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ELECTRICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS Omo-Buildq Dclmtion <br />I hcrcby rftim undcr pcnalty of pcrjury thrt I m ssmpt form thc Conrsclors' Liccnsc Lrw for thc follovring rcson (scc.703 1.5 Busincts <br />md Proforion Codc): Any City or County which requircr . prmh to @Ntrud" dtcr, improvc, dcmlirh or rcprir uy ilructuq prior to it! <br />isruancc,alsorcquircathcspplicantfor$chpcmittofilcasigncdstrtcmcnt thathcorthoitliccnsd purruurtothcprovirionrofthc <br />Contractor's Liercd Lrw (Chaptcr 9, Com.ncing with S@tion 7000 of Division 3 of thc Burincrr ud Profqsiou Codc) or thrt hc or <br />shc is cxcmpt thcrcfrom md thc buir for thc 8.llcgcd ffcmption .An!, violttion of Sastion 7031.5 by uy tpplifrt for r pcmit rubjcct! thc <br />rpplicgr{o a civil pcnrlty ofnot morc thu fivc hundrcd dollus (S500). <br />I/1, u omcr of thc prcpcny, or my cmployo with wrgcr u thck rclc @mpcntrtiort will do tha work sd thc ttructua i! not int.ndcd <br />or offtrcd for tdc ( Sd.7044, Buin6! ud Profc$ionr Codc: Thc Conftcror't Li@nr La* du not rpply to u ow of thc prcpcrty <br />who buildr or improvct thcr@rl ed who dGr sch work himtclf or harelf or thtough hir or hcr om omploys, providcd that sch <br />improvcmcot! uc not intcndcd or offqcd for $lc. If, howcvcr, thc building or improvcmcnt it rcld within onG y{ of@mplaior\ thc <br />Owcr-Buildcr will hlvc thc burdcn ofproving thlt hc or shc not build or improvc for thc purporc oftdc). <br />_1, { omer of thc propcrty, rm qclusivoly contrEcting with liccmcd @ntrrton to onrtruct thc prcjcct ( Se. 7044, Burinsr md <br />Profqsion Codc: Thc Conlnclor's Li€nrc lrw docs not apply to e omar of propaty who builds or improva thqcon , ud who <br />contrEct! for such prcjccts with s Conurcior(s) liccnrcd pumrnt to thc Cont rctor'3 Liccns L!w.). <br />-Im <br />undcr Scction P.C. for taaon <br />Dstcl <br />I hcrcby rflirm undcr pcnalty ofpcrjury ono <br />_l havc ud will mEintrio r Ccniliqtc of Consnt to SclfJnrurc for workcru' omp.nlrtio4 { providcd for by SEtion 3700 of thc <br />L8bor Codc, for thc pcrfomancc of thc work for which thc pcrmit it itscd. <br />_lhavcudwillmaintrinworkcrs'@mpcnstioninsurrncc,u rcquircdbySectionST00ofthcliborCodqforthcpcrfomsnccofthc <br />work for which this pcmit is issucd. My workcrs' compcn$tion insurucc wicr ud policy numbcr u!: <br />Policy Numbs Expircr: <br />- <br />(This scrtion n.rd nor bc complctcd if thc pcmit ir for One hundrcd dollur (ttoo) or 16r) <br />\ zll4nify thrt in thc pcrfotrune of thc work for which !hi! pmit it itlucd, I rhrll not mploy rny pcmn in uy mmnq s u to <br />U6camc rubja o thc wrkcrs ' @mplrultion hur of Cdifomil md agrc that if I rhould bomo rubjoct o thc workor' <br />provirionr ofSecion 3700 ofthc kbor Codc comply with thos prcvitions.. <br />DEIC <br />WARNING: Frilurc to t@rc worko' omperoation <br />fincs up to onc huodrcd thoulmd dolls! (3100,000),in <br />thc Lrbor Codc, intcra$ ed 8ttomcy'! fs. <br />ovcrrge is unhwful, ud rhrll <br />Eddition to thc con ofcompcns8tion,a5 <br />I hcrcby rmrm und€r pcnrlty ofpcrjury <br />thc Businc$ and ProfcssioN Codc, ed <br />LICENSED CONTRACTORS DECLARATION <br />thlt I m liccnlcd undcr provirion ofChaptr 9 (ommcncing with Scction 7000) ofDivirion 3 of <br />my lic.nsc is in full forcc ud cffect. <br />Liccnse Liccnsc Numbcr <br />DstG: Contnclor: <br />CONSTRUCTION LENDING AGENCY <br />I hcrcby rffim undc pcnrlty of pcrjury thrt thcrc ir r rcrotruction lcnding rgcncy for thc psfomue of tlrc work for which thir prmit ir <br />i$ucd (Scc. 3097, Civ. C.). <br />Lcndcr's Nrmc: <br />Lcndcr's Addrcss <br />APPLICANT'S DECLARATION <br />Rcgulstions (Titlc 40, Prrt 6)Dcmolition PcmiteAlbcstor Notifi crtion Fcdcral <br />_ Rcquircd Lcttcr ofNotificrtion <br />with dl City md County <br />rnd County to cntq upon thc <br />abovc mcntioncd propcny <br />Applirut or agot sig. <br />Pcmittec namc (print): <br />insp€tion lc <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)4/p/tl-2 =;r/sZ ../ <br />Ceilings (Hard & Sotfit Rough //*,t,/14 t*,ib<-ztt-<a, <br />Ceilings (T-Bar Rough)//t7/tt -aJ 1- <br />Meter Release <br />Rough //r r/tt .j-z*a w <br />Service Meter , <br />FINAL it-lrey'u t{/a) <br />Notes, Remarks, Etc. <br />'// -/Y&, <br />/