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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWNOR BUILDER DET,CARATION <br />I hd.b) a mrm unda poalr) o t pnrury lhar , h ci empr Eom lh. Conti.lo( Lic.ns. lrw fo, $c following r.@n lsep 70.t 1 5 <br />Busih6s ard Profsion Codc) Anr Ci) or Counry *hich r.q!ir6 a pdnn lo connod, rnd, improk, &inolish or r€par dy <br />nrudue rim ro i's sumcc, .lso rcqurB rhc applicot for such Fmit to file a sisncd slalmol lhat h. or sic h liclNcd pucuarl <br />'o <br />rhc prorisioN uf rh. Conlrrcloir Lic.n*d L.v (Cnrg6 9, Comnmciq w n Sarion 7000 of Divisiofl I orrh. Busind ed <br />ProI6ions Cod.) rrhlr hcorshc is rr.mpr lhoelron and the tq!6lor rhe.llcgal cxmprion AnyyiolalionofSe.tionT0ll.5btey <br />applta for.p.flnr subJdtsrh. applrcmrro a.n,ln.nrlr) ofnor,nc(rhe fi\. hd.dr.d doll6 I ttuo) <br />Wl4'*^""""rn*n").o,m]emplo)6whua86srhctrelcc"mrornn.\,lrd.rh.sorlr.drhcstudr6mr <br />Inrad.d.ioriq.dlorel.lS(T0,r4.BNrn6sddltof6sio6Codcl1leCont.ctocsLi..N.kwdo6no(rpplytoeownsof <br />rh. pmDdy *ho bdil& nr nn!ro\6 rh@n. a(t sts &s wh {o fiims.lt or h€sellor rhrouAh his or hd oM cmploy6, <br />rrnvd.d rharsu(h mpmrods m nor mrsd€d n o lTd.d lor s.l€. la ho\Bo, lh€ tuildios or nqrovddt G $U wnhid on.,a <br />orrohpldiotr 'h.r\16 B{ib6 willha\. Ln hmk6 of prcvi.g thn h. or sh. dil mr build or imFov. th€ Ftrpc1y for llE purFFof <br />I. a oMc oarh. Fopcry. m .rcllsiv.ly .otuadin8 wnh lic@cn .onr.doB ro .rErtucr rh. pmj6r (S(. ?044. B6io6 <br />ud ltolerion Codc: Thc Conradors Liccnsc Law do6 not apply to own6 olPro!..ry Nho buildr or iilrovd lndon, <br />rnd who.ontradsao.suchpmjec*nhdCo.lr.cto(rltftalptuuMrlorh.Conrracroistic6sLap)le 2l//- 291i """". <br />a- <br />IECIA8AIION <br />I h6cby artrm unda Fnrlry or p€jury o.. ofrh. follo*iq d(L6rioB <br />I havc ed will msinrain e Cd ificat. of Cosdl ro S.lalnsure for erke6' afi,.nsalion, 6 D.ovid.d for by S(l io. I700 oflll. <br />bbor Cod., loi lh. Flome.c of lh. work lor whi.h rh. pdnir is issu.rl <br />I haveand willmoinlainNor[€ri compmsalion insumn.e, s rcquirc{ bySclion 3?00oflh€ l,aborCodc, aor rh. pafomd.. of <br />lhe work for Nhich this p6nil is is€d. My workeru' compesal ion i6ur c.cMi6d poli{ynumbs ec <br />wor*ss' conpeelion pn'vi.iotr of Sdion .t700 oaln. Labor Cod., I shall. aoRhwnh compl, rvilh rhoE provhions. <br />WARNINC: failurc lo suc Norkm compo$ion corsasc is unlarvful. and shall subj(t & drld).t lo dihina] <br />civil fincs up lo onc hun&cd rhoMd doUm ($100,000), in addilion ro rhc of .ompc6arion. danrse a <br />SEliofl 1076 oflh. Labor Code n a6l and allomey s f6 c.. <br />L( t,tNsaD (1)N llra( toR <br />DECI,ASAITOtr <br />I hdeby arEn und6 p6.lty ot Fjury that I m li6s.d u.da !6vision of Chrpl6 9 (omm6cin3 pilh Section 7000) of Divisiot l <br />of rh. B6in6 dd PmfNio6 Cod.. 3rd m, licarc i! i. lull aor.. &t .rdr <br />CANSAUCIJONIENDINCIGENCI <br />I h@byarm undd pdahyofFjuryrh ti@is a codrudi.n Lndin8 18 cy torli€ p€fom c.otlh.vo fot which lhi. dtil is <br />isual (Sc.30e?, civ. cl. <br />A.SILICANLPICIASAIIO! <br />I nd$y atrm rnder pdahy oapajlry on. ollh. following ddldarions: <br />Dmohion Pa6ns-A3b6ros Norilicalion F.d6.l Rcsulalions (lillc 40. Pant) <br />Rquiicd Lard of Noi6..ron <br />-l <br />cErify rhal rhe t nsal rqularions rqsdin3 6b6ros rchofal e no' applic.blc ro rhis ,or<r <br />I cenilirhai lhrrcre.d lhir aplrlic o nudsrarerhatlhcaborcinfonnarionscntrd I agrero romply \rirh all( ir, ind (iunry <br />o.doan.6 and Stale Laws rclalin-! ro buildinB cosrrucrio hscbr.trrhor izc reprBcdariv6 ollfiis City Md Coumyo dre ulon(he <br />above moi ioned popd! fo. iEpcdion <br />/\ppli.rnl or AEenl SiEn{ltrrr <br />Pcrn'ile n{nr(prinll: <br />/1-29-/y <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 />Building <br />Under Slab / Floor <br />Bondin g/Grounding/UFER <br />Transformers <br />Torqueing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Qeilings (Hard & Soffit Rough <br />Ceilings (T-Bar Rough) <br />Meter Release <br />Rough Atqi'q ) <br />Service Meter ( !r <br />I <br />FINAL tE3 t1 [satu&t ,\ <br />Notes, Remarks, Etc <br />Communications Cable <br />l ltq <br />Numb€. Iiptes <br />- <br />rhai in rh. psladancc ollh€ work lor shichthispcmir is issued,l lhallnot @!loy any pde. in aoy,nmd <br />, ", /y'7-7-'c <br />L.nd.r.Ad,n6 <br />- <br />a. <br />c* <br />-T------