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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE tD/stG.COMMENTS oMa-Buildd D.clarati@ <br />I h6.by aflim unds pcnalty ol p.dury thar I d .xhpr fm rhc Cdt84o6 Licosc La{ lor thc followine @o (* 701 I J Buif,G <br />aid Prct6siq Cod.) Any City d Couir, uhich .cquiG 6 pdmit to c@Euci, .lta. imp@q danolish o! rcpd, My slrude, Fior ro its <br />i$!de. also GquiB rh. lpplimt ftr rlcb Fmir ro lil. a riSn d slatd6. ihar nc m ih. i licdcd plBuet ro tn. Fovisim of thc <br />Conradors Lic6&d ljw (Chapld 9, CnEhcins wirh Sr o. TOOO ofDivisie Iof$cB6in6 dd Prcfeids Cod4 m lnd h.d <br />sh. ir cx6p! rhftfim ed thc bsir lr rh. dl.8.d .xoptid Any violdim of SeliM 703 I J hy uy +?li6t as c pcmir tubjcn rhc <br />appliot to a civil p.n.lty of nd mrc ths fiE huidrcd &ll4 (1500) <br />_I,6M6ofrh.p.oFrir,dmymploycwnnw.gdath.nrok@mp.tuarid,willdolhcedledth.,hci@is,otirtc.d <br />d o,I@d fa ial. ( Sd 70rr4, Buire ad P.ofsioE Cod€ Tt Conr.lclct Li6s te dc nor rrply to e own6 oflh. pror.ny <br />wlo bnilds d imFoc $.@n, od wto do6 s@h wort hi@lf or h6.lf or tnmd his tr hd (M mployc. prcvid.d th.t such <br />improvmcn6 e not irrcndcd o ofi.rcd fd ial. li hacvn, O. building d inldovddl i! $ld vithin @c y@ olcmpldd. dE <br />Ownd-Build.r vill hayc lhc budd of povi.8 lh.r h. or 3hc rot build or ihprov. fd *rc porpGc ol salc) <br />_I, E oms 01tn. pDp.,ty. m.xclqir.ly @otr&ri.g *irh licos.d c@b.doc io c@r!d $. Fojd ( Se 704r, Buind ud <br />lrolgion Cod.: Th. ConF..rd! Li@r t wdo6nor.pplylodom6oaFoFtywhobuil&aimFovdfia@.&dwho <br />conlr4ts for such prcjeti witn r cmF&to(, li65.d pull@r b rh. cdlrerdi Liffi. I-3w ) <br />_l e cxcmpl udasccion A &PC fdlhkrc6o <br />loB(E$laMlErsaroNlEcldB4lla! <br />I ha.by altrm und.r p.nalry of pdjury onc of th€ followir8 d.clmlios <br />I havr dd vill oaintaii . Ccnific.tc of Cmdt lo Sclllffuic lor worl..6 c@F6ario., a prceidcd aor by Sftrio. 1700 oa th. <br />L.bor Cod., lor $c pqfomecc of th. wtrI for which th. Fmit is issucd <br />-l <br />hav. Md will msinrain wst6 cmpds.tion insumc., s rcquiEd ty Sction r?0o oa ih. L3hc Cod., for rh. Fdmdcc of rhc <br />wct for *hich (his p.mn is iss!.d My wortdi comp.nsation ihsurMc. .sid ed policy numbd arcl <br />lolicy Nmh.i : Expi6: <br />#ffi;;ffiffi il h lor On. hun&cd dolld {1100} or 16, <br />ad *bich ihis p6m isissu.d.I <br />aws of Califomir, 4d asr <br />r?0o oa d. rlbor Cod., I sh.ll, fodnw <br />WARNING Failua lo scurc *orts' cmpcnsto covcrasc n mployd to cnminal p€nahia Mdcivrl <br />lin6 up ro @. ho<L.d diou$d .lous (l loo,ooo),in lruitioi to th. c6t of <br />rh. L5hd cod., int 161 6d .nm.y\ fG <br />d.mag6 d provid.d for $c Setim 3076 of <br />LICENSIJD CONTRACTORS DI'CLARATION <br />I hfthy .fim uhda p€nrlly oaprjury thlt I m li@.d undd pr@ition of Cn.fld 9 ( <br />(h. Bqi.6s d PDf6sioB Codq d my licdsc i! in full f<M ed .flcr <br />-o <br />I h.rcby aliim ud6 ,.flalty of p.rjuy fial $d. is . .o.rtructi6 <br />ilru.d (56. 1097. Civ. C.) <br />rh; p.rio'Danc. ofrhc work ior shich rhis p.nntr i <br />AIII.ICANLIDEC!.ASdIIO!Ddol o PmiE Asb6r6 Noiifica o. F.d.r.l Rcgularion! (Tnlc,lO, Pdl6) <br />Rauircd Lcn6 of Norifi cdion <br />-x,thar th. a.d.r.l r.Buldions r.Bddiig 6b616 <br />rhar I havc rcad thk agplicari.. Dd sbt y *irh su cny Md coung <br />ordinac6 dd Sla!. Lavs !.luinB lo building <br />lbovc m.nton.d prop.!1y for intp.crion I <br />Site-Work <br />Underground <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Life Safety /Low Voltage <br />Fire Alarm / Dampers <br />Building <br />Under Slab / Floor <br />Bonding / Grounding / UFER <br />Transformers <br />Torquing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Rough <br />Ceilings (T-Bar Rough) <br />Meter Release <br />tsxrll (9r,, <br />Rough ?nrc <br />f i:t-r <br />9AMC B-13. I 30. 556, 667 <br />Notes, Remarks, Etc. <br />Pole Bases <br />Communications Cable <br />Service Meter <br />FINAL L.n&ls Addr.$ <br />r-----r----- <br />F