|
ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DDI,CANATON
<br />I hctub, afilrn !nd.r tc.!lr, (n p.rjury rh,r I m.xenll,l 6nm rh. ConracbF Liccne tj* ro. rh. lolnr*in8 rub. (Scc.703l 5
<br />Busincss !flI Ptulcssiun Cod.)r Any C y .r Coudy which rcquirc\ . If, nit lo co.s|flc1. oX6. impmvc. dcmlish or E Et any
<br />(rucrurc. l]rix to ns hsuancc, also rcquncs $c lpplicanr lbr suchtdinir ro lllc a signcd (otcoE.r rhal hcorshc is liccn\cd pnN&nr
<br />t, rh. provi\iois ofrhe Co.r.r.rois l-jccrscd ljw (Chaflcr 9, Cohrrkn,g wirh Scdion 7{rn.i Divkion I ol rhc Businc$ nnd
<br />Pbf.snrns Cod.) or rhd lE or sh. is crcnpr thcr.fn,m and rhc hri\ for rh. .lh8cd .nmprion AnyviohlionolScclionT0:ll.5hyany
<br />npplicont for a rcnnit subjNls lhc applicrnl to acivilrcmllyofnol mordhrn livc hundred dollan (35m).
<br />I. usftr.f rhc prnFny. d ny cntk,rt r silll sas.\ as rhcn sE .omp.n$ron. will d rlr *dk Md rh. ,trrurc k fr,r
<br />i .n1L\l .roftcrcd Lr s.lc (56_ 7014. Busincs md Prorcsi()n\ Cod.r ThcConri.tols Liccn\c t wdocstrotlnrlylo,noencrof
<br />rhcpmpcrry *ho huilds or iq'mlcs rhcicnr. BDd wtn, d@s such wrt hirnscll or hcrrcll or rhn gh hi\ or hcr o*n cnrrloyccs.
<br />proridcd rhlr iuch inll)nnrrnh e mr i.rcftl.t ar.ffcrn f.t vb Ii tn*esl rrr huiuinA o. in{mwmnl is $ld sirhin onc yre
<br />ol onpkrion, rlt Owncr Buillq *ill hnvc ihc hunlctr ol prcving rhd hc or \hc dil tror hrild or i'nproE rhc ltmFny ftn rhc purlx& of
<br />-1.
<br />!s o*rcr ol thc ropcd y. am crclusiEly conrr0dins *irh liccn*d conrracrr\ r,' onndcr rhc Ir,,Fr I s.. 7(]t4. Bunm$
<br />ntol Pi,f6\i.n C.d.: Th.Conracroi s t-i.cns.l-rw docs mr ryplrr. anosno.fItul.dy wh. builds or inrrrovcs thclcon-
<br />lod who $nrrucls hr such rmjccts wnh r C. rudo(o lkctr$d tDsuanr ki rhc (bnrracrn s l,icensc l-a$).
<br />I urc\cnpl undcr Scr
<br />traBtrl;&rraMPEa$traN
<br />DESAAA.IIIIN
<br />I hcrchyafin utrdcrpcnrliyolpcrjuryoncofrhcn,lbqinsdc.lmtiotrs
<br />-lhrvc
<br />andpill minhin a Ccn iicarc of Conenr ro Sclf.lNurc for eorkcrs conDenslrioo- as povided aor hy Smrion:1700 orrhe
<br />L.bo! Codc. tor lhc p.rtbrmncc of rhc work for whhh rhc ,.rnri! t is$cd
<br />I hrrnid sillmri'rrain workcrr con,I.trsarion in\nrancc. a\ rcquncd h!S.crn,n.l7(l)ofrhc Ub{r Cndr. in rhc l].rloanrkcu{
<br />rhc work forshich rhhFrn,ir i\ i\{.rl My workcr' .onrcnei ion in\uBtrc. cntri.rrrtl Fli.ynumb.r tc:
<br />-Expircr:
<br />l.cnni rhir in tht p.rroi,Mrcc.frh. wo.k for whth rhi\ p.rinir n hsu.d. I rhall nol cmployany pc$n io !n, mMrcr
<br />$ as ro hccor* subjcct to rhc wortcr\'.ompcnsal ion laws olCalilorni!- und as@ ihrr ir I \hould lt..m rxbrc.r k, rhc
<br />*orks\.onp.lsdi{nrpn,visionsofSftri,n:lT0Oofrhclltl)rC( c. l shf,ll. fonhwirh .omlly wirh ih.* [ovisions
<br />WARNIN(;: Frilurc ro surc rorkcr\ corpcn\arn,n..rrrs. i\ uflrsiul. trJ \hnll suhjc.r i c r o)$ ti oniralNmlt-^r intl
<br />ri\il nnr\ up ro otu hunJr.d rhorsrid dollrr (:!l{1o.ffx)), in rtdirion ki rh..on orco.rN s.rnr. drtrBgcs d\ rro\nlcl lnr lhc
<br />Sccrnn:l0Trrorrhc l-nhnC(xlc. dcrc{ rtrJ rnonry \ lcr\
<br />L1._ ^t;1)
<br />DECI,AXA.IIO!
<br />I hcEby ofitm u dcr p.Mlty ol p.rjury lhul I rn lien$t undd po\ision of Chaplcr I (omnErcins *irh Sccrbn 70@) of Diviqion l
<br />of rhc Burincss rnd Pmf.ss6ni Codc, ,nd my liccnsc h in full fo.e ond cficcl.
<br />';"):latg 4r L
<br />I ccnili rhd rhc rcdcral rcguhlions rcgudir8 nshcslos rcnn,valarc nor uDplicubh lo rhn pfl,jccr
<br />lcrnll.vrhrr I hkr.sdrhis xpplicJriu,Jrxlnrlcrlrrrhcrh)vc innm,xrior n..k{r lrFRrt).onrdt\erhallCityrni(iunr}
<br />(rudhn. a,n hcrchynurtiizc rcprr*nr,rn.\ orrlnr Ciryaid Coutrry lo cnrs uB)n rnc
<br />7-Ja't\(rt'?it4 ^lu
<br />orJinanccs JtrJ Srarc LawrrcLriryrn buiUitr(cun
<br />Jhtrc m.nr, rd nnrrny rd in\,NnINrrricl
<br />nrr^-, *n*., *,**r* Aft
<br />P.mrire nahe , pnn, r: -Ll -t V-)l"zz---
<br />Site-Work
<br />Underground
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lile Salety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab i Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soflit Rouqh
<br />C eilings (T-Bar Rough)
<br />lvleter Release
<br />Rough \uqlt ((*t1rltv.(IO,
<br />Service lt/eter
<br />FINAL t\lrq lU,(,YY\pt*-rrs./
<br />Notes, Remarks, Etc.
<br />Pole Bases
<br />clft,-
<br />CoNSTRUCTmN LENDIN(: ACENCY
<br />I hcrchy rlltnr unncr Fnallyol Nrjury lhul rhcrc n a conshrcl6n t.dir! lgctr., ti,r rhc Frlanrui.c.rrhc work lor which rhh lcnnil n
<br />i\\u.d (Ss 1097. Civ C ).
<br />I rn'ic''. NJmr
<br />tridra' JJ.$
<br />AIIIICANLDECLAXAIIIIN
<br />I h.r6, aflim undcr F.alty of lcrjuly orc of lhc follo*in8 dehEtions:
<br />D.mlirion Pcrnns Asb.srol Notincdion Fcdcnl R.gulrlions (Tnl.ll(). Pfi6)
<br />-Rcqutcd
<br />lincr olNorifi corion
|