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ELECTRICAL-INSPECTOR RECOHD <br />COMMENTSDATEID/SIG. <br />Site-Work <br />Under round <br />Pole Bases <br />Li ht Standards <br />AS Pool Fountains <br />Si ns monument <br />Fire Alarm / Dam ers <br />Communications Cable <br />Build in <br />Under Slab / Floor <br />Bondin i Groundin / UFER <br />Transformers <br />Sub-Panels <br />Air Conditioners <br />Roof To ui ent <br />Facto Wired Unit <br />Walls Conduit <br />% <br />Ceilin hsHard & Solf it Rou <br />hCeilinST-Bar Ro <br />l\4eter Release <br />Rou h <br />Service [t/leter <br />FINAL <br />Remarks, EtcNotes <br />OWNF.R BUILDCR DELCARATION <br />I hcrchy amrm udo ,..0lly ot pcrjory rh,r I m .xc.rfl fiom rhc Conrn.bN Li.cnsc I2w lnr r hc tollowing enon (Scc .70'l l 5 <br />Buiin.* d l Pofc$ion Cul.): ny Citt or Counry shich requt i ! pctrnir tt coh{ cl. lllcr inPrcvc. &mlGh 'tr rc!'rn onv <br />stdclurc- I,ltulo ils n*uan.c. llso rcquircs rhc npplicad lor such Iicmir o nh o sisncd (lrctunr rhd hc or shc i1 licencd lunuml,.. <br />er rhc F,vrsions of rlE Comra.rot s Li.cnsd Law (ChaPrcr 9. Co.rmrcins qirh S.ction ?(xt) ol Division -1 ot th' Busincs rnd <br />Pmrcssions Codc) or rhlr ir or shc is cxcnu rh.(fton and $. hash fot ltc rlLgM cxcnrflion Anv viol.lhtr of Sdi6' 701I 5 bvanv <br />anrlic.nr f.r s p.nnir rubt.crslhc umli..nr ro a.ivilFn.lrrotoor dtr.'h fivc htrndr.d dou!61S500) <br />l. {s ouncr of rhc pt,Fdr, or ory c'nllotNs wirh wrScs .s rh.t slc conp.trsotion. Nill do rhc wort ad rhc snfu h mr <br />inrcnlcd or ofi.rd for srlc ( 56 ?01,1. Bu\incs rnd Arfessions C{xlc Th. Conrra.ror's Li..nsc L{w doc\ nor +plt lo an owdr of <br />rhc pmFny wh. h{ilds ff nr9mrB rhcNn- od sfiu des sch wtt him\clfoi h$$lfor rhmush his or h.ro*n cq'lovccs. <br />pNid;d rh,r sxch inDNrcmnk m ior ir cfrkn or offeEd for slc. !r, bwcvcr. rtf, hu il iry or irrynorcrnr i\ $ld wthin orc )u <br />;l complcrion. rhc OwMr Builde! will hn* lrt budrn ol povnrs rhar tu or {t dil nor trilr or nr'llbrc $c ImPca, ror lhc Nrlns ot <br />l. r\osnfiolrhc nDncny, r'ncxclusivclyconnding sirh lic.trscd..olrlcnEt,.onsrucrlht lmjc.i (Scc 1044. Btrlinc\r <br />.nd holb$ion codc rhcc.trtrcr.is l.i.c \. t)w doc( nol llPlyi, nnos cr olltr)nrny who buildsor imln,vcs rh.ton- <br />rnd who onn rls lbr such Pr {cch wirh ! Conrncbn s) li.cn*d lusumr b rh. (in mcfi s l-iccn\c kN) <br />I a rxcnrpl trfd.r S.rr <br />Drle: Owner:wotx!]ls' rrruprnslttol <br />DECLAMIIO! <br />I hcrcb, allird utul$ !.n.llyolFrjuryonc ot rhc lollowins d(l[dions <br />-l <br />hav. aid will dinllin a Gnifrotc of ConE lo SclHnru,c ror wotkos on{rnsrio.,.s Inolidcd lor bv Srrion l7m of rhc <br />tihor Gnl.. for rtE F.rornEmc of lhl sot* r.t which lhc permn n is.u.d <br />-lhavcandwil,mainltritr*ork.6 <br />conFns.lion iNurarce. !r EqxiE{ tv Sr.'iion 17fi) of rlE lihor C'd'.lor thc p'rr'mm' or <br />rhc eork ror *hich ltis llcdir ir is$cd. My wo qi omp.nsttion iflsuruce .srhr 0d !'oltv nunb.r m: <br />Pul',I \un$(r:--- <br />-!.cdiry <br />thar inlhcFrntrndn.corlh. wort for whichrhis Pcrmil n issncd l sholl not.q'lov inv rcnotr in anvmnrct <br />!o as lo tEcotu subjccl lo rhc sortcs mmP.ns.riotr laqs ot Cslitomia. &d !8rcc ihtr ir I shou ld hccomc rubjNt b the <br />porkcr conp..saliutr Pn'vhions otserion 3700oflnc LatDr Gi. l shrll. fonhwirhco.rrlvrilhlhocpbvisions' <br />WARNINGT Failurc to surc sorkos ompcnsalion .ov.ngc is unlostul, and {hall subjccr trn cnlplorcr to qitund Fn'lli's and <br />civil fincs up ro on. hundred rhoxslnd dollm (SlOoO0O) in addnion ro th. co{ ofcoDp€nrorion. dom8cs as fl'vidcn ror ihe <br />Srxon luT6 ofrhc tah,lcoJc. inrcrcn !n'i dlnmy ( rds <br />;:"")"zv;;'""" ^,.^,u r4- ,2*,- <br />I ICEi\SED CONTRACTT'R <br />DECLAS&UA! <br />I hcrby.fiiirn undcr l.olty of pcrjury rhar I sn licns.d ur'dcr Foti\idr ofChorrcr 9 (L\,frmrcins wirh Sdirn 7U)0) orDivirion l <br />of rhc Busims a.d Pmfc*ions Codc. and my licc.* is in lull forc srxl cllNi <br />{a-r-o*,( <br />(:(TNSTRIICIION I FNDING AGI'N(]Y <br />lhcrcbyrllirEx(lcrpcnrllyorlcrjuryrhtrrlhmhacoiicriunlctrdiDsarcncyr.rrhcpcrlhroanc.olthcworkftrwhi'hlhnPcrmiri\ <br />hsucd (Scc 1097, Civ C.). <br />t-cnici\ A,ldr.s <br />AELISANLDESLAEAITO! <br />I hmby dim !.der pensll y of pcrjury otc .l lh. lolhwinS dNlqalions: <br />Dcmlirio. ftr.r s-Ast stos Norifi.arion Fcdcrll Rcguh.ionr fink 40. Pdn6r <br />R.quirrn lJlrcr of Nolifi dbn <br />-l <br />ccniry th!! lnc fcdcrtl dgxl,rions rcBarning astE{os rcmvd orc nnl srdicablc to lhis peixt. <br />-l <br />ccnifylhal I h!!c rnd $is.pPltarion ard $arcrn rhe!tD!c infomlion n orccl t ,ere lo onlpl, wiih all Cilv {nd Countv <br />;di,amcs;d sr'rc L{es rl,rini io blilding conirucrion. sd hochy adhoria rc[c*Drativ.s ofrhiscnv and counrvro enld ulb' r <br />ffi:-H;"'*T'Y .io ."," 7/a/r r <br />prr,,,e nnme , prrnr):._ .. 3hq am -,zL/u rcia- <br />APPROVALS <br />Lile Saletv /Low Voltaqe <br />Toroueinq <br />,tvJ ?1_Walls (Rouqh) <br />1rJ>r)'t ltal rc <br />VAL.at I l?a)*lPltg -t, <br />txrofl s Nanr <br />-