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APPROVALS DATE ID/SIG,COMMENTS Oma-Buildn Dcldation <br />I hd.by affm unda p.Dalty of p6juy rhd I u ddpt tum rh. Cooli@E' Licce t w for th. follovirg r.ea (G 7031 5 Bsird <br />&d Prof.$ion Cod.): Any Cily or Couty which Eqlir6 6 tqoir to @Ntrud, alta, i.dprov.. dcmlish or rtpat ey sEu.tuq Fior to G <br />Lssu&c., aLo r.qut6 lhc applic&i lor such ldnii |o fiic a sisn.d ltal@d 6.l nc o. inc is lic.c.d p6uel lo lhc prcvtioE of {n. <br />C.nr&br\ Lic.ed Inw (Ch.fl6 9, Comcncire vith Sdlion ?000 ofDilision I old. Bqi.6i ud Prof6cios C!d.) or dar n o. <br />shc is crdp thacnom ed th. t€sis tor th. allcscd ddplioD .Any violarioa ol Scrion ?01 L5 by &y applicmi f., a p@it subjels rh. <br />@Dlicarld-r cn'l D.nihv ofnor Eor.$e fiv. hd&.n dollm rl50o). <br />,/ |, d oMs oI d. prbpdy, or my dplo) 6 vlln vas6 d thct $L codp.nario4 will do th. wort dd |!c situdu. ii .ot ifl@d.d <br />or ofd.d aor sal. ( Se.?044, Bsins and Proftssioos Cod.: Th. Conr&ror's Lie@ L.w do6 .or .pply ro D ou@ ol rhc propdry <br />who builds or improvd lh6@tr, ed who do6 sucn worl him.lf or havlf or rllrugb nis or ha om dplo,6, providcd lnd Mh <br />improvddti d. ,or i .nd.d or ofa.d for salc. Ii hovda, lhc buildirg or inprovmat ir $ld wirhir orc ye of€oaplaio., $. <br />o,*r6-B!ild6 will hav. ihc hrd@ ofprolir! rhar lc or llrc nol bund or improv. aor tn purpos oiel.). <br />_I. 6 oMq of lhc propdrn d aclusivcly @nus.lD! wirh licscd @oEelo6 ro coGtlc,r rn Fojd ( Se.704.{. Bairs ard <br />PmfsioD Cod.: Tn C.n1tuor's Licd. L.w dM Dor.pplyro doMs of propdry who boil& or inprcv6th@r, ed wno <br />coDEets for such projels wnh a Coilreto(, licGcd pummr ro llc Codrador's Licce bw.). <br />(-o(, <br />I I h6cby afl'm undqp6rlyof p€jury <br />!oa$as_eor!EErsdlro!_!-Ee!4aa[a! <br />.ncofth.followin8decld os: <br />_l bov€ &dwill nain1ain a Cad6ql. of Coosr to SdHB@ for wort6 conr.Mrio4.6 provid.d for bySarioalT00 ofrh. <br />Llbor Cod., for rh. p6fo,Mc. of tnc vork for wnicb tt Fmn L Lsucd. <br />_l havc ed will nainBi, work6' @Dp@rion ituudc.. a rcquircd by S.crion 3700 oarh. hbor Codc for thc paloll@@ olrhc <br />wort for whi.h thts p<nit i3 i$ucd. My wort6 @npaerion i6ufuc. cana &d policy n!6bE dal <br />PolicyNleb< ErpiG; <br />#ilffiffi.:;ffi; <br />for or. hundrcd doll4 {$100)o.l*) <br />vhkh t[i5 pqEn i5 i$u.d, I shall no! @ploy &y paso in &y 6@a so 6 to <br />ad asE tha! if I should b6oEE subjcl to rhc vort6 <br />comp.Balion provisioN olSetion 1700 ofth.l,bor Cod., <br />,*6 / 7s/ot- <br />WARNING: F.il{. io c@ workas' coet edon @v6.g. is @lawful, &d lhall subjer & @plotq lo rn in l p.olri6 .rd civil <br />fa6 up ro oic hddrcd $oaed dol6 ($ 100,000).i! addirio! 10 tlc cos ol coop.nsadon, d.e.s6 a providcd for t!. scrioD 1076 of <br />d. bbor Cod., inlsd od fiomy s fc. <br />LICENSED CONTRACTORS DACLANATION <br />I hscby afrm uod6 p.nlny of psjury tnlr I e li.dcd und6 Flvisio! of Ct pl6 9 (omcirs * t Setio. ?000) oi Division 3 of <br />n\c B6ircs od PrcfsioE Cod.. ud my lic.e ir i, tuU foEc md.il6t. <br />CAISIBUqIIoIIENDINC.ACENCY <br />I tqcby allm uadE porlty of p<juy tbal rh@ i. . cotrnNcrion lodine ae@y lor lh. pafo@c. of t!. wort for whicb tnis pa6t is <br />i$ucd (S.c. 1097, Civ. C.). <br />APPLICANT'S DBCLAN TON <br />Daeltio, PmiteAsb.stos Nodncldo! Fcdd.l R.*ul.rioG Gnk 40. Per 6) <br />_ R.quiEd t ldofNotifiario! <br />_I cdiry thlt ln€ fida.l ..gulrioa r.gqdi.g ab6toi .@val e @1 apllic.blc !o tl'j. projd. <br />Z: I cat,t rh.t I hav. Bd ihi! !p?h@on &d c thd lh. sbok infodlion b @Erd. I igc to @eply eith .ll city ed Couly <br />r.larinS ro buildi.S coah.tioi. ed ho.by alrhort r.pra,hriv6 ofthis Cny.rd Couty to 6ta lpon dr. <br />>-o2\ <br />el A G t9.t4 -t Pc F,< ,r& <br />G,/azy' a <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 />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Rough <br />Ceilings (T-Bar Rough) <br />Meter Release 7/b/06 (/*?tar <br />Rough <br />Service Meter <br />eQ <br />ELECTRICAL.INSPECTOR RECORD <br />Word\wp51\Forms\Permit. -lnspection Permit 03.31 06 <br />Sub-Panels <br />FINAL <br />Notes, Remarks, Etc. <br />L-,lo'i Ad&6. _