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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUtI,Di]N OELCARA']ION
<br />I hcrc6, afiirnr uMc. pcnally of Erjury rhar l ar.xcmpl riinr thc C.nlracloF l,icensc ti* aor rhc folk,sing..av{ (Sc?0115
<br />Bu\inc$ rd Profc$ion Codc): Atry Cir, or C.rdy which .cquirc\ { Ixnd d .oNflcr, dtcr, inDroic. dcmlish nr rcn8n ony
<br />srucrurc. prior to irs irsuancc. aho roquncsltu amlicanr ror such pcrnf ro 6lc r siBncd sllrcnrcnl lhat hcor she h liccred ltrrsu,nr
<br />b rhc F,vnionF of lhc Conr,ri(n \ Liensed Lar (Cnaprcr 9. Commncing wirh sc.rion ?fi)o of Divisirn I oflhc Eusinc$ and
<br />Pturcs{ions Cod.) oi
<br />'har
<br />tE oi shc i\ cxc.rrr th.r.frun and rh. bnsi r.r rhc allcScd crcmplion Any vi(nalionofScdion 70115 b, "iyltplicanl lora !.rmil subjels lhc anpli.anl loacivill)cnaliyoinor mrclhan nvc huidrcd doll,tr* (S50o).
<br />l. as owrcr ot r h. pmlrnt, or my cq)lo)es wirh *agcs I rhcn sh .onr.n{ ion. qilldo rh€ so.[ ud lic$rlm i\ mr
<br />i e lci oroffcrcd forslc(SE 7l!4, Alsinc*lnd Prcfc$ions Codc: Ttc Conracb i l-iccnsd bw do.s nor Aply lo an o*ncr oI
<br />rh.rtuFdy who huilds or nqmKs thNn. sd wtu dds .h k,& himsclf or hcrelf or lhrcugh hh or hcr own cm0k,yccs.
<br />providcdrhd snch iqrorc.rnb m mr i.rcndcd ororjircd Lrsh lL howcrr rhc hiuin! or improvcmd is$ki*irhinotu FU
<br />ofc.q,ldhn. ltE O*ncr Blildcr willhlvc rhc hrdcn ofFoviry thd nc o, shc dA mr hild or i,r'r,o{ rhc pop€ny ror llt puitb$ or
<br />-1,
<br />asovncroflhc prolcny. !mcrclusivclyconrradins wirh liccn*d conrEcron Io $n{rud rh. lft,j.tl (scc 7014. Buiincs
<br />Md Phfcssb. Codc: Thc Contu roi s LiNn\. Lrw doci nor lpply t. an owno of!rupciry*ho builds or imlrovcs thcrcon.
<br />ud who mntmds for such pmich * irh a Coirrrcron, liccnrcd pu uor ro rhc Conkactn\ l-iccn* tia)
<br />-l
<br />oDcrcDfl uDdcr Scct
<br />Dole: O*.er
<br />woRxnlrs c'oNlpFNsATl()N
<br />DECI {R TIoN
<br />I hc,cl,y nffirnruodcr Fnrlryoipcrjurronc orrhc ftnk,wio3 dcchErn,ns
<br />I hrv. dwillnri .h!CcnilkrrcoiConscr loS.llltrnr.ntrwo c^.onllcnsari('n,r\ tn,v'dcdnthySc.lionlT(xrofrhc
<br />lib(radc. for ihc p.rfonu ..orrhc work fitr *hi.h rhc Fnnir a i\sucd
<br />-l
<br />havc rnn will mrinl!ir workcr' comp.nsrri,,n insrrrN.. r\ rcqLn.J byStchoi ll(X)ofrl[ l-ohor(ndc. for rhc lcrftrnrnc..l,hc\i'tro,|lhihrl,r,mtr',tr.u.JM'\r'rc'"'.',m!.n\Jtrnin\u'xfr.,rr'.lFlrrrn$.rJrc
<br />.. , Ultith,r{a4 ("r\ *ts*,o,"*,*i-R-ilii@,-3idt .,o",\.\ i{
<br />I c.n ify r har ii rhc l.rfonMm ol rh. work for whkh rhh rcnn is issuc{|.I sholl D.r cmplo} anypcrDn in trny manncr
<br />$ sto hcconE subjed ro rhc s.!lc6 conFnetio,laws ofcalifo.nia. aid "sN rhrr irI \k,uld tt.oft suhj.d to rlr
<br />$!rkc^ comtcnsalion lovisions ofSN'n,n.l?OO olrhc lnbq Codc.I \hrll. r(dhwirh.onPly wirh lhos [ovhions
<br />WARNING: F,ilur. ro surc sorkc6'c.np.nsarion colcr,Bc is unh*ful. and shrll an cmphtcr n, dinimltEtrrhis.nd
<br />.ivil lincs up b om hundrcd lhousand dollm (S100-ul0). nr (ddilion to lnc co\nnp.nerio.. d,m6grs rs rrovilcd lor lhc
<br />)"'lii.l(}'u8."zu'tuJ
<br />I hcEby rflim undcr pcMltr ot p..jurr rh{ I a li.cnwl !nd$ In,vkio. ofChaprcr 9 (cnnnrc.ciflA wilh S(tion ?00)) .f Dili\ion .l
<br />ol thc Ausircs aM Pmfcsstuns Codc- lnd Dy liccn* h ir tull lorce afll crr.cr.
<br />luq%(
<br />-"f,UG.&3i0JL ."",*",",, (NY
<br />COISIAIJCIIONIENITN(i3CINqX
<br />I hcrb, dmrmundd Irn y ol p.rjury rh.l
<br />'hcm
<br />h s c.srrudion lctrdiry a8ctuy lor rhc ne'rornufte or thc wo* ror which rht Fnnit is
<br />ksucd (Sec :1097.Civ. C ).
<br />AIELICANLIECIABAIIQN
<br />I rmt, trmnn und.r I&nal,, or pfijury onc or rhc rollowing dftLralionil
<br />Dcrmlirion Pclnits Asbcsros Norificntio. FcdcEl Rcgu hr io.s (Tit Ic 40. Pd6)
<br />-Rcqlncd
<br />Lcu( or Nnif'calbn
<br />I ccnify ttu rhc ltdcr.l rcgllllions rc3ading oshcnos rcmrnl lrc nor rpplic8blc b rhis F)Fcr
<br />L#ry rhd r harc rcad rhr appr icrri()n nd{r(c!hrrtlrc l-rc nlnn dntri i\.o'rNt.I ro.onDlywnh all Cnyan{l Coudry
<br />o,li'uNc\ xrJ Srlnc I rtrs r.Lri',! n) huildin!( [yrn,lC.unryk) rtrrdr trtxm r,f,
<br />drtrr mtrrioncd pr,!.dy n" i.s
<br />,\pplir nl or \aMl Sisnnlrrr ,","A[.lG 08 2018
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Salety /Low Voltage
<br />Fire Alarm / Dampers
<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 (Rouoh)
<br />Ceilinqs (Hard & Soflit Rouqh
<br />Ceilings (T-Bar Rough)
<br />lvleter Release
<br />Rough Akt/ i't 5\ff11
<br />Service lvleter
<br />FINAL 't/9Vlt z\b
<br />Notes, Remarks, Etc
<br />Communications Cable
<br />Sub-Panels
<br />aiffi
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