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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE OWNER BUILDER DELCARATION
<br />I hseby am m unds Fnalty of pdj"ry lhal I an .x€npt iion lh. Conlractou Licmc Larv fo! lh. folloNin8 lwn (S(.70 1 5
<br />Businds aod Plofcsion Cod.): Any Cily or Couniy which rcqunB 0 pflril lo coNlrucl. alt6. improve &nolish o clan my
<br />srtucruq pmr ro irs isu&cc. liso riqutr6 thc applic&t lor such rEnir kJ 61. a signcd sr.lcmdl rhn h. or 3h. is lics.d p6u t
<br />lo lhe povaions ollhe Contraclois Liccnsed t rv (Chagd 9. CormEn inS wirh S(tion 7000 ol Division 1 ofthe Busines md
<br />ProlesionsCode)orthal hcorshe is srcnpl thqcfro,n.nd thebsis aortheallc8ed.idrtlion. AnyviolalionofS..lion7011.5byany
<br />arnli.air aorap6it subjelsthe applicaturo6.'!'lpcnahyolndmor€th..fiv.hu.drcddolld($500)
<br />l- 6 oNrr of rh. Fopcny. or my cmplolG Nirh \raA6 as rh.ir sl€ conlmFtion- NiU do rhl Nork and rhc srrudE is ndt
<br />in'mdc{ or of€r.J for sle(Se.7044, Busin* and Prel6ioB codc Th. contadois l,icsc t^u doB nol applr ro.nolvndol
<br />rh. pBrEly 1(ho buildr or implov6 rh@n. od \ho d.6 such \orl hnns.laor hssclao. rhbush his oris ov.mplo)e6-
<br />pror'dcd thar such ihrov@rs d. nor inrdded or dfirql ror ek ![ ho\'56, $. buildins or inpmrchar h $ld silhin one ra '
<br />olcomplclion. thc O$nd Bu d€ wiu h.w lhc burdo of Foring fid h. or she dil nol b{ild or iflFoE the prordy nx thc purlok ol
<br />l. asoM€rofth€!.opq1y. ane:ch6ir.lyconrrflcrirs\irh licmscd conrracroB lo consrrucr rhcpmjEr (Sr 7L\44, ausi.L\c
<br />and ttof6i,n Cod. ric(o.i,.ciorsLic€nscl-0NdoBnotapllyro.nosn6olprcFl!wnobuilGo!tnplo\.srhss,.
<br />Md sho co.r6ds tu su.h poj(ls sirh a Contado(s) licats {j pu6ua ro rhe Cdnradors Li.ds L!N)
<br />I6.r.npt undlr s(tioo R & P( firih'srcn$n
<br />}!aa{!8!:(a!uENsarq!
<br />DECIAIAIo!
<br />I hereby a,Iim undcr p€.alty olpgjury one ollhe lollowin8 decltualioNl
<br />I h.ve md rvillmainrain aColificarcolcoNmr ro S.lf-lNUr. for troddi compqstion. s provid.d aor bySclion 1700 ofth.
<br />bb.r ( od€, for lh. t6aome.. oarhe $orl for s'hich rh. p6mit i, isr.d.
<br />zMha!€ and s 'rl m.mram q 116' comp€nsar 'on 'EUEnc.- 6 rcquircd by scclion :1700 of rh. Lrbo. cod.. lor rhe psaomme of
<br />rh. uo'l for$hrhrh"Fhr E BU.d M) 10,16'.onp<nsarnnrcu'&..cffi. rndF,ln) numlra.
<br />c,,,,t",-/PAL,Uz€4-<-
<br />n,,,,., n,,,"n, (,/ fi'Z c 7C- 1 -97 7
<br />I cdilyrhar i. rhc pdLrnrancc oarhe sork aor $ nich rhis pdf,n is is$'cJ,I shalloor flployanrp€6on in any nrnn6
<br />h dlo tt ofte subjer ro rheNorfr* .onp.nsarion laNs olCalifomia. and asE thar irI shoukl becoo. subjcr ro rhc
<br />trorkds.onpdsrionprovnionrofserionl7O0oarh.IabrCodc.Ish.lltunhwnhconplyNirhrho*provisi..s
<br />$ARNINC I aihrc (o *.ue \o'k€rl con,pe,,sil'on .o\s.se is trnlarii'|. and \hrilsubi(( in .ntlo)cr x, annntrlltlihi.s atrd
<br />d$6rand .me) s rc6
<br />2..'
<br />t!(!!sg.xnNrsc&&u&!!r.8{Mr
<br />I hdeb! artrD onnd p€nalt, ol pEjury nlal I m licos.d uhdo Folision otchaprh 9 (.ommtrcin8 wilh Sdion 7000) oaDivision l
<br />ol rhc Busins d Pnl6sbisCodc, dd oylicose isin full fo,G d.ttrr
<br />r.i.e*.craa$ CzD
<br />".,., tz@ ?7f ?aa
<br />c^,"{w l'11--
<br />coa a.uguo!.rElDlNcjgENcv
<br />Ihmbyammundrp€.ah,ofpdjuryltaltheis3onsr.lb!,cndingagdcyio.lhepqlommc€oflh.worlbrwhi.hthisFnilis
<br />iss!.d (Se 10S7, Civ. C).
<br />AIILIQINLIICI,AtrAUAI
<br />I @ atrm unddpaahy oar.rjury o.. ollhr rolowing dmlaalioc
<br />Donolirion Pmi$-Asb6ros Norifi.ltion F.d@l Rcsularions lTirlc 40, Pan6)
<br />Rquir.{ Lelrd of Norificaion
<br />I cdify r har rhc lcdqal r€sular iod r.lanlins db6k's rcnrcval de not apDlrable k, rhis pmj6t.
<br />I.dib rhar lhav.rcadrhn arplicarionodsrarcrharrheab\c 'nfonndi.n is cor(r Ialrerocomply$irhallCiryandCounty
<br />ord$.n.es.rlSr.rcl-x\rs'.ldii!bburldnr!..ns'u.fotr,rtrll[icl)t.riltrwc'clI.sci1arr6riirhis(ir!md('r
<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 />Communrcations Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueing
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough .tz-a &z za
<br />Service IVleter
<br />FINAL 4tr/eo Z/,:,a '€/2.'>.2, )
<br />Notes, Remarks, Etc
<br />IDiSIG.COMMENTS
<br />Sub-Panels ,*--L/A
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