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APPROVALS DATE ID/SIG.COMMENTS <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 />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 />trxpll rFn <br />Rough <br />Servrce Meter FEB -'2019 <br />FINAL <br />Notes, Remarks, Etc. <br />OMd-Builda Dccldarion <br />I hcrcby .tfim und.. p.ralty oi pqjury lhal I m .t6pl am fic Corl6cto6 Lictuc k* for th. follo*iis c6q Ge70r l 5 au.inB <br />md Prcfgiion Cod.) Any City d County vhich rcquirg 3 pcmn b @nsrhc! alt.r, improv.. d.nolish ofucp6t &y mcrurc, ,.rn ro ils <br />issu cc, rho rcquiG ftc arpliqnt for ruch pmil lo 61. a si9cd slar@61 th h. or sh. i5 lic.nr.d plaual ro $c provisiw of ln. <br />Conradols LieM.d Lrw (Chapt r 9, Commacing wilh Sc.tiotr 7O0O of Division 3 ot tfic BBin* &d Profciois Cod.) or $at h. or <br />shc n .xopl 64fbm ad th. bsb as th. .ll.E.d .i.mprion An, viohion oa S.crion 701 I 5 by uy applisr for a p.nn subj.cr rh. <br />agplic&t lo a civil p.nalty of nor morc to liv. hlndrcd dolld5 (1500). <br />_1, s owncr oirhc propdry, orhy cmploycd qith wasB a lhctsolc mpcisation, will do thc worl lnd thc structuE ir.ot inlcnde<l <br />or oif.Ed for sal. ( S.o ?0a4. Busind ed Pror.$ioDs Codc Th. Contr,crors Lic.,!. Law dB nor apply ro d o*nq of rhc proD.ny <br />whobu'lds oiimpmvc th.mn, dvho doo luch work hiru.llorh6dfor throu8h his or h.r ow..mploycs, provrdcd lhar such <br />improy.mcnE dc not inldd.d or offcrcd forsalc.I( hovcv.r, thc buildinsor improvcmcnt is sold within onc yd of complllion, ftc <br />Own.FAuildcr willh3vc lhc burd.n ofprovin8 th3t hc or shc nol build or improvc for (h. plrpos. ofsal.) <br />_1, do*ndoflhc prop.ny, m cxcluivcly conE&tinswirh licasc! conlladon ro consrrud rhc proj4r ( Scc.70a4, B6rne. &d <br />Pot6eion Cod. Th. Cortraclor', Liccns. kw dc rot apply ro u oqcr of proF9 who buil& or inprovca ih6m , ed who <br />.ondaB aor such p,oje$ pnn . C@racb(, lienscd puEudt to 6. Conbacror'r Liccnr. La* ) <br />_l M cx.mF undd Salion _,8 & P C for lhis r.con <br />WORJ<ERS COMPENSATION Df, CLARATION <br />I hcrcby alfi m under penalty olp.rjury on. of rhc follovin8 d.clrations <br />_, h.v. dd will mainlain r C.nifislc oi Cons..l ro S.lalnsure ior work6 compms.tion,6 prcvi.Ld for by Setio 1700 otthc <br />Libor codc, for d. p.rfollMe ol rh. *olk for which th. pmn h islu.d <br />_I hav. mdwillmainr.in wdt.6 cmpas.rio iB!ruc., d r.qut d by S.ctio. 3700 of thc Ljbor Coa., fo. ltjc p.rfmec. of O. <br />wdt for vhid thii pdmir ir i$u.d. My wd*6 cmlo$rid iDsu@c. @ir Md policy numbq e: <br />Policy Num6ar_Expn6 <br />if fic Foil i. for Oic h]id,cd dons {l 100} or l@) <br />700 ol$c lllor Codc, I shall, fonhwnh <br />a cnploy*lo fiihinal p.n.lri6 ed civil <br />hundrcd lhosed dolls (t I00,0m),h addniotr io thc c6t of ddig6 6 provrdcd for thc Sccrim ,076 ol <br />rhc LaborCodc, inr.r6t od .lloo.yt t cs <br />UCEX$A-CONIBACIOEiIECIABAIoN <br />I hcr.by atfim und.rp.oahy ofprjury ${ I d liccnrcd undr peairioi ofchaptd 9 (@dh citrs wirh S.crion ?0OO) ol <br />$c Burin.s sdProa6sio.s cod. md licnsc iB in full forcc and.ftat <br />I hd.by rftim und.r p.n.lty oapqjlry that te is a c@hction ledins rgdcy for fi. pcrfmec. of th! wdk fd *hich thii p.dit ii <br />isiu.d (Scc 1097, Civ. c.). <br />APPLICA]IT'S DECLARATION <br />Defiolition Pcmil$Asbat6 No fi@doi Fcdral R.8ul!1ioN (Tn|. 40, Pan 6) <br />_ RcquiEd Lcn rofNotifialion <br />Klhst thc icd.ral rcsulatim rc8ddins <br />th.i I havc cad this arplic6rion I aSre roconply*itn allCityand Coonty <br />od Sllrc Lrwr rcladrs lo <br />abov. m.nrion.d prop.ny ltr <br />v6 oirhis City dd Coun <br />ELECTRICAL-INSPECTOR RECORD <br />Sub-Panels <br />tl <br />I