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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.OWNER BUILDER DDLCARNTION
<br />I h.r.bt allirfl undcr Enally ol Frjury rhar I {m cxcmfl fr.d rhc C.itacr.* Liccnsc L.r ior rnc folk,wi.8 rca$n (se 70315
<br />Busincs aod Prcfcssn,n Codc): Any Cny or counr, whi.h equ,rcs i lErnit h condocr, rlt.r. nvmre. rknnlhh nr rcIBn any
<br />drucrlrd. tIbrb irs i*uamc. trlso,cquncs lhe amliclnl fo, suchlcrnrir tr fi|. ! \ie.ud estcmnl thal tEor stc h licc.{d pu*ulrr
<br />k,lhc pmvtions of rhe Comra.ttr s Lic.nscd Lrw (Chrtrcr 9. commncins *ilh Scdion ril)o.r DivGn'n I oa rhc Blsincs\ and
<br />Pmfcsrionx Codc) or Odr tr or sh. ii crcry)t thcrcliomand thc b..is lbr rh. !l lcgcd .rc mp' ion An, violalion olSccrirn 70.11 5 by any
<br />,ppli.nm ro.. r.rnln suhj.rls thc appliclnl ro aci!ilpeuhyofnor tu,rrhln tiv. hundtcd dolhs (1500)
<br />-1,a\o*turorrh.,tuFny.ornycmplorrcswirhpascsaslhcirsoLcotrrpcosdnrn.silldo'trwo.rdthcsr,kft!mri cnd.d .! ontmd ior slc {SE.?OI4- Ausincs lnd Pmfc\sions Code Thc Cbnrrlols LkcnE Liw do.s Nr tp/y lo 0. owncr ot
<br />lhcpml'cny who builds or i,Illrelcs rh.mn. and wh. dN su.h wo,t himsclror hcrslfor rhn,ugh hir or hd own cml,loy.es-
<br />,bvid.d rhrt ruch i'nFtuvctrns m r{ i culql or .fla.c{ for slc li how$s, rh. t iBins or iqKNnEnr h eU rnhin oM Fr
<br />of.onplcrion, rh. Owmi Buihn willh!rc rhc burdcn oipnvins lhd lE or shd did tror huild or nllrtmE rhc nmEny t'ot rhc jfurrM ol
<br />-1,
<br />rsowncrolrh.pnJpcny, anrcrclusivctyconlr.clins pnh liccnscd conltu.roE b .onnruLl rhc Projccr(Scc 7Or4. Busnc$
<br />dftl EDfsrion Codc: Thc Conlrrols Li..nsc ljw do.r nor apply ro ,n o*ncr olpn,P.ny wio hnild\.i inlprcvcs rhcrcon.
<br />nnd $ho contacN ror su.[Eojcclssith0Contra.lo(t lietr$d pu^urr r. rhc Conticio. s Licctrs LIw)
<br />I mcrcmfl undcr S.clk A & P(- lorrht rcasor.
<br />u8tr[&5]L:0]lfENs roN
<br />DECI.ANAUON
<br />I hcrcl,y.flnflrundcr pcnalr, oi pcrlury onc ofrhr r(rk,sing d..lriions
<br />I h.vc alxl will minlri. s CenlfEatc ol Conrnl ro Sclf lnruE lir w.rkc6 coqr.nsalion. !s Pmrid.d ror byS.clion3?00oflhc
<br />ljtx)r Cnde, forrhc nedormn.c ollhc wo for whih lhc pcnnil i\ isslcd
<br />I hn\.rnd \vill nrNim \r.rl$ .onln.n\xri,n, i'r\!rrtr.c. r.
<br />'cquircd
<br />hr
<br />. '. Lrl M\r-'Ld,'..i tuhii.r'i, .trJ'.c
<br />W/uutrt Cc6ta -tn>
<br />Sccr ion 3700 .f lh. Labor codc. for ltE pcrfonmkt or
<br />clEicr nnd nolict nu'nhd ec
<br />9 (.\ ,\4,t
<br />-l.enifyrhrr
<br />inrhc pcrforron( or r hc w.rk ror lhah rhi\ p.irnir n hsucd.l shallnoi cnplorant pcrson in any ararncr
<br />b !\ ro hcd,m \utirt b ihc wo cn' .ompcnsdion lows ol a0lifornia. ,nd rst. rhd il l should b.conrc sul,Fd h rh.
<br />wor[crs c.mpcnsBrion povisioB olsccrion ]rmof lhc lnhor C()dc,lshill- ftnrhwirh.onrrly rirh lhor nornn,ns
<br />W XNTNG l,riturc ro {curc *orlci\ La,hp.nrdn,n .ovfdtc i\ unhtrtul. !trd \lrll \uhi.r ,n c 9l,,)ct ro rininll Pc rlr'rs and
<br />{ islr[) (xr0r n rnlil lnBlcs as F)vidcd fd rhc
<br />;:::'i0G"u$'?ulu:
<br />I hcrcby atriin undcr pcnally of lcrjury rh, 1,fi li.t.r.d und.r fn)vision ofChnplcr 9 (comftn.ins Pnh sccrion 7m0) oiDivnion l
<br />o, rh. Bnri'rsr dnd PmLssions Conc. and my licen* n in tuU ,orcc and ctrc.r
<br />(7 I teo"q
<br />'"1116 &&2018 .."*"... 1k*0nr\
<br />CONSIEIICUIINIINDTdGAGDICT
<br />, hcEby lirtrm undcr pcnlhy oi pcrjury thar rhcrc is d .onnocrio. bndins ascn.y for rh. pdforlffic of lhc wort fin shi.h rhil F.nn k
<br />isru.J{sd 1097. civ. c.).
<br />L.ndcl' Nrmc'-
<br />AIII&'ILDECI.ANA ,tr
<br />lH,ylfiimunder pcmlry oa pcrjlry o.c orrh. tolloqing dNlrt'ions
<br />Dcmlnion P.rmirl^st slos Notificalion !-cderal Rcgxk ion\ (Tirl.40. Pan6)
<br />Rcquircd Lrttcr oI Nol iftalion
<br />-l
<br />errilyrher rnc rcd.ral rcEuhrions BgordinB rstr.ros rcflnral arc noramlic$lc h rhisrmjccr
<br />!-r...iirv rhnr I hrvc rcsl rhis,nr licrri{nr rntl{rrcrhri rtu fi^r iirlnnnrnotr ywirhdll ciryrtrd counry
<br />onlinriccs rndsrarc t-rwsrcl inBro huildiryc lcl)lcscDrdilcs ofihis ciry rnd counryro carcr ul].trrtE
<br />D o';Ll A:"o r ,,i-l.lG 0 E 2018
<br />Site-Work
<br />Underground
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Lile Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />[J nder Slab / Floor
<br />Bondino / Groundino / UFER
<br />Transformers
<br />Torqueinq
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rough)
<br />IVleler Release
<br />Rough 6tt//.t 6r\KA
<br />Service l\/eter
<br />FINAL 6f2*/fn >I) 6'I
<br />Notes, Remarks, Etc
<br />COMMENTS
<br />Pole Bases
<br />Sub-Panels
<br />rhovc nrDrn)ncd pii,l^-nt r(n rsN.lidr
<br />Appli(a orAaen(slgtulore
<br />I
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