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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS ID/SIG.COMMENTS OMd-BuilddD.cle on
<br />I hdcby a,Im und.r Fnalry of pcrjury th.t I m cxmpr aom lh. Co.tuctoR Licd& Law for rhc followins Eson Ga.70r I 5 Buin.$
<br />md P.ol$ion Cod.): Any City or Couiy which Equt6 . p.mn to @.!t dci, .1r,, imp@v.. &molish or .cp.ir y ntudur, #or ro ir5
<br />issu .., slso Equi.6 t. rpplidl for ruch p.mir lo fil. a !i8n.d sur@al thar nc or sh. is lic.nscd plBu r lo $r Fovi.ion! of $.
<br />Coiretor's Liccird Ltw (Ch.pr.r 9, Conm@.i.g eirl Setion ?0o0 ofDivti@ 3 ofrh. BNi.6s 6d P&lBiod Cod.) or tnar h. o
<br />sh. is cxchpr $cr.fM od thc bait f6 fi. .llcgcd ddplion Any violatid ols@rion 7011.5 by ey applicur for. p.mn rubjea thc
<br />appli.et to 6 civil pqalty of ror ftoE ftd firc hundrcd dollaB (t500).
<br />_I, a ownd ofrh. Fopdty, dmy cmployes wi.h wu6 a fi.irsol. compasalion, will do tncwork.nd rh. shctu. h not inrcndcd
<br />or ofiqcd rd sal. ( s.c ,044, Businds &d Protai@, Cod.: Th. Cont icror't Lichr. La* dq nor appl, to r oMcr of th. prcp.ny
<br />who blild! or improrB $.@n, &dwho do6 such vork himclaorh6dlor through his or hc. Nn cmployca, providcd thal luch
<br />improvmcnts u. not inl6d.d d oiIdrd for ral. Ii howlvr, th. buildin8 or imp.ovo.nt is rold within @. y.aofconpl.lo, rh.
<br />O*n.nBuildewillh.v.d.bu.d.noaproving6.rhcoish.nolbuildorinprov.fo.rh.purroscofsalc)
<br />_I, a own.r of t. proF.ty, m d.luiv.ly conu&rin8 wio lic. cd @.i.rcr6 !o constrlcr trc Fojer ( S.c ,Oaa. Bsi.e! dd
<br />Proa6sion Cod.: T1. CoErctort Licni. L.w &d nor lpply to e ownd ofproprry who b!il& d inprcv6 lh6c@ , &d who
<br />coiraclJ lo, such projds wilh 6 Con!&to(s) Iic@.d pusuul ro rh. cor'elor's Lic.E. Ltw )
<br />Id.,.mptunddsa d ,B &PC fd ll]i! E6on.
<br />lqBtrInrcAI&llSAIAN-AEC
<br />I h.rby aflim ud{ p.aalty ol pdjury ooc of fi. following d.cluarionsl
<br />I hav! dd willmaio|aii a Ccnifiet! of Consdt to Sclf-lnsurc for work.Ei comp€nsalion, 6 provid.d for by S@tio 1700 ofrfi.
<br />kbor Cod., aor th. p.rfm@ of ttu worl for wlid $c p.mn k isu.d
<br />_l havc ed will mainlain wdkcEr comp..salion insuE@,6 r.quiEd by S*tion l?00 oath. t lor Cod., t6 $c pdfohs@ ofth.
<br />work for which this ,6i1 ir is!u.d. My *orkq @rQ.s.lion iiiu6n@ @i6 Md policy nlmbd d.
<br />Poli.yNumb€r Expt6:
<br />(This rdioi nc.d nor b. @6pl.r.d ifrh. p.mir is for On. hundr.d dollas lll
<br />*hich rhis pamir ir issu.d,
<br />ol CalitomiA, and agra lhll-rZ',thd in rh. p.rf(mec. of rh.qork ad
<br />Labor Cod., I shall, fonhwith
<br />dolldrl (l100,000),in ldditid .o th. dt of
<br />inr.r6t {d a(om.y i 4.6.
<br />I hcr.b, ailm und.r p.nahy ofpctlry lhal I M,icacd undd trcvisi@ ofch.p!.r 9
<br />lhc Busin6s d Prof6sions Cod., ed m,ii in tull fo@ md.ff.c!
<br />Lic.n.. Nmb.,
<br />L rh. p.ri@,nc. of lh. w*k lor which rht Fmn i,
<br />civ
<br />APPLICANT'S DECI,ARATION
<br />Dmolnion Pcmi(r-Aib<t6 Notiilcaloi fcdml R.gul i6! (Titl. .0, Pd1 6)
<br />_ RcquiEd L.n rofNotifistion
<br />I (n,qdiar lhc f.dd.l EsdleN EBsdrnE
<br />lll.anfy rhlt I h.v. rcad tnrr applrclrron dd agrc. to comply wnh.ll Ciry
<br />ordinecd ad Star. Lavs r.lainS to bui
<br />abovc ncnlioncd pop.ny for inrp..tion /'
<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
<br />rro I ,nt0
<br />Rough
<br />Service Meter SAMC &43, 2€
<br />FINAL
<br />Notes, Remarks, Etc
<br />DATE
<br />0 556. 667
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