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ELECTRICAL-INSPECTOR RECORD <br />IDiSIG.COMMENTS Own.FBuildo D.cle.tion <br />I hcrcby afiim undcr porlt, oapdj!ry tha! I m d@p( fom rh. Conl&rm' Liccns. Law for rhc lolloqing..son (kc 7031 5 Burin6s <br />6d Prof6sion Codd Any Cit, or Counry which r.quiG . p.mil lo .onsruc! ahd, imprcv., doolish or rcpat rny srrucrur.. pnor ro rri <br />i53!&c., llso r.qut6 thc appli@nr ior su€h pqmit ro filc a risn.! srarcmdt th hc or sh. is liccns.d puBudrtolh.provisionrof!h. <br />Coitaddt Liccmcd Llw (Chapd9, Commc.cing wnh S.crion 7000 ofDieirion I oftc Blsines sd Ptoi6s,on! Cod.) or ar hc or <br />rhc is cxchpr lhdcflom d thc b6*lhl allcs.d cxcmplion Any viol,rion orScdion 70ll 5 by m, appli.ul lor. p6n subjeB rh. <br />applicanr lo a civil p.n.lry of nd thm fivc hun&.d dollds (1500) <br />, dny coploycd wiln was6 d lh.irrol. cmp.nsation. wrll do th. worl ad rh. rttucrE. rs oot inrcndol <br />?04!, B6in6 ed Proa6io.5 Cod.: Th. Coihcror'r LieN. L.w aG trd .pply .o u ovn.r of thc Fop.ny <br />daon, ud who &.s sEh *o.k hiNclf d hoclf d thrcugh his orfi6 @n.mployr6, Fovid.d lhar such <br />nradcd or of.r.d for sal. Ii howcvd, lh. buildins or improv.mot is $ld within onc yd of c6pl.!o, th. <br />will h.vc thc burdd oa prcvinS lhar fi. or sh. nor build or improv. for tu purposc ofs!lc) <br />d o*nr of in. prop.ny, m .x.lqiv.ly .onE&rine wnh lic.ns.d co.rdo6 to coisttud $. prcjat ( Sa '70!,1, Buins ed <br />ission Code Thc Con!'&toir Licms. L.* d6 ior .pply ro & owi, of prcpriy who buil& or inprovB dd@n , hd who <br />conracB aor such pmj.ci' with r Co.LEro(t li@scd ro $c CoirB.toar Licchrc Law ) <br />It <br />I h.rcby affim undcr pdalty ofFrjury @c <br />I havc dd will m.inrain a Ccnifidc ol Coiscir ro s.ll-ln!ur. for sod.6' compcnseti@, B rrolidcd for by sarion lT00 ofrhc <br />Labor Codc, for lh. Frfomecc of lh. work ior *fiich lnc p.mil is ilsucd <br />_l hav. md willm.inrain wo*.6 @mpasation iaurdc., a r.quir.d by S.clion 3700.i th. L.bor Co.L, ao, thc p.rfom&cc ot rh. <br />*ork lor wnlch lhis pmir ir ilsu.d My wo*!ri' comFsitio i.lurDcc cai.r Dd policy numb.r acl <br />iot bc cooplctcd ilihc lamir is for oi. huidrcd dolla {t100} or 16s) <br />iry that in lhc pcrfomacc oilhc *ork for which rhn ir issucd,I sh.llnotcmploy uy pcEon in lny m.M.r!oa to <br />bnd. subj@( (o $. worl6 ' c@paiation laws of Cali foh, <br />S.cion3700ofrh. Labor <br />WARNNG Failur.lo sccurcvorkcB sholl subjccl M .hployd to qiminal p.n.1ti6 ed civil <br />,i.6 up lo onc hundr.d lhoGnd dona (l l0O,O00),in lddnio to 0E cGt of @mp.is{ion, (llma!6 s prcvid.d for rhc Setion 3076 of <br />lhc Labor Codc, inrd6r ud lnom.y's f6. <br />UCEISED.CqNIMCIAB&DICIA lq! <br />t h.rcby.inm unddFndry ofpajury ddI m licccd uid6povi6im of Chlprd 9 (cmmdciie wnh Sc.lioi 7000) of Divirio I ot <br />thc Businst ud Plof6ioN Co.l., d hy liccne ir in full forcc Md.il6t <br />Cqd9IBIC1|IOU,EEDIXC.ACIICI <br />I hd.bt amm undr p.n.lty of p.rj!r, $al thft ii . consEu.rion lodiDs rsocy rd 0E lqfcl@a of rh. sdt lor *hi.h $ir p.mn i3 <br />i*ucd (S*. 1097, Civ. C.). <br />APPLICANT'S DECLARATIOI! <br />D.nolitioi Pcmils-Asbets Norillcaiion F.d.r.l Rcgulations (Tnlc 40, P5n 6) <br />_ Rlqut d L.n.! of Nolifi6li@ <br />_l cqliay that th. a.doal rcsddins 6bsts Enovd u. nor applicabl. torhis proj.ct <br />calion d starc thar rh. .hov. inlom.tion i5 6rer I agrc. ro conply wirh all Ciry and Counry <br />auihorizc ,@r6c arive oflhis City ed Cluty io cntcr upon rh. <br />q.lru loa <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 />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 />Rough <br />Service Meter <br />FINAL 6its/ar J '-2.""2 ,_6/r;"Jrh4 Z;r"CZ.,a <br />Notes, Remarks, Etc <br />1-od ) <br />APPROVALS DATE <br />Sub-Panels <br />Md 6Er. rhar ifl should <br />Lic.nr. CIa _Licdc Numbd_ <br />D{. _ClnEctor