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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE OWNER BUII,DI'R DEI-('ARATION
<br />I hdchy alfim undd paally of foju,r_ lhar I an.r{mfl fmm
<br />'hc
<br />conlraclou Licas€ l-a\v lor thc folloNins reM. (56.70:115
<br />aBin6s dd Proa6sb. Code): Any Cily or ( ouflly Nnich relot6 a p€r'nil 10 .onslrucl- 61t6. ilnprorc, dmolish or rc?at .n!
<br />srucrur€. rior io its 6suan.c. also rcqune rhc a$hc-r ror !u.h l.mn ro 61. a sisn.d stahdr rh.r he or snc is lic s.d pGuol
<br />lo lnc provisions olthc Conrmclois l-ic.nsd l,a*'(Cfiaprq 9- Coon ncins Nirh sdlion 7000 olDivkion 1 ofthc Busins Md
<br />Pof.ssions Code) or rh.t he or sh. is .acmfl tnd.ftom ed lhs b6is lor thc allcscd €xmplion. Any violalion ofsmrion 70115 by d,
<br />applicanlloraFnitsubj4tslh€applicantIoacirilpc.aly.tnolnrcr€rhanfiv.hu.drcddollds($500)
<br />I, ar o\ n- of rh. l*op.ny, or m, cmplorc $irh $ ag6 s rh.n $k co,np€.slion. sill do thc \rort a.d rh. srtode ! nor
<br />inrdd.n oror.rcd for el.(Se.7044. ausinBs and Ltolsions Code Thc Co.rEdor's l-iccosi Larv do6 nompplylo.no$rd of
<br />rhc pmlEnv *'ho builds or i'nl,6v6 rhdstr dd * h6 rh6 such *rrk hi,ns.lr or hm.llor rhrou8h hs or h6 o$fl €rnploy.6.
<br />prolidcd rhal such imlrovflors e mt inlod.d or or6ql for sl. lt how6s. lh. hoildins o! impmrdndn is sold \ihin on. )w
<br />ofonllldion. th. O$ nd Buildd \ri[ na!. th€ hlrdo olForin8 lhn hc or shc did mt hoild or inFov. lhc poFly lor $. lnrpo* ol
<br />l. as o{nn of lh. txol6!. tun crclosiv.ly conrracting vilh licosed conimdoNro e!$ru(1 the poj..l (S* 7044. BBns
<br />aod &oltsion Codc: Th. Conrraclois Licos. Law do6 nor applyro d os6r orpropdy qho builds or inprov6lh.rmn.
<br />md who co.h* aor $ch projdG wnh a Qr Bcto(, licds€d punrui ro rhc Cod,adois Licm. Lrw)
<br />I &n exernrl !trdLy Sdion . B. & I'.('. torthis rcavm
<br />Dlrc own€r:
<br />!oaxEal(o!!8E!s4!I!J!olcuaarra!
<br />I hscby.mm u.d.r p..ahyolpdjury onc otlhc rollowins d(h.alio6:
<br />Ih.!c d s ill roinlaio a Cenificatc of Co6€nr lo S€lf-lnsur. fo. *ork6 comtdrmrion, 6 prolid.d for by Ssl ion 1700 ohhc
<br />tib.r Cod.. fn thc pdaomscc ol th. solk for Nhich the pfitril is issued
<br />Ihav.andwill ainrain $oit6 co,np.carioo insu6n.c,6 r.qlted by s(tion 1700 ofrh€ L.bor Codc. torlh. Fdfomdccof
<br />thc \ork fo, rvhich rbn poir is t$ql. My $ork6- comp€@rion idsurdc. .mi6 and Flicy ntr,nbq e€
<br />,-," . nWviLAvl Z)rrOtrt
<br />1,.\Nu,. , wcst.)zl l0o t3 ill tlD
<br />l.cniayrhat in rhr tElonnamc of'hc \rort aor $hich rhis pdrnil is issu€d. I shall nor €nploy any nc6dn in an, nend
<br />$ as to b.co'ne subjd ro rh€ sorl6 co,np(sar ion hws ot Calirodia, and ar€ rhd il I shauld b€cotc subjel lo thc
<br />Nork6' compenstion prelisrcd of Sedion 1700 orrhe tjtor codc, I shall. Lnhsith comply wiri lhos ptolisions..
<br />\YARNINCT failurc ro sur. sork.u onrpsalion covd.sc is nnlat(n'|. and shall subd d dtlqo b rrnninil par0]ris and
<br />.ivil find up to onc ntrndr.d thotrsand dollG 11100,000
<br />shri.n 10_6 nf rh. trl[r r'od.. hrdd udarorc. s16
<br />). h .ddilion lo rhc cosr .rLomPcnsain,n,
<br />I hd.by arm undn pcnalry o apd.jry lhar I m li.asl u.dr proltion ofChrprr 9lconnnocins rvilh Sdiotr 7000) olDirision l
<br />of lhc Busio6s and Pml6ioru Cod., ard my licds. s r lull toic. dd .frcl
<br />,.""*"".*. CIO Liccns.Numb.. Offi?<V
<br />^" , | | qlzrlo .on*dd:L \4V t rat ad^L
<br />CONS'I'RIJCTION T T'NDIN(: AGENCY
<br />I nmby amm nndd pcnalry of psjury thst ihs. is a coDnrudion ladins asocy for Ihc pdfond.. olrhc work lbr $nich this Fmh is
<br />issued (Sc.1097, Civ. C.).
<br />A.IITICANLDECIAS{IIA!
<br />lM), allm rnd.r pdrhyoapdjury on. of the tollowinS dclaalions:
<br />Dcmolirion Pmis Ash6ros Ndrincarion Fcd.ral Rclularioos (Ttl..l0, Pd6)
<br />Rquircd trne of Norifidion
<br />IcslilylhatrheGdcralr€sulariosrcgedinsdsbcrosr.mnalar.noraptli.ibl.torhisprold
<br />l#diay rhar I hak R.d rhis arpli.irion.nd sr.t.rhar rh..b\. inaom.riotr iscotrcr.l asr* ro cohply wnh.I ciy and cou.ry
<br />ordinancG and srarc t-.$s rl.rin8 ro buildins conslrucrion. ard hd.byauihorizc n6 ofthis Ciryud Comryro ord uF,. rhe
<br />nbo\c mcnrnrned propeny hr insp(ri ,
<br />.\Dplicinr or As€nt Sisnanrc: X
<br />r",,r,*,.*(,*r,ur, t( F-y'I {+z\^. tlqlza-.
<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 />Communications 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 Rough
<br />Ceilings (T-Bar Rough)
<br />lvleter Release
<br />Rough
<br />Service Meter / 7F|NAL t /Ll,/e<tE l:-lltzt-l ./
<br />Notes, Ren{/rks, Elc
<br />-t
<br />ID/SIG,COMMENTS
<br />Pole Bases
<br />Sub-Panels
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