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ELECTRICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG. <br />Site-Work <br />Underground <br />:: <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 />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Rouoh <br />Ceilings (T-Bar Rouoh) <br />Meter Release <br />Rough <br />Service Meter I <br />FINAL //u/tt - <br />Notes, Remarks, Etc Ttv <br />OWNER BUILDER DELCARA''ION <br />I hoeby amnn undd poahy of pojury 0'ar I o q€,nfl lio.n lhc Conlraclo6 Lic.nse Llw for thc aollowitrg r6on (Sd 701 L5 <br />BGin6s dd Proleio. Codc): A.y Ciry or Cosly stich r.qut6 a p6nil ro connru.r, alrd, inprov., d.moliih or r.p.ir ey <br />smdu., pnor ro ils i.sue.e, al$ rcqui.6 th€ alplicd lor surh Fmn Io 6L a sitn.d sraroal rhd hc or !h. b licas.<l pcu;r <br />Io rhc provisioB ol th. Conlracloie Lic.ned Liw (ch.g6 9, Comnminr wnh Sdion 7000 ol Division I olthc Ausin* ed <br />Prer.sio6 Codc) or rhar h. or sh. n €xdpl thg.fion aod th. bsh for Ih. all.e.d ddption. an, violarionolsdion 70ll 5 by rny <br />applicanl for a p.mil subjats lh. applicml to acililp.balryoamr,nor.rhe fivc hu.dr.d dollaB($s00) <br />l. a ownd ofth. prcpqrr. or my .mploya wnh wasd a t.i sL conp..elion. will do tne work ed fic rnde b nol <br />i.btLd or ofid.d aor sr. (sa 7044. Bcin* sd PioreioB Code Th. ( o.li.cioi! Li..a t w (t)6 ml @ply lo M oMd of <br />rh.pDpoly who huil& o, idpo6 rh6@i. ed vho do6 such @it hituelt or hddaor rhmqh his or h.. oM.mploy.6. <br />provid.d thr! sxch ioF.vamlsEior int@ded orofir.d fo.el€ l[ h.wos. dE hiEing or inprovml t eld whhin on. y@ <br />oacompldiotr lh€ OM6 BuiBd will hsw tnc l,trdo ofFwi,g lhd nc or sbc did rcl b'rild or improw lh€ popory for $€ p{qrs ol <br />l. aowndoathcrroroly, m.rclusiv.lycontadin8 snh hcos.d co.ta.'om <br />'o <br />codrucl rhe prord {Sa. 70,1.1. BsmN <br />d ltofCsin Codc: 'I hc contacloi s Liccnsc ljs do6 not appl_\, ro e orn6 of prop€ny who buil<k or ioprova rhdon. <br />and sho coiracts for slch poj.cts {ih . CornDclo(s) lic€ded puGudr ro rhc CDnln.tols Li<as. t,w) <br />-l <br />ner6fl undo S<tion-. A &PC for rhis r€don <br />Drle: Osner: <br />.E946lAs.CqUtENrArA! <br />oEct alallo! <br />I h6ct'y amrm und6 pEalry of Fj!ry on. oalh. followine ddl@l io6: <br />_l h6ve and will <br />'nainrli. a Cdrincatc olcoNot ro Sclt lauE for {ork.G onrpdelion. s provid.d aor by salion 1700 ol the <br />l-abor Co<le. for thc Flonnancc of thc wrl fo! ahich Ihe pqmh is issucd. <br />I hrv. a.d $ill mibtain vo*eo conp.mrion iBurmc., a requiEd by sation 1700 ol lb. kbor Codc. fo, ln€ rEloruncc ol <br />is isu.d My workdr comp€.elion insurnnce cad.r ud policy nuDb€r uc: <br />Ir-l-\? <br />-l <br />c€niry lh.l i! lhc p.rfoMc. ollhc vork for Nhich lhir p€.nn is Gu.d, I shall.ot @ploy aoy Fson in any mm.d <br />so aro b.comc slbjd u thc wrlds comt@rion lawsoacalilomia. dd rgd rhar iiI should bqo'n. subjd lolh. <br />M.[6' .onpdsrion polbioG ofse.rion ]700 of rh. Ilbor Cod., I slhll. fodh$ nh snrply wilh thok pmvisions.. <br />WARNINC Failurc to su€ work6 co'.p.carion cowa. is unh$rul sd sh,ll subjd d 6nphr.r to simiml Fuhid Md <br />.ivil lincs up lo onc hund,ed lhouend dollaB ($100.1)u0). arlditon I cos ol conlpaerion. denaB6 s povid.d aor lh. <br />Sdion 3076 ollhe t bor Code inler6l ed itor*y r <br />DECIASAI,ON <br />I hd€by arlro undd perhy ol pdjury lh,l I m liccnsj und6 pDlision orchaprd 9 (coB'nacins wnh selio. ?0({) of Division l <br />ol thc Buin6 ed PrcfsioN Codc. d'd my licN G in full forc. ud .1161. <br />,",", ( t <br />h g ct0 LLI b <qo<q6 <br />(e<l-t oo ,>askms <br />llll-fll3.lrtlA.L-Ililllt]1irlljr (I <br />I h@b, allm @dd Firlry o apajury rhrt thd. i5 r odtuction L.dir8 a!fty for th. pdfoll]rmc of lh. woi. lor Ei'ich lhh p6an ii <br />asu.d (sd 1097. ci!. c.). <br />AITLI(AtrTDICIAAAUO! <br />I lEi$,afmundd p<alr, ofptrju., on.oarh. aollovinB ddlratio i <br />Donolirion Pmil'Asbetos Norificarion Fcdaal R.sularions (TnL 40, Pan6) <br />-R.qut <br />d lnrd olNolifi carior <br />-l <br />cdiry thal d. f.ddsl r.&htioB r.86din8 ah-ios rmov,l r. not rpplicablc to Ihis pmj6t. <br /><Y**,ry tnu, , *'" * ,nO spplicario. &d $.rc rhai rhe abov. infomario! is coftd I !sr6 ro comtly snh au cny and counly <br />ordinanc6 d sIal€ Lls Elarirs to buildins connruclion. a'd h6€by aurbort. rF6dr.riv6 o aui Ciry and Colnly lo 6t6 upon th. <br />atnle nrsrioncd prcpeny lor <br />( <br />,,,," ll-2Q-tt <br />E1ZI <br />COMMENTS <br />,.,",\\-?q{8 <br />.-"*..,3pn <br />L.ndei. Ad&*: _ <br />IT <br />I <br />I <br />Ii-