,1, Blrincs ed <br />ProfBrion Code Th. ConE&tols Li@.s. t w dc nol o?ply ro u own6 of propsty who buildr d imprcvB lnfton . md *ho <br />coc.G ad 5!ch prcjEts wnh . C@tr&!o(, liqscd p!6umr lo di. Contracrd! Licci* La* ) <br />_l m cxcmpt undd Satid _,B. & PC fm thk r.Mn <br />WORKERS COMPENSAT1ON Df, CLARATION <br />I h .by rffim unddpdcltyoipsjuryoi?of th.follo*in8d.cletiois: <br />_l hav. ed willmainEin rC.ni6.{? ofco.s.t io Sclfjnsor. forwol6 compo!.ion, a prcrd.d ad by Serion 3700 of ftc <br />Labor Cod., lor lnc pffo|fucc of ll1. wolk ld which th. p.mir ii issu.d. <br />_l h!v. 6d will minEin wnk6 @mp6!.tioi i6uM.c, a cquicd by Seioo 3700 ol thc L$or Codc, fd 6. p.rfm @ol$. <br />wort for *fii.h this pmi( ir issucd. My wor&.R cmpcrsadon inluru.c .sia &d policy nuhb.r e, <br />Policy Nunb.._Exptcs <br />dffi;#d#;ror on. hqn&.d doll6 {lt00J or ks) <br />is iriu.d. I rhrll nor 6ploy <br />or t. Lr!@ Codc, I sliall, fonlwid @opl, <br />WARNINC Failur.ro saurcBork.B conp.nsrion covcrag. is un <br />finB up to onc hundr€d lhoaMd dolla (l I Oo,oOO),in .ddnion to th <br />thc Labo. Codc. int rBl ed dlomcr! f.B. <br />I h6cby lllim undq p...]ry oa pqju.y that I m licmcd ui&r provision of Ch.pr& 9 <br />$. Blrin6t &d ProfdioDt Codc ed rry li@sc i. in flll l(re ed.f.cl <br />I fi@by .ffim und< Fnriy of pqjlr, tl'{ dt@ n E dsflrctio <br />i$u.d (Se 1017, Civ. C). <br />la.ircy for $. ,qfmrn@ of dc w*t fd whi <br />APPLICANT'S DECLAR-ATION <br />D?molition P.dit-Asb.rtd Nolificdio, f.d.cl R.8uhn6s (Titl. 40, Pln 6) <br />_ Rcqut d Lcltd olNotifiq{is <br />ly wnh rll Ciry ud Counry <br />abolc nciiorcd fop.n, fd inlprcion pur!N6. <br />k City ed Couiry lo.ild <br />Site-Work <br />Underground <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Life Safety /Low Voltage <br />Fire Alarm / Dampers <br />Communications Cable <br />Bu ilding <br />Under Slab / Floor <br />Bonding / Grounding / UFER <br />Transformers <br />Torquing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Rough <br />Ceilings (T-Bar Rough) <br />Meter Release EAFI f<ED <br />Rough r:-.^ U I {t,!:, <br />Service Meter SAMC 8.43, 2 90. s56 ca; <br />FINAL <br />Notes, Remarks, Etc <br />APPROVALS <br />[-----T------ <br />I