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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG., O*n.rBuildcr D€.lntion
<br />I h.r.by amrn u.dd p.ndly or r.rjury rhd I m .x.mpt aorn $c ConracloB l-icens. Lap lor ihc followiiS r.doi (rc 701 I 5 Businsi
<br />ed Prof6sion Cod.) A,y Cny or Counry qhich ..qui .s . p.mit lo @nsrucl. !ll.r, improvq d.molnb or r.pdr My sttuctr{., pnorlons
<br />issurn..,.ko r.qut.s thcipplici lor $€h psnir ro 61. ! sign.d st!r.E. thrr i. o, sh. i! lierd puMri lo $. pEvirions of rt
<br />Contncioa3 Licc.&d Lru (Chapts c, Comm.n.ins with s.dion7000 ofDivtiotrl ofllEBusin6s.nd Proa.$ion! cod.) or rhlr he ot
<br />!h.is.r.mptrh...iodrndth.bsisforlh.!U.B.d.x.mptionAryviol.tionofS*tion?oSt5bruyappli.mlfor.pcmisubj{$rh.
<br />applicanrror.ivillcn,hyoand oor. than liv. hundr.d dollG (S500)
<br />_ l. as owner of lh. popeny, or ny .mploy..s wnh wsg.s .! $.ir sle @np..erio.. will do th. worl ed $. srructur. h nor inr.ndcd
<br />or off.r.d for $1. I S( 7044, Burin.e! .nd P.oldsidns C6d. Th. Cont,cror's LiGe l-au do6 nor rpply ro u oun.r ol rhc prop.ny
<br />*hobuilds or improv.s th.r6[ md !n6dcscl u himelfor hs*lforrhrdgh his or hd own.nployes, tfovid.d rtu such
<br />improv.m.oc c nor inr.nd.d o, o(ferd for sl. Il how.v.r, rh€ buildiDs or imFov.menr is lold wnhin onc yd ot co6pl.tioi. rh.
<br />own.F8uius will h.vrfi.burd.nolprovinSthat h. or sh. not bnild or imlroE lorrh.pu9ose6fsrl.)
<br />l, !sowns 01(h. prdpcdy, rm.x.tusiv.ly contr.dina wilh li..6.d o.trrcrors ro co6rruc1rh. proj€! ( s.c 70.11, Bosincsand
<br />Pror.ssion codc Thc Conrictois l-ic.ns. kw d@s nor rpply ro I o,n.r oi propcny who builds or improvsi th.r.o.. and who
<br />conrads aor $ch ,roja6 *irh . cont'aclo(o li€.nFd pureinr rorheco.ricroai l-ic.ne Lar )
<br />I m ex.n,pt und.r Se.rion
<br />WORKf, RS COMPENSATION DACIANATION
<br />I h.rch! rmrn und.r p.nrhy orp.rjury on. of th. folloqins dEludions
<br />I h!v..nd will mrinr.jn ic.nin.icofcois.ntto S.lfjn$r.lor mrk.i! .omp.n!.rioq,. provid.d lor by SEtion 37oo ofth.
<br />l,bor Cod., lor ih. p.rlominci of $. wort lor which rh. pdsn ir is.n
<br />Vtrav. ed wiu n.inrdi wort.G' omp.nlrtio. i.$rincc, .! ,.quned by scdior l?oo or ih. bbor c.d.. ro' th. pafomnc. of rt.
<br />uotk for which this p.rmil h issu.d My m.kBl conp..srnion insuruc.6i.r.id policy nuEb.r rr.
<br />cm.r C"s/lz. lzo,nL
<br />,^nrr@ Fxpi.s L/
<br />( Tlis Hrion ...d nor b. @apl.l.d rf lh. D.rmrr n for Or. hnndr.d dolld ! (t I ool o' l.s, I f 3
<br />I c.niay rtul ir th. D.r{orn.nc. olfi. work
<br />b*am.5ubjd b tn. work.s ohp.Niiion I
<br />@mpensrion provi.ion! ol S..tion l70o olth.
<br />D,E 3-! t-.)or L-
<br />tor uhich lhis p.rmn is issu.d,l slBll nor enploy rny p.Eon,n any manncr so as ro
<br />rws orCalilohia, Md.ar@ $!r ifl t,t
<br />WARNINC l_lilureb sor. wor k.6' comp.n$rion cov..ss. n unh*aul, dd hill subjc.ran.mplov.rLocnmi.al rialriAand.ivilfin.suprootr. h!.dr.d ihousr.d dollaB(1100,000),in.ddition!orh.asofcompcnslrion, drh!8.5 rs provid.d fo!rh.S.c .n 1076 of
<br />lhe r,rbor Cod., int.rcsl Dd atom.y s fc.i
<br />I,ICENSED CONTR CI'ORs DECLAII,ATION
<br />I he,eby ailiraond.rpenihyolp.rju.ythar I.mlic.,sd undn provtion 6fCh.pld 9 (@nm.n.ing *ith Scdion 7o0o) ofDivirion 3 of
<br />rh. BBin.ssind Proa.slio.r Codc, lnd my lic.ns. i. in frll for.c ud.S.cl
<br />1q 3L_a)e al L
<br />-15'lL
<br />CONSTRUCTION I,ENDIIIG ACENCY
<br />I hcrdy lirm und.r p.nrlty oa p.rjury thll lh.r. ii . @mlru.tion l.ndi.8 rg.rcy for $. p.rfomn@ ofrh. wrk lor rhi.h rni! pmit is
<br />i.tu.d (56 ,o97, Civ C )
<br />Altug4Nr-LsEg48 floX
<br />Dcnolirion PdmitlAsbcsros Notificdioi Fedeal R.suldions (Tnle 40, P.n 6)
<br />R.qun.d ktre.of Norifi orion
<br />I c.nify lh.r th. f.dcrul r%rlrtions r.gedins sb.sros r.movil rr. m! .ppiic.blc 10 ttus projer
<br />I cenify thar I h.v. r.rd rhjs lpplication ud sr .rh.i ibove inlormarion t cotrecr l.Arc.rocohply wrlh lll City ed Counry
<br />ordinincca rnd Stale Lrws rcia , and hscby iuthoriz. r.pr.s.nt.ti!doalhisciry lod County lo .nrcr upon rh.
<br />ahovc m.nrion.d ror.nv aoi
<br />3 -r i^la tv
<br />/ut I C,/
<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 />Itleter Release
<br />Rough S/sr77J 'f;*-<c,x AL-'
<br />Service Meter
<br />FINAL 1/.t4/za,I'ib.e-a 7n-,88
<br />Notes, Remarks, Etc
<br />M\WP51\Pormil-lnspeciron Forms\Eletn€l l.sp*tion Ro@rd doc 03 31 06
<br />COMMENTS
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