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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS rD/srG.COMMENTS Ownr-Buildd D.cldatio
<br />I h.r.by rmm undd pa.lry oaFjury th{ I n.xmpr fom d. ConrBrm Licds L.w l* tn. following lwo (se.'70r I 5 B6in6
<br />ad Prcf6sid Cod.) Any City or C@nly which Equird . pcmn b dslrucl, aha, imFov., ddolish or cpair ey iruclu.. rio t it
<br />issudc., also r.quiB th. applicdl lor su.h pmn lo fiL a sisncd slarcnat $ar hG o rhc ii licc$.d p6uur to lll. Fovisids of rh.
<br />CoE&toar Lictu.d t w (Ctal.r 9, CmmadnS eilh Scdon ?000 of Division 3 of th. Bqirc od Prcf*ior Codo o thal hc d
<br />sh. is cxmpl thm6m ed dr ban fd drc allecd ddpliq Any yiolatid of Sero. 70! I 5 by e, appli@t for a Fmn subjeti rh.
<br />applicrl b rcivilpcnahy of not mrc the 6v. nundrcd dollE (S500)
<br />_I, a own.. oa fi. Fop.iy, or fry dployc qi0' *aa6 a rh.n 3ol. comp.nsdion, will do fic *ort Md th. shcru. i3 ool inb&d
<br />* ofcrcd ld srl. ( S* ?044, Bulins &d PdfBsions Co<L Th. Conl.rcror's Liqsc Law d€ not !9ply lo & owncr oa fic proftr9
<br />who builds or imFove $c@n, dd *ho dc s@h *dt himclf or h6dl or lhrough his tr hcr oM dployds, provid.d 6ar roch
<br />improvdoB q. rct inlad.d or ofa.Ed for sdc Ii how.vd, ih. blilding.r ihprcv.funr is $ld wilhin oc y.d ofcomplaron, dr
<br />Oma Build{ *ill hav. tn. burdd of provine i6ar hc or .n. nor build or imp@v. for O. puipGc of s.lc)
<br />_1, a ownd of rh. prop.nr, e .x.,siv.ly conhrin8 witn licas.d.@hr6 to dnru4 th. Fojd ( S.c 70,1.1. BEin6s e.l
<br />Prcadion Cod. fic Contutors Lim5. tjw.lG not apply to ownd of p.opaty who builds aimprovB tha@n. ed who
<br />conLEl5 for such prcle6 wnh a Contr&to(, li6s.d puEubr ro thc Conroctor's Li6,. Liw )
<br />_l m cxmpl udd scri6
<br />YqBTEBIEOT4IDXSAIQN
<br />I hocby affim undd !.nalty of FrJu') onc of dic follo*ins dccldalionr:
<br />I havc dd eill tuinl.in a C.nifi.aic of co.sor to sclf-losua for wortdr cmp.nsaion, a provid.d for by scti6.3700 or$.
<br />t2hor Co{tc, fd thc Frfmd6 of $c wolk ld *hich 6c p6rnn h isud
<br />_l havc ed will mainrai. *ct.B! ohp.n5llion iBurdc., a rcqniEd by S.clion 3700 of th. Lahor Cod.. for lh. p.rfomsc. oatn.
<br />work ftr which rhis pqhil is hsucd My worl.6' @FDsario. ia,me ffid ad Flicy r@bs e:
<br />Polic, Numba Erp,B
<br />dffi;b. compl.l.d iarh. Fnn ir fd On. hundrcd dolla lll0o) oi l.$)
<br />Daamucc ot lhc *ort fa which this ra,nn is is!.4 I sh:ll
<br />work6 ' conpasion las of Calia@i4 dd agr. d, if I
<br />@npasabon provis'ons of sdionJ,",&'/-//-ol 7o0oflh. Lalor Cod., I shall, aonhwnh
<br />WARNINC Failurc to sdurc *ork.rs' cmFnsrion cov.rag. is mployd to qiEinal pc.alliB dd civil
<br />fin6uplom.hu lnd titudd doll6 (S 100,000),in addilion ro lh. cd of cmFxali@. dm.g6 B prcvidcd for 0!c Scrion JO76 of
<br />thc Labo codc, inldd &d armcy'r fc6
<br />I h6cb, alfim undd p.nalty of !.rjury ttar I d licdrcd undr prcviciM of Cnaptd 9 (
<br />lh.Businds d Profssions Codc, udmy liccnscis in lullforc. ed cff.ct
<br />I ha.by .mm udd p.nrlty of p,jury th.l $6 is . @ilEucrion lqdins lsmcy for lh.
<br />isu.d(Scc 1097,Civ C)
<br />oflh. worl ior thth rhis p.mir is
<br />AII,IIqANISDECI,ABAIIAX
<br />D.molirid PmiE-Albd6 Nodncld@ F.d.i.l R.8ul*ier Gnl. a0, P.n 6)
<br />_ R.quircd Lcnd of Notifidion
<br />comply willi all City ad Couniy
<br />of rhir City dd County to ard upor rlt.
<br />abovc m.nrioncd prop.ny aor inspetion lurpos6
<br />I
<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 />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 EXt 'IREP
<br />Rough I"EB I IUIJ
<br />SAMC B-43 ,m i{e ,77
<br />FINAL
<br />Notes, Remarks, Etc.
<br />DATE
<br />Service Meter
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