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ELECTRICAL.INSPECTOR RECORD <br />APPROVALS ID/SIG.COMMENTS Oma'Builda D.clotion <br />I h.Eby lflim und.r padry of Fjury ttlt I d .r6pl fm lhc Conn&to6' Licosc I-t* for th. Lllowin8 Bon (s.?01L5 Aqin€5 <br />Md lrofgsion Cod.) Any City q C.ury which Equir6 a p@it lo conrlrrcl, dt r, improv., ddoliih or Ep{r y suucre, Fid ro iE <br />i5s!dc!, d5o r.qun6 lh. .ppliot for such p.mir io 6l? a si8n.d slalmol $ar h. or sh. is li@ns.d puBudt to 6a p.ovilions ol $c <br />Contractor'i Lic.n,cd Law (Chaprcr 9, Cohmdcins wior Sccion ?000 of Division 3 ol dc Businds ad ,rcf*ions Codd or $.r h. d <br />sh. is .xmpl $crcf,m sd th. bsis fa $c dl.g.d ddption Any violdrio of S€tion ?Ol I .5 by uy spplicut for 5 F6n lubjdr d. <br />appliwr ro ! civil p.Blty of nd ndc lhq fiv! huhdr.d doll-5 (IJoO). <br />_1, d owrcr oi $c Fop.rty, or ny cmployco vith wa86 a th.ir solc compcmotion, will do thc vo* md th. 3trucrur. t Dot inEnd.d <br />d ofa.d ltr s.l. ( se ?04a, Baine Dd Prcl*iMr Co.r.: Ii. Condrtr r Licai. k* .ro.i nd .ppt, to u Ma or lhc pror.ny <br />who builds or improve lhtun, ad vho dG ruch vdt hiru.lf or h6.lf d ll'rcud hii or h.r *n hploye, providlt! rhr such <br />improv.hoE e not ihlodcd o oftcrcd aor sal.. Ii hww.r, th. building e improv.mdt k rcld wi.hin on? y.s of @mpldro. th. <br />owia.Builds will hrv. tt. bur&. orp@vins thar h. or!h. not build or imprcvc for $c puDqe ofs.lc). <br />_1, s ovn.r of ln. prpdry, m qclsiv.ly @ntutir8 widr lictu.d cmt&bB ro c shd th. prcj@l ( Sc. 70/14. Buind ud <br />Pdl$ion Codc, Ttu Coir&brt Li@.r. Law dG not .pply ro u oM6 of pro?sty who buil& d improvo ln@00 . od sho <br />cmt''ac$ for such proj@6 wnh a cmrr&ro(, limr.d pu6u4r ro drc cont-adof! Licd$ L.q ). <br />_l m cr.mpt undd S.ctio <br />WORI'ERS COMPI]NSATION DECLARATION <br />I h.r.by alfrm unda pallty of p.rjury onr of rh. followi.S dal{uio.r: <br />_l h.v. ed will m.inr,.in a C.nifi*tc of Coisnt to Sclf-lnsur. for Mrt6' @mp.nsaion, a provid.d for b, Sanion 1700 of$c <br />Labor Cod€, for ih. p..f@Mcq of $G work fd which lh. Fmn i! isucd <br />_l h:vc od qill ruif,t in wqkc cmFn!.1i6 idutu@, a Equtcd by S@tioi 1700 ollhc tlbor Codc. fn thr pcrf@dc. of lt)c <br />wot aor which dii p@n ii iisu.d My wot.R' @npc$ation ituum@ @id ed policy nuhbs d.: <br />PolicyN!frb.r Expt6: <br />A^^^ <br />not b. .mplctcd il thc p6mn is tor on. hyndr.d dolle ll I0o I or ls) <br />rh. p.rfomd@ ol$. work ar *hich <br />b.ao. subjer to d. eo,k6 ' compaBsti@ ls* of Cati <br />ofrhc Labor Codc,I shall, ffihwio' <br />WARNING FailoEto sa!r. wortqs conp.isalion covcasc is .mployd ro eiminal lEnalrie d.ivil <br />fin6 up ro on. hundrld lhoBud dolla (t100,000),in additid lo rhc <br />rh. Llbor Codc, inr.r61 ed .l1oh?y's frd. <br />6 prcvid.d for $c S.ction 10?6 of <br />I h.Eby .(im undq p.nalty of pcrlrry drt I d lic4.d undd prcvilim of CnapB 9 <br />th. Busin6s dd Prof6sions Codc, &d hy liccos. is in full forc. and cff.ci <br />() <br />I hcrcby afim undcr lcnalty ofD.rjury thar th4 is a coniructid .s.ncy aor lh. p.rfmanc. of <br />'hc <br />w*k td which rhi. p.mi i! <br />i$!.d (S@ 309?, Civ. C). <br />AIPLIC^'{T'S DECLARA I ION <br />I Ddolir'on PmirrArbaros No ficauo F.d.ral R.Sulalior (Trtl. 40. Pd6) <br />R.qut.d LaE otNorifi arion-v lhal lhc fcd.ral r.gulaions r.grdiog 6b6t6 <br />lnat I havc rc.d lhk appli@ion dd rdl.b comply *i0' lll City ed Counry <br />odindcd dd Sl4c Lnes rclring lobuildi.g ofrhh Ciry ed Count, lo 016 upon rt. <br />abov. mcntioncd pmp.ny fo i.tFcrio.of <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 />Building <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 <br />Rough EtrANI ,n!q <br />Service Meter <br />FINAL s AMC 8-43, 29C , 556, 667 <br />Notes, Remarks, Etc. <br />DATE <br />Darq Ownq: <br />Lcrde! Ad&s. _ <br />Under Slab / Floor