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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS (iltNt:R B(' -trr-R Dt.t.( 1R,\TI1)N
<br />I hcftby,ntrnr undcr pdnalry r)r lcriur) rhat I an cr.'nB ltur rn. Contrtor' L,iccnt hw for thc {oll'$irB rcaso! (SEc 70115
<br />Businc$ a,xl Prorc$ion Codc) Aoy ciry or Counry $hi(h r.qoncs a pcrrnir k, onslrucl- sllcr' inpmlc. dcmnli\h I (nJir M)
<br />srtucrurc. prbr ro ns hsuancc, als rcquncs rh. aoPli.dn! ror \u.h Pcrmir ro fik I si8rcd slalc'ft r rhsl hcot shc is li'cn$d PUN'nr
<br />ro rlE provisiois ofrh. conkrcxn\ t-i.cns.d Llw (Chlprcr gcoalmcncin! wirh Scclion ?OU) of Division I otlh' Busincss "nd
<br />PDfcsn,ns C.dc) or lhil tr or \hc s crcmfl rhcrcf.om dd thc bask tu rh. rllcgcd cxcmPlnrn nv violdionorsc'lhn?O'rl5 bv 'trv
<br />rppll.lnrro.rncannsuhjdr\rhcaPFlicanllorciviipcnn[yolnolnherMtrnrchuodteddollus(3500).
<br />l. as oqner of rhr tioFny. or m, cnfk,yccs wirh qrscs as rhcn st smpe.s,ri(,r. sill do lhc w{'lt 'al 'h'
<br />ntud@ is fln
<br />i cxlrtl d oflcrcd f.i sic rSE ?0:14, Busircss flnd Profcsi,rns Codc:-Ihc C.nt,.kn s Licens lrw des n.l ordv lo atr owntr or
<br />rh.Fmldy wlxr huilds or in{,mrcs rncEln. ard *ho dms sh h* hnn\.llor hcr\cltor rh.ouEh hi\ or h'! o*ncmPk'vcc('
<br />pn,vidld r; sudr in{turcnrrh N mr inrdndcd ot offcNd ir ssh ll. hoNcrcr. ilE buildin! .r imPovcmnr is eld $irhin on' ,enr
<br />;f.rm1l)Lrhn. rtE OB;r Blil&r eill tult 6c trrdc. .f liovirB rh,t hc or \hc did ml blild or irprov. rhe PDFnv ror lh€ plrll)t or
<br />-1.
<br />asowEroarhc pnipcdy,0mcrch\ntlyco ra.tine *irh liccnsd coarrachn ro consrrucl rhc Frrc.t lScc. ?O14. Bu(i'rA\
<br />lnd PorssionCodc: Th; Co racror'sl,iccns.LzwdocsnolaPllyrornowncroipoFnvwhobuildsornnpr'vcslhcrcon'
<br />,nd sno cont chlnr su.h px*ch wirh I Co nklcron , li..n\cd l,uslanr hrhcCotrlra.rois l-i.ctr{ tj*)
<br />_l amcrc.\, utrdcr Sccrio*alp*&
<br />llMr\tslIrQI
<br />I hcrchynrnrmutrdcr acn!llyot!.iury.ncotlhc rolnrwint dLtldrlion\
<br />I hav. ,rd eill minraih a ccnificolc of Con*d ro Sclf'lnsurc ntr sorkcn compcns,t ioh. .s Pmvitd n' bv Salion 1700 or lhe
<br />Llbor Adc, fd thc pcrrorroncc ollhc *ork tu whth rh. Frmir i! issued.
<br />-l
<br />hdw 'nd will mainrain wo.k.( .ompenslrion insuran.c. as rcquncn hv Scction 37OO of rhc hb'r Code. rd rh' pcrrolmmc or
<br />rhc wor* lor qhich lfih Frmil is Lssucd My sork(s compcnslrnrn insxarcc cadct ud B,licv numh.r 4c
<br />I ccn ir rhar in rh. Ntformom. or rh. w.r& lor wlli:h rhis F nn is issucd.I shrll ml enlnlov anv!'non in anvmanrcr
<br />$ mb hc.orc $jcciro rht *orkns @nrPcn\arnnr I'rws oi Californi andJ8rcc lhnr ifI shotrrd bcc'ft subjcct hrtE
<br />wolkd(.omE.slrinntnrvi\tunsofsccrio.]?ulolthcLtrtx,Codc.lrh,ll.ti,nh*irhcomplvsnhrho*F$vtions
<br />WAllNlNc: }lilurc to €culc *rrkcB comprnsarion colcfulc is unh$ful. Nd tl.ycr b rnninnl Nnrki.s rod
<br />civil Inrc\ xp t, onc hundred rhous,nd doll!6 (Su)o.ofl)
<br />Ssrion.1076.frhc hhor Codc. imcrcst nnd urknEy\ Ifts
<br />*,Lf-/a?/zga
<br />l hcrchr oafim undcr rcnahy oi pcrjfiy rllll l rm lientd !.d( rovision ofCh,prn 9 (ommncing sirh Scdion Ttxr)'fDivisnrn:l
<br />ol rhe ausincss .nd PDr.sio.s Codc, and my li.chs. n in tull rbN nrn .fisi.
<br />LiccrscCla$r-Ih \N.trI'.
<br />C(INSTNII(:T!(IN LXND!N(: AGENCY
<br />I hcftby ,firm utucr Fmhy or P.rjury rhr ihm n a conslrucrhn kndine !8cncv f thc Frformncc or rh' work tr whi'h lhn rmn is
<br />hsncd rscc lO97.Civ C ).
<br />t^ cr'\ A'ldm'J
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<br />AELICANT-DLCLAMtrA
<br />I lErty rtnm undcr p€nohy.f,)crluryone oirhc tulhwnrS d.cl0ruln,ns:
<br />Dc.nlirion P.nnik-Ast sros Norilinlion ltdcrrl Rcgxlurions (Tirlc 40. Pdt6)
<br />Rcqrrcd l-crrcrol Norifi.dir,tr
<br />I.dlilytI lhe tcdctulr.Sul bns rcB&ling ash(slox rcn)ral I. nol $nlic$h ro rhir lrojd
<br />I cdi,ithal I tuvc r.dd rhisanplicarhr
<br />oi(linrnccs rnd Srrrc bws rclrl irg io htrildi
<br />,tbv. mtrrioncd pDlrny for inspccrion rul
<br />i\..ncd llsrNro.onflywilhallCiry,trdCounry
<br />rcprc\cnralivcs ofrhis City 0nd Coxniyro cnlcr uIonrhc
<br />Apli.s or,\A.trtSirmlore+4 '/i"
<br />^,""y/t/zz:
<br />Underqround
<br />Pole Bases
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Buildinq
<br />Under Slab / Floor
<br />Bondinq i Groundinq / UFER
<br />Transformers
<br />Torqueinq
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilinos (Hard & Solfit Rouqh
<br />Ceilinos (T-Bar Rouqh)
<br />lvleter Release
<br />Rouqh
<br />Service lVleter tFINAL &,*,o-r-/) //.za//4,4P /'8)
<br />Notes, Remarks, Etc. '/- iIJ
<br />Site-Work
<br />Communications Cable
<br />Sub-Panels
<br />trndd'. NunN
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