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L <br />APPHOVALS DATE ID/SIG.COMMENTS <br />Sile-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 />Communications Cable <br />Building <br />Under Slab / Floor <br />Bonding / Groundinq / UFER <br />Transformers <br />Torqueino <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soflit Rouoh <br />Ceilings (T-Bar Rouqh) <br />Ir/eter Release <br />Rough <br />Service Ir/eter <br />FINAL Ttz@/ul @&) <br />Notes Remarks , EIc. <br />-T <br />lkc*lt <br />4 \) <br />L/ <br />OWNF:R BUILDER DEI,CARAIION <br />I hcrcby rrrrm uMcr pcnally ol lcrrury rhar I am.xcfrpr rorn rhc Contr.on Licctrsc Lav lor lhc followinS rc.sn (Scc.70ll.5 <br />Blsincs 0M Profe$ion Codc): Any Cily o. Counly ehich rcauncs r p.n.ir ro consrrucl- rllc!. n.p.ore. demlhh or rcnzn rny <br />irucrure. priorro irs hslance. a\o requtcs rh€ appliclnr tor such rEnnit to filea sisned arcmenr rh,r h€or sh. is li.c.scd fl*ua.r <br />to th. pmvisions oi lh. Contacbls Liccn\dl Lau (Ch,prcr 9. C.nrmcncirg wnh Scctim 70tD oi Division I olthc Busincs and <br />Profcsions Codc)or lhal hcorshc iscxcmpt lhcrcio,nand$c b,sis lbr lhc allc8cd cxcmprion Any liol(ion of Sdioi 70:ll5 hy u, <br />Blplicxnrfitr!pcnnilsuhjccarhcrpp]icrtrrroucivilpcn.ltyofnornDrclhrnfivctundrcddolltr^($5(I]). <br />l.,s owncr ofthc Ooncny. or mycmployccs with waBcs as thcn sob conrrnsalion. eilldo inc work oftl rhc srrucl@ i\ nor <br />inrcndql ororic.cdforsalc(56.?044-BusincsandProic$ionsConclhcConrmcroast-iccnseliwdocsnoraDrrlyloanowncror <br />rhc fnpcny uha buil&or in!,mvcs tb.rmn. lrrl who d@s su.h w)n hinscltor lrrslfor rlrou8h hh or h$own csploycc\- <br />providdd rh such inyn,vc rnN m nor ir.nncJ or onadl f{r str. lf. h)acvcr, ih. huilting oi inlPovcmd k sld wirhh onc yra <br />ol dmpkrion. rhcOqner Builder sillhaw rh€ tudcn otproviry rh, he or she dU not hild or inpow thc rnDdy ro. rb. puqx^c or <br />-1. <br />asovncrotrhclropcny. anrcx.bsnclyconrrucring wirh liccnscd conr.rros ro cnnnrud rhc pnt&r (scc 7&.i1. Bu\i',u\\ <br />a*l Pn,lasbn Codc Th.Conkrttr s Li(.nse Lrw docs norapplyb riosn.roftro0cdysho buildsor n riovc\ rh$con. <br />rnd $ho co.tricls l'(,r such DDj$ts wirh a Cbft&ro(9 l,.crscd tur suinr to rlr (nnrncrm s Lic.nsc Lrw) <br />-l <br />smcxcmpl undcr Scclio <br />I l[ffhl rllt'n uDdcr I)cnrlryolpcrtnry <br />II$CLA.BtrI]ON <br />-lhrrcand <br />sillnuinla r Ccnitcaleotcotrrcnllo Se1fitrsure l'or rorkeF con,Icn\srion- as F{,!idcd r.r bysccrio.r?morrh. <br />L{bor Codc. Ior llrc pslonuncc ol lhc work tbr which lhc |f,irn a nsucd <br />rhc {ork lnr {hi.h rhislrnnir i\ i\\dd Mt*.rkc^ conlll.'sJri.n i',sunncr crtrirr n rlict iuitbcr:trc: <br />I ccnify rhd i'r rhc pcili,nmncc oflh. work lbr {hi.h rhi\ I)crnrir i\ issucd. I drll tror ctrlPloy 0ny pcrsor in rn] manncr <br />so rsh hconrc $bicct to thc wortcn comncnsrlion lawsofCrlilornin. and urccrhar ii I stu,uld l,ec.nE suhr.r k, rh. <br />NorkcN coflrl,cnsationlmvhi.nsoiScdion37ftoflheLnhorCodc.lsh l, fonhsirhc.m y sirh rho* roltions <br />WARNIN(;: Failurc h sc.urc $oikcr .otrDun\lrnm.ov.rrsr is unl wrul. rtrd sl l subjc.r ur cmplolcr to.riarinal ricnalrics and <br />civil nn$ up b o d hunded rhousrnd <br />SNrion t(r7ar oarhc Irl- r C.d. inr.r.d <br />r xJd (id k, rh( .or nl c'nnltilJrnlr, Jann!.\ r\ t,o\nldd lnr r[. <br />1 :,4 <br />Ihenby,fur'nu.dfipcmllyorp:rjuryrharInrli.c.\cilundfilrovhionolCh,ptdq(omnrn€in-!wilhScclion7mO)ofDivisionl <br />ol rhc Businessand Proic$ions Codc. ud my licensc t infullfo.ccan.lcllecr <br />CONjiIf,IJCIIONIDNDIIC.&GENCI <br />I hcrcby aflnm undcr rnalty of pcrjury lhat thcrc t a constdclio. h.dine ngcncy fo! thc Frformncc of lhc wort fitr whi.h rhis FYnii i{ <br />ksucd (s .:1097,Civ. C.). <br />A.TIUCANI.DICLAEAIION <br />I heby aflim uMcr lcnalry ol pcrjury onc or rlr lollowi.B daluir io.s <br />Dc.bliri.n Pcr.iir\ Arb.{os N.rifi.arion F.dcrrl Rcgul.rions Onlc40. Pan6) <br />Rcquircd I.ncr of Norili.dior <br />rcBUlarions rcEardirB ashcsos rcnDlrl irc nol0plliclhlc ro lhis I'rorecr <br />i{rxnd{rlclhxrrh.rh)v. i',rh'mri(nr i\.or.cr I aar.c t..o rdy *rh.ll City.nd Counry <br />nEcondrcri,r.rndhcrch,rurhorizcrrprsr tarir.\orr[isCiry{trdCoutrlyk) <br />fi)i i) <br />ELECTRICAL-INSPECTOR RECORD