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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Under Slab / Floor
<br />Bonding / Groundin / 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 />lvleter Release
<br />Rou h /ni l!
<br />.-l
<br />Service Meter
<br />Notes, Remarks, Etc.
<br />Osa-Blildd Dcclearid
<br />I h@by amm ud.r Fsally olpdjury lnar I o crdpt lom thc Contado6 Li6s. kw lu tn. follosinS.eon (rcc.7o31.5 B6ins
<br />md Profdiq Codc): Ai, City d Counq whi€h EquiG . Fmit lo c@nlci alrcr, imprcv.. dcmolish d Ep.ir , itiucturc. Fior ro ir.
<br />hsuo.., dso r.quiB d'. rrrlidt fd sucn Fffin lo fit ! 3ign.d {ah6r $.r hc d shc is lica*d p6Br ro th. provisio$ ot $.
<br />Co.Eer6's Li@nscd Llw (ChlPtd 9, Co,m.ndng wirh Sccd@ 70m of Division 3 of lh. BEin63 dd Profsios Codc) or rh.r hc d
<br />shc is .impl lb.rcfrm ed $. b6is i- $c itlcScd .xdlption Any violaiio oa Sdio 703 I 5 b, oy lpplidr for r pcmn slbjc.ls lh.
<br />appliet to a civil p.$|ry of not turc rtd firc hundr.d dolls (lJoo).
<br />I, a ownd oa fi. prop.ty, or my .nploy*s vnn wos.s s lhct solc .mpas.rion, *ill do rh. wo* ed lhc stru€.w is not in!6.t d
<br />or offcrcd rq sol. ( Sc ?0a4, Auios ed P.of.sio.s Cod. Thr ConElclor's Lic6s. Law d6 nor rrply lo& ownd ol fic prop.ny
<br />qho builds or imprcvB rh.r.on, ed who dG s@h *ort him.lf or h6clf o! rhresh his orhd o*n dployd,, !.ovid!d d8l such
<br />imFovm.nts e hor inrcnd.d or ofacEd fd $1. Ii how.vcr, d. boilding or ioprov.nor is sold within o. yd of co6pl.rrm, {n.
<br />Oqnr-Build.r ,ill h.v. th. burdd oi prcvins (hal h. or ih. nor build o. inprovc for ih. purpc. of s!t.)
<br />L a ownd of$c proFny, m.xclBiv.ly @nE&tns with licdscd mhd6 t6 co.ntuct rl). p.ojcct ( 56 7044, Bsins ad
<br />Pror6sioo Code Thc CMtrernt Lic.e L.* r,c nor apply ro u om6 oa prcFiy wio boil& d improG lhatd , Md who
<br />coitua ad slch poj.d. yirh a co,rer*(, lims.d puFudr to $c conE&lorr Lic.N. t5w )
<br />_l m crmF undd S.c m _,8 & P C ad inii Eson
<br />_own..
<br />I lialc dd will nainlain ! C.nifiar. oa Cons..t lo S.l 6urc for worlcE cmpdiation, s povid.d for by Scdion 37OO of th.
<br />Labor Codc, for thc P.rfma of inc vork for which ln. Fmn is i$u.d
<br />_l hwc md will moint h wdkh' cmF$.iion iNlmcq s rcquir.d by S6tid 3?oo of rh. t$or Codc, fq $c pcrf@e@ otd.*ot fo whicl lhii Fdn is isu.d My wdk6 @pcnsrion insuoe ffi6 od poliry numb.r d.
<br />(This 3*tion .ccd nol b. @mpld.! if th? Fmn i5 aor On. hundrcd dollm ll I oo I or 16)
<br />_l ccnify thd in th. p.rfoodc. of dr *o* td whhh rhi. hmir is i!su.4 I shall nd mploy ey pdson i. dy hMnd so d to
<br />b.cm. subjccr lo $. *o .n mp.nsari@ l.E of Califmii! ed.sE rhar if I shoold bc@mc subj.d lo rh. wo*tra
<br />@mp.n$rim prcvisions oa Seti@ 37Oo of th. L.bc Cod., I shall, fonhwit codply wnh lh6. FovkioN
<br />o*" .<--/2. 6/
<br />WAXNING Failur. to seurc wnt@' cmpdralion corcr.8. is ulMful. dd shall subjd & mplord t simi..l p.natri6 d civil
<br />fioB up to 6c h!f,drd tnoqd dous (l10o,000),in .ddirm ro lh. ccr ofconpasdd, dsnlae $ prcvidld fd 0!c Scctie 10?6 of
<br />$. hbor Cod., in&rd ed anomcy's f6.
<br />LTCf, NSED CoNTR,{C:TORS Df, CI-ARATION
<br />I hcrchy alfim und.r pa.lly ofp.rjurr lhal I h licai.d undd prcvtioi ofch.prcr 9 (@mm6cin8 virh Slcion TOOO) ofDvi.ion 3 of
<br />thc Buindr sd Prcfdi@r Co<!., ed my li6sc t in aull fo@ ed .fL.l
<br />CONST*UCTTON LENDING AGENCY
<br />I n@by aoim 6dd pcn.lr, of p.rjury dlar rh6c is . con*ruclion lodiiS rg@cy fd 0!. p.rfffisc. of lh. wdt fo which rhii p.mit ir
<br />isicd (Src. 3097. Civ. C)
<br />APPLrcANT'S DECLAIATION
<br />Dmdnion PmiE Asb6l6 Notifidio Fcd.r.l Rcgllaridi Gnt. 40, Pan 6)
<br />_ Rcqoicd L.lr6 of Notifi stid
<br />_l cftiry tat tlc f.rlcral rcgularioi r.e.rdiis Bbdc Emovat e. nor rppticablc lo this prcjc.r
<br />_ I ccr{ry fiai I hrvr E d 6is agplicario ed sbr. rhal lh. sbovc infom.rion h c@er I agd b compt, wnh dl City 4.1C@nry
<br />ndireca dd Slalc tjws rchinS to building dsrrucrio, 4d hftb, lulhdia rcpr.staliv6 of this Cit, ed Counry to cnt r upo rhc,bov. moriqcd prop.ny for irrp.dion purps6.
<br />WORI<ERS COMPENSATION DECLAAATION
<br />I hcr.by amm undd p.nalty oa pdjury orc of lhc followins d.clE.tions:
<br />E__
<br />Spas, Pool, Fountains
<br />Building
<br />EEQNI
<br />FINAL J. fol]" .15 /
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