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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNI'R BIIII,DER DEI,CARATION
<br />I h.rcby arfii,n uMcr pcnall, r,f pcrjury lh0t I m crcn+ rmN Ihc Cotuaclor' Liccnsc L.w for rh. aolk,win8 rcts,. lscc 7011.5
<br />Busnrcs !.d Pnfcs\nin Codc) Any Cny or Colnry *hich rcrtui'cs a Fflnir ro con{ .r. alr.r. i'n[ov.. dctrDlish or EIon any
<br />sm.rur.. arntr ro nr issuoNc.,h. rcquircs rhcappl{anl ror sn.h r.mil ro filco slsncd slotcmnl lhol hcorshe ir li.cnscd p!^o.nr
<br />ro rbc prcvnion\ ofrhc Co.racrorr l-i.rn\cd ljq (Chaflcr 9, Comfttuins wi(h scclion 7000 or Division I oi rhc Burinc$ lnd
<br />Pofc$io.s Codc) oi rhd h. or sh. n crcnrpl
<br />'hcr.fr.n,nd
<br />!tu hNis for Ihc allcCad crcn{'rion. Anylioloriooo,s..rionT0ll5hyiny
<br />rltlicant lbr a pcmi subjsis rhc appliqnl to LcivillcMllyofnol mrerhan fivc hlndrcd dolldr(3500).
<br />_1, ownc, olrhc phpcny. or hychpbrrci sirh wase\ as rhen sb..mp.ns,(ion. willdo rh. wGkMl rhc srtrrw h ftn
<br />im.nL{ or olicrcd f(, qlc (S(. 7(N-,1. Busircs Nnd Pmtcssiotrr C.dc T}E Conrrctor's Liccns ti*' drcs mr oplly ro !n ost, .f
<br />rh. !'mlEny who 6oil.li.r nrryorcs rhcmn. a.d wno des \Eh w* himseltor hcr*lfor rhmxgh hk orhd own.nltloyecs.
<br />p.ovidcd rhrr such inDmwnEnh rrc nor hrcMcd.rofic.ql for$h.lt hosckl rhc hriHinE or iqmwn.hr ir$U Qirhin.ic t{.r
<br />of.oint)Lriotr. rtr O*ncr Builds will h!!c rhc t{rdcn ol Imri.g thd hc or shc dil ml tuild or impmt the I6Fny for rtf, pury,{ of
<br />I.is.pnc.ofrhcl)nr.ny.!mcxchsivclyco r.dnr8 wirh li.cnscd conr0do^ ro con{dcr rhc pmFr (sc. 70.1.1. 8ui \r
<br />a.d Pflric$hn Code: lhc Conr,crois Lice.{ l,nw docs nor applyt,,6own.r or|,o!.dy who huilds o. inrF,vcs rher..n.
<br />rtrd qh. snrtu.rs ror such pmi{h wirh a at nrcrods) lhcnscd,ru6u0nr torncContrcroir l-i..hsc hw).
<br />I amcxctrrpr u .r sccri
<br />Osre.t )f,rxtsltrgufrNstlllJN
<br />DEILASAIIQN
<br />I herc$y ani,rnundcr pcn0lryoip.rjury onc of rhc,nll{,wii8 dcchrations
<br />lhivc xlwillminldiriCcnifi.ricofConsctrlloSclalnsurclorBorkc6compcnsd,n,rrpn,vid.dl.rbys.crionlT00oirhc
<br />Lrt(trCodc, f(, thc p.rfornu.. ofrh. *ork lar shi.hrhc p.inil h isrucd.
<br />,l hrvc rnd wilr nminxrin worlcs conDcns ion insudncc. as rcquiE-d hy Sc.r i(,. ]?U, or rhc ljhor Codc, lor rhc rdnnmrcc ol
<br />lhc sork loruhichlhh pennil is isslcd Mywo*cs mqEnqrion i.\!ranscri.rdd fxrli.y nun'h(rm
<br />I edifyrhor in rhc FrlarnDi.c olrhc uurl for whichrlrh p.nn is issucd,I $rll.ot enDloyanyl)cn.n in anynrJnftr
<br />so rsro h..orB suhF.r ro lhc mlt.rs clmpcnsitiotr l0ws olCalifomia. and osr rhlr irl snodU tt onF subie! t' ttE
<br />w.Aoc conr.n\ariotr prov(iotrs or Scdion l?(x) of rhc litrr Codc- I shlll. fonhvirh comply w irh rlr,r pbvisionJ..
<br />WARNING: rzilur. t, sm work r' co,npcnernr .ovca8. is unhBiil- Md snall subFr un .nrloltr ro dimnrl I'cMlties otrd
<br />civil nncs up ro onu hundEd rhousnd dollus ($loo.mo), in addirion lo rh. Lod or.onwn$ri.n. domScs as pmvidcd for lhc
<br />Salio. 10?6 of rhc Lalnr Giq inlcrcsr and allomr\ fccs
<br />LICDNSED.CONIAACIAA
<br />DICIASAIION
<br />I hcsby lffirmundcr !.n!lly of ri.lj!ry lnal I an lien{d undcr !rcli\ion orch0lls 9 (commncins wilh Scdion 7000) orDivhion.l
<br />of th. Busircrs and Pmfcssions Cod.. ond nry li..n* h in tull forcc ud.ficcr
<br />Licetrsc cln$
<br />-l,i..n\c
<br />Nu'nbcr
<br />llde ('onlruclor
<br />CANiIBIJCUAN.LEII'INGACENII
<br />I hcrcby rrlim lndcr pcnoh, otpcrjlrr rhu rh(. n a conn dion Lnding,gcrcy aor ihc pcrf{trrurcc narh. work rorwhi.h'hi\ Frmir is
<br />i$ucd {Ss.3097. Civ. C.)
<br />AITUIANIIIECIABAIION
<br />lMryullmrunder Den0lry of I,c!iuryonc oarhc tollo*ing dcclmriois:
<br />Dc rlnion Prrmns Asb.ios Norifi.orbn r'cdcml Rc8ulnrions (Tirk40. P.n6)
<br />_Rcqxn.d tJtr.r ol Ndiff,ati'n
<br />I Nnifyrhar lhc fcdera I r.8u lht ions Egldnr8 lshesos rcrmval are norapplicablcr. rhh proFr
<br />_l ccni,i rhd I hlvc rcld rhis appli.rr ioo snd (!rc rhrr rhe *nrc i.rodarirn i\ cofr\r I a81e ro .onl['ly wirh rll Cirt lnd Counry
<br />ordi'n'ncc\ trndSiarcL,ssElarinstu huildingconiodn,n. a hcrch,aurkrrizc rq,cenrali\cs oflhi Cirylnn Counrr ro enr.r !Ix,n rhc
<br />rhovc mnlidrd nmn nyfor insFdion ,)urlio{cs
<br />AppliuDl or ,\A(nl Silnrlure
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Slandards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm i Dampers
<br />Communications Cable
<br />Building
<br />Under Slab i Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels I t/0to '.rlzttcwt I lf-J -
<br />Air Conditioners I
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Solfit Rouoh
<br />Ceilings (T-Bar Rough)
<br />Itrleter Release
<br />Bough t/ol/* t 'YLt*t*/t7,
<br />Service [/]eter
<br />FINAL fl1dn ';tua>+/a
<br />Notes, Remarks, Etc ,/
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