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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG,COMMENTS Own6-Buildcr D@lmtion
<br />I h@by aflim uda Fnalry of pdjury lhat I m d.mpt foo 6c Conl6cloE Lic6s. L.w for thc follopinB r6oD (sd.70l I 5 B6o6s
<br />d Prca6ion C.d.): Any Ciiy or Couty which GquiB . Fmn lo c@3truct, rltd, impmv., d.molish d Epat sy sdctuq prid lo i6
<br />issuec., aho rcqutd fic appliot for such pcmit io fi|. a si8r.d sratmar rh8t h. or sh. is licdscd pua@r lo rh. prcvilions ol $c
<br />Contr&lols Lico$d La* (Cha!!6 9, Coooddng wi$ S.cion 7000 of Dieision I ofrh. B6inB ed Prcfdiod Codc) or ti.t h. d
<br />shc is cxmpt ttcr.frm ed thc bsis fq lh. dlcscd cxmplion A.y violalion of S€lion ?03 I 5 by uy apdi@l fG a p.mn rubjcl' !c
<br />rtplikr lo !civil Fn.lty ofnol m@ the fiv€ hundr.d dolla (t500)
<br />_1.4 own.r of (n. proFty, or my mployB $iln s!a6 a $cir 3olc cofrFNaIioo, will do $c wo* ed U. srucr@ k nol irta&d
<br />tr olrftd f6 sal. ( Sd.7Or4, BBin* dd Prcf6sid. Cod.: Th. Cddclor's Li.m. ti* do6 rd apply to e omq of rhc prcFd,
<br />wno huil{ts or imprcvB th@o, dd who dG .eh wnl hiG.lf o h6.lf or ln@gh his o ho Nn mploy.6, provid.d $ar suct
<br />ioprov.m.nri E nor inhd.d or off6.d fo s.lc lf, h@dcr. rh. buildrngor improv@oi b sold wi6in onc ycrof @mplc.im, rh.
<br />Ovnd-Buildd will hov. th. burda ol proving $ar h. or shc not build d improv. for th€ puryc. ot ssl.).
<br />_1.6 os.crof$c proFny. m cxclBiv.ly conrrerins with lic.nscdcdr@lom ro cosrruc! rh. Foj..l ( Scc ?o44, BBi.6 ed
<br />Prcadio. Code Tnc Conr&td 3 Liccnsc Las do6 nor apply ro u oMd of proFty who buildr q ihprovd th66n . ed who
<br />onhctl for iuch prcjeB wnh . C@ra.to(, limcd pu6@r ro rhc C@dc(or'r I-iensc taw )
<br />_l e.xdpt @dcr S.ciion .B & t C ld this eeo
<br />WORI(ERS COMPENSATTON DECLARAIION
<br />I n.r.b, amm udd parlty ofpnjory on. ofihc loU irg del@riort
<br />_lh!v.edrillroi .in aC.nifi@I. ofcons.l lo S.lf-l.suE fq workcs mmp..sdim, a povidcd for by Setio 3?00 ofth.
<br />Ldbor Cod., aq U. pdfmdc. of th. work aor vhich thc pcmn is irsucd
<br />_l have ed will mainlain worl6' chpcnsation insulocc, a r.quncd by Sccnon 3700 oa th. Labor Codc, for lhc pdfofldcc of lnc
<br />wtrk for vhich tht p.,mil is issucd My vtrt6 cmFnsalion if,suree cMid ud policy numb.r e
<br />Policy Numb6 Expic:
<br />Gnis s.crion .cd fld b. cmpl.kd if th. pdmn is fd On. nu.dr.d doll4 ll I00l o 16)
<br />_l.dil, thd in thc pafmec. of rhc work ad which dlis tEmit is hsu.d,I sh.llnolrnploy ey pdson in ymdn.rsosto
<br />bc@c subjftl lo thc *dtcE ' cmp.nsalion laws of Califomi4 ad .gre lhat ia I sh.lld b..omr tubj..t to thc w6k6'
<br />comp.nsadon provisionr of S.ction 3700 of rh. Labor Codc, I sh.ll,fonhwirh comply wilh tis. provtions
<br />WARIiING: Failuc lo s.cur. v6*6'€mp.nsdion covsa8c is unlawful, ed shall subjccl d.mploy.rro criminrl r.nahi6 Md citil
<br />finB up to on. hun&cd lhosed dolls (ll0o,O00),in oddnioD to thc csl of comp..salion, &ma86 s provid.d fd th. Setid 3076 of
<br />d. Labo. Cod., intd6t dd atmcyt fB
<br />LICENSED CONTRACTORS DECLARATION
<br />I hcEby adim und.r poalry ofp.duy th.t I m liccond urdd prov'sion ofchdptcr 9 (commcncins with Sccrion 7000) ofDrynion 3 of
<br />thc B6in6s dd Proiaions Cod., ed my licds. is in aull forc. &d cffccr
<br />o"" jiLz22/bz/ c:."r^,t*
<br />CONSIBUCIIoX-LDIDEG.ACENCI
<br />I hd.by amm @dcr p.nalt, ofpojury Oor $q. is a cosfuction ladins,86cy for $. p.rfm aof th. wdt fd*hichihi! pcmir is
<br />iss!.d{S* 3097, Civ C )
<br />4I!!rcANI5DEEIA8I!I.DT
<br />D.mohion P.mns Asb.(o Notific,tio Fcdcdl Rcsu lari ons (Tnlc 40, Pan 6)
<br />Rcqutcd L.ncr of Nonliation
<br />I erlily tat thc f.ddal rclularions rcEading ab6tc Enovd ec trot applieblc to this proj.cr
<br />_ I c.niry lhat I havc r.d fiir applt ion d sbr. rb& rh. ebov. infomaion is @tur I lsre ro cmply with all Ciiy &d County
<br />ordindcB ud Slarc Lsws r.lalin8 to building coGh.rio. dd h6.by audoria rcp,!frl.rivB of rhis Ciry ud Couty io atcr upon rhc
<br />abovc mmlim.d pIopcny for insF.tim purpc6
<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 />Building
<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 F\r-t- *ii
<br />Ceilings (T-Bar Rough)E TIIAEIJ
<br />[\ileter Release FXPIEl FN ctrD n t ,nro
<br />Rough Ftr?II SAMC 8.43, 290, 556, 667
<br />Service l\ileter
<br />FINAL
<br />Notes, Remarks, Etc.
<br />Communrcations Cable
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