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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS Owf,6-Buildd D.cleltio
<br />I hqcby affim und.r paalty of pcrjury lhar I m .xmpt fom thc Conlrdm' Li6i. Ilw fc th. followin8 Bon (s6.701 I 5 BusinG
<br />dd Prcf*io Codc) Any City or Couty which EquiG . pcmn lo €dstruc! alrd, imprcvc, dmolirh or rcpat y rrldur., riq ro iG
<br />irsrmc.. abo Equtq th. applicd for such Fmir lo filc a sisn.d strlmot thd hc d sh. is li6r.d puEudl lo thc prorisions of rhr
<br />Con6&ttr\ Licdscd Llw (Ch.pld 9, Commmin8 *itn Sdrion 7000 of Divirion 3 of ln. Busin6s &d Profdios Codc) u rh{ hc 6
<br />sh. is .xdfl th.i.ftoh dd dt. baas fo tic allcg.d d.nplio Any ,iolatd of Sccr,o. ?03 I 5 by ay arrlicul for a Fmn iubJell $c
<br />agpli@r lo a civil pcnal9 ol not moE th& nw hun&.d doll6 (S500).
<br />_1, N ownd of $. propdty, tr ny nploys wnn *.96 B dicir solc conpc.iatio., *ill do $. work d thc itru€tE is .d inbdcd
<br />or offftd rd salc ( S.c ?04a, Bcin6s ud Prcfdsids C6d.: Tti. C6ntuld'i Licalc Lav doB not lpply to 6 omd oa !n. !rcF ry
<br />eho buil.,s ot idprove th@6. ed who d6 5uch wdt hims.ll or hB.lf or through his or hn @n @ploye, provid.d $arcuch
<br />implov€mcnll e nol inladcd or ofldcd fd sslc ll hovdcr, d. buildingor imprcvd.nr is rcld vi6i. on. yc, of @mpl.tio, rh.
<br />Ownd-Buildd will hav. rhc bord@ oa prcvine .[at hc 6 rhc nor boild or improlc for th. puQ6c of salc)
<br />_1. a oMr of $c pror.rty, d cxclGiv.ly conhcring wnn licas.d co,turG !o c@tducr d. Foj.ct ( Scc. 7044, BEin< sd
<br />Prcadion Codc 1]ic Con!_&td's Licmc Law tlo6 nor apply ro s oMd ofpropary who builds 6 ioFov6 rha@ , ed vho
<br />enEea rc such piojd5 wnn a co.rado(, lic4cd pu6@r ro th. c@E&!or's Lic4c l.lw )
<br />_l m cxmpt undcr S€tio _,8 & P C fd dis rc&n
<br />Policy Numbd Expt6
<br />(This setion n..d not h. .epla.d ia ln. ponil is for Ooc hund..d dollds {t l0O} or 16l)
<br />I aniry lbar in thc Fromue oa thc wort fc whi.h dis pdmn ir i$u.d. I shrll nor oplo, dy p.@tr in ey lMn.r so 6 ro
<br />b.cm. subj.a b $. wo'k6 @mp.isaron l.s ofcalifohia, Md ag@ $ if I should b..omc sbj.d lo tnc *61.6'
<br />@mpdsalion provisions of Sccrion 3?00 of th. L.b.r Cod., I rhall, aonnwidr conp,y eirh $6c Fovisids
<br />Da*-6ar.22,/ Awft*,,
<br />-*---:-
<br />WAf,NING failE to sccur. *orlc6' conprnsr,lio covdas. is nnllwful, dd shatl tubjdt m dp,oy.r to oiminal p.nald6 md civil
<br />fin6 !p lo o.. hundrcd tioBdd dollB (r l0O,00O),in addirim io lhc cdt of.mposario, d@se6 6 providcd for rhc Sedo. 1076 ol
<br />$. kbor Cod., int.rd ed atron"r'3 fc
<br />LTCENSED CONTRA'TORIi NECLARATION
<br />I h@by amm undE paalty ofpajury $ar I d lidscd u aprcvi5iM of Cn+ts 9 (@mocin8 *irh Scdion 7000) of Diviiion I ol
<br />lh. Buli.es dd P.of6sids Codc, ed r'y licosc is in full for& ed .flct.
<br />Li6rc CIN _ Li@s. Numbcr
<br />CAXJiIBUCIIQIIIIDAC.ACDNCIIhacby.mmuddp.naltyoapajurydattfti!ac6srructi6lhdinBt8@cyfeth.pdf@.cofrh.wdtlorwhichlnispehirh
<br />isu.d (Sd 109?, Civ C)
<br />AIIUCAXISDECIJAAIION
<br />Dcfrolition Pmhs-Asb6l6 Notifidion F.d.ral R.gdado6 (Iitlc 4q Pan 6)_ R.qut.d L.td of Notific.rio
<br />_l enify lhat thc fedcEl EEulalioni rSardi.g Bb6tcs movd ar€ not appliebl. to rhis prcjer
<br />_ I .aiay ihd I havc rcad dt .pplicaloo ed sE!. $.r thc abov. infomarion ir @rcc! I agrc. to cmply wnh all Ciry ed County
<br />ordin c6edSkt LaM alatiig lo buildiig constru€tion, d h6.by iu$oiz r?pBat riv6 oi $is City dd County to 6rcr up.n rtc
<br />abovc m.nijon.d prop.ny fd insF.iion purp66
<br />6
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torquing
<br />Sub-Panels
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />trYPIP FN
<br />Rough
<br />Service Meter FFBOI 2019
<br />FINAL
<br />Notes, Remarks, Etc liArvI\J o-fJr zsv'-gs,-l,._
<br />Air Conditioners
<br />Da,r.: Own.rl
<br />WORI<ERS COMPENSATTON DECLARATION
<br />I hd.by rflim udB pdrlry ofpajury or. of$. followiig dcclo.rlioN:
<br />_l hav. ed will hainrair a C.nificd. oac@sor !o S.lf lnlm forsdka'cmpo$ari6, a povid.d for by Sdtim 3?00 ofrh.
<br />Labor Codc, for thc pdfdrM* of dr wort for *hich th. p.mir is isucd
<br />_l h.v. dd rill maintaif, wdkm ampd.ri@ iGu@e. a rcquiEd by Scctid 3700 of th. L$or Cod., fq rh. Ffoll@@ of rh.vo* ltr which lhis p6mil i5 issud My work6' .@pdsari@ insumcc ffin ed policy numb.r a..
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