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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE tD/sto.COMMENTS OWNER AUILDER DELCARATION
<br />I hdcby amm uid* p6nlt, of pdjnry lhd I m.x.mpt ttrrn r Conrado* Li.en.. lr\r aor th. follo{ing r@n (Se 70ll5
<br />Busines and Prolsion Cod.): Any Cily or Counly $hi.h r.qut6 a p€rnil lo .lnslrucl. all6, inprore, d.molish or rcPan e,
<br />shdue. prio! ro ns issoecc, slso rcqun6 lh. applicet for soch ,.mnl lo ,]lc a sistcd nain. rhai h. or sh. is licB.d puuuer
<br />ro rh. previ.ions oa rh. Ctnlr.crors Lic.nscd Lss (cMOd 9. CommcRins wiih Sdiotr 7000 oI rrivision :r oalh. Bciod d
<br />ProfNio.s Code) or thot h€ or shc is cxcmpr lhdcnoh and rh€ basis lo. thc allcs.{t .rornio.. Any liolalion of Sdioi 70115 ty any
<br />applic&t ror r pdir subjers rh. applicmr ro r civil pmhyof nor mor€ rhM five hu.dr.n dollds ($5C{)
<br />l.N ovn6 ofth. pmp€rly, or my € ploy6 sirh { as6 s rh.ir $le comp.M ion, s iu do th. "ork d thc slrucluc s nor
<br />imadrJ or olr6.d aor el. (56 7014. BBins Md PiofsioB Cod.: Th. aonlracloi s Lic.N liN do6 not apgly tu M ow.r of
<br />rh. I'lp6ty lho boilds or inlrov6 thd@q dd who dc lsh M* hm.lf or h6elao.lircush his or hr otrr.nployG,
<br />prolidel $ar !o.h ihrovadls de no! hldd.d ff or6€d lor slc. lf. hostvr, thc hrilding or imp,oBndt is eld wilhr orc )@
<br />ofconl9kiio.. rh. OMr Buil&r *ill hav. rh. htrda ofrioli.g th, h. or dE did not boild or imprev€ lh€ fr$Fry aor th. pupos of
<br />-1.
<br />6 orrs olrh. proldy, !n .xclusiv.ly contoding lvnh lic.ns.d conrdos ro consrucl lhe pmjd {s< 70,14. Blains
<br />and l\llision Codc: Thc Conrr.crors l.iccnsc l,aw do6 nol applr ro do*n6 olprop.ny $ho builds o! improv6lh.r@n,
<br />dd sno conrads ror slch pojdtsrilh. Conta.lo(, ltens.d pu6ldrl to rh€ Contrcrofs l-icd* tjtr)
<br />_l ar ex€opr undd S(rio
<br />uqB6Ets_caMr!N$I!9!
<br />DECIAEAITS!
<br />I hqcby aflirm unds Fulty of pojury onc offic foltou ing dftldllioa:
<br />-l
<br />i.v. and will oai.rain ! Cfiifi.atc oaco.mr ro S.lf-|Btrrc for wortcE @mp.tutlion, a Foviddl a6r by Sdtion 1700 o f th.
<br />Labor Cod€. for rhc Ffo.r@.. olfi. wort for *hi.t rh. pdnn b isu.d.
<br />I hav. and will mainrain work.B codp.dalion iNurdcc, 6 r.quircd by s<tion 1700 of lh. rjbor Cod.. for lhc pqfomdc. ol
<br />thc mrt for ethh thjs p.mn is isu.d. My work6' onpaBaion iBuec. mid $d policy numbd rc:
<br />"*., ' SioIb+urnC
<br />'alt+o5to1
<br />-l
<br />cdrifo ihar in r& Faom&c. oafi. wort aor whi.h lhis p.mn is issu€d. I shall nol mploy any pdso. i. doy mmn.r
<br />s 6lo b€.onE subjat lo th. sort6 compqsation lfls ofcalifomid. dd as@ rhar ifl snoud b..omc subjel to lhc
<br />worldl compeNlion qovisioN ofS..lion 1700oflhc Lab.r Cod..l shall,lonh$nh comply wnh lho$prcyisio6.
<br />WARNINC: Failur.lo Bue sork6 .o,np6.lion .ov@!c G unlavlul. d shall subj<l u drloy6 ro aiminal Fnahi6 d
<br />cilil li.es up ro onc hu&.d rhoMd dollm ($100.000). i..ddnion Io lhc co, olcodp.Balion, dda!6 6 pro\id.d for lh.
<br />Ssrion 10?6 oIlhc LaborCode i q6tedatromy'stB
<br />o.,", tl -2t" - (B o ^Juclitsfl(l)fr&icrqBl)rclt&u&!
<br />I hs€by amnn und6 p.n lty ol pdjury rhar I m li.abdt dd6 lnrvision orchaptr 9 (co,nmocins wilh Scclb. 70ul) ol Division 3
<br />ot th. Busins &d Prof6sio6 Code. ald my lice@ i! in rull for. ed.lTet
<br />e €oo89
<br />tb]
<br />coxslauquoNj ElDrtc-ac[lcl
<br />I h*by armn und6 pcoalry of pdjury lhd th@ is . 6osruc1bn lcrdine a8@cy for lh. pdtollrucc of th. work tut whi.h
<br />'hn
<br />p6,nn i
<br />issuql (Se. 1097. Ci!. C.).
<br />AIIUCANLDECIAAAIIA!
<br />I hnibr.rnn undd pdalty oapsjury onc oflhe fouoNin8 d(laalions:
<br />Dcnolirion PmirsAsbcros Norific bn F.d.ral R.eularions (Tnle ,10, P.n6l
<br />Reqtrtrcd LcrrcrotNotlicdrii
<br />I cdiay rhd tb. a.dEol r.sulations Essdins sbdos rsnoval uc nol afplicablc lo lhir prcj..l
<br />Va.,n, *", , ** .*o tro applicarion o.d llarc rhn rhc .boE intomarion ie cond. I aBE ro comply wnh all cny sd couoty
<br />odinan B and St.tc L.ws Elalins to buildins onsruclion, d b6eby aurhoriz. rcFMiarive oarhis Cily ud Codty ro 6i6 utb. lhe
<br />trlF!enr (i(!rd flof.n\ li)r insp(ri.n tu,r)ses
<br />^pDrir,trr
<br />or aa r si*n'(rr.: )A ]^ V e"-^-l
<br />Pr.ninrnx,t(rrn ):E "Tr,r. V n nJ
<br />.{*>J *" tl:26.1?
<br />Ncau:rEr./
<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 />Torqueing
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />Ivleler Release
<br />Rough duq1n rl,t?2..L,22
<br />Service Meter tt
<br />FINAL oltn )Vt til,?-Xvt p,oe)
<br />Notes, Remarks, Etc f 11 r a1
<br />ro -oi-t4
<br />*", (t-AG l€ c,u..,-[ E- \ts4.f
<br />L.ndd s Ad&s
<br />Sub-Panels
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