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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Founlains
<br />Signs (monument)
<br />Life Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bond i n g (cround i ng-)/ U FER //-/3-fr /Lct::rJelzo, Z,
<br />lranstormers
<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 Rouqh
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough
<br />Service Meter //'/r-/1 /1 7)t ,r./r.z> 22.
<br />FINAL //-/ r- /c tz At qrJe 1n3 Z'7
<br />Notes, Remarks, Etc
<br />OWNER BUII,DER DALCAR,lTloN
<br />I hqcby amrm undr poalry ol pdjlry rhal I m .rcmfl nom rh. (-ontracloE l,icos. l,* lor lh. folloNiry rc&. (S( 701] I 1
<br />BosinBs 6Bl Proleion Codc) Any City or Counly rhich r.qut6 B Fnir lo .odtud, alld. imtmva d6nolkh or EPat an,
<br />slructurc. prior to irs $udcc, aLo rcquiB rh. applicd for !u.h pdmn ro fi|. a sign d slalmal thal hc or $c is licoa.d pu6uail
<br />to rh. Foli.ioE oaLh. Conlr.clors Licmscd Lav (Ch!pl6 9. Commencins *ilh S<rion 7000 oaDivision I oflh. Businss ed
<br />Pmf.sions Codc) or th.r fic or sh. is cx.mpl th@Fom and lhc irs6 lor rh. all.r.d .rmBion. Any violalion of Sdl ion 701 I t by ny
<br />applicanr ior a p.rm subj.cls lhc applicd lo acivilp6!hyofnor nrorcrhan liv. nundrcd dollaG ($500)
<br />L s osnd olrh. pmFny. or my mplorG with wasB s lncn eb comrEnelio.. wiu d1 rh. sork and rhc iodrc is nol
<br />inrod.d or o rs.d for sl. (56 7(}ll4. Busi.s md Profdrions cod. Th. co.lraclors l-icce Lla do6 rot pply lo m oMr of
<br />rh. pmFry sho buil& or nngrov6lh@n. dd wh. do6 sch {!rl hims€li or h6.la or lhouch hi .r hd otrn .mployG,
<br />provid.d rhal ruch h{rov@.,n. e nor imdd.d or ofid.n tu d. Ir, h.sd6. $. hrildin3 or imFovmHl is $B wnhin onc )d
<br />ofcomplelion. rh. ownd BuildE will haE lhc hdo olFovins lhd hc or sh. did tur hrild or i,rFo!. fi. poFry ao! th. DUt o$ oa
<br />l. 6o\rnqofrh€ In'rEny, ,n ciclusi(lyconta.lin! *irh licms.d oradoB to coNrrucl th. Foj..l (S(. 7044- B6in*
<br />a.d Piifsio. Cod.: Th.Contracro.s Lic.nsc l-avdo6rol applyto o{nq orprdpdrysho buildsor improv6rhdNn.
<br />6nd trho conrads for $ch projds *nh a contadorls) licdsol ru6ua io rh. Contraclor's l,icmc lrtrJ
<br />I dn uren,pr und{ Scctfi
<br />",,., t/0*c.o'-(Q
<br />DICIAIAIIA!
<br />I hd.6y ,fiirm undd pd.lly of pcjury onc oflh. follo{ins d(lmri.ns
<br />I nrvc ed will @rrain a C.dificar. o I Const b S.lalcur. aor sor[6 compdstion. 6 Fovid.d foi b, scrio. ]700 oflh.
<br />Labor Cod.. for thc pdfotmcc of th. soll lor stich lhc pqfril it isudi
<br />I hav. and will nrinrai. workds compcns.rion insurancc. as r.qut.d bl. Sstrcn3700orr& I$.r Cod., aor rh. p.rfomec. oa
<br />rh. sork lor$hichrht pdmir is L$d Myworksi conDosrion iBurancecms and p.licy nunbf &.
<br />Ceid:
<br />Iccnifylhatinlh.FrlonDanccoalh.\o lor\hichlhispa,nn is i.su.d.I shallf,oi dnployany p€6on ir lny mens
<br />s .i ro b.{on subjd ro rh. \.rtft .omp.nslion laqs of Califomia. and aa@ thal ir I should hd:om. lobldr to rh.
<br />$0116' compostion pmuisioN of S..lion I700 ollhc libor Codc. I shall. ronh\ h (o,npl, sirh rlF* provisions..
<br />WARNINC Faillre ro Gurc sork6 (hp.tu,rion ..vdrs. Ls unla*ful. .nd sh.ll subje.l an mplo)s lo sinintl !i6.lri: &d
<br />civrl fincs up ro onc hun&.d rhoumd dollds ($100.000 ion. duas6 a provil.d loi rhc
<br />s*ri.n :1076 !f rhr Lal codi im.d dd .lbfty s
<br />D!gdAAIIO!
<br />I h@by amn" undr Fmliy of lqjury thd t d licqstd udd Fovbnrn ol(n,pi6 9 (ommocrs wnh SEI ion 701)0) of Divtsion l
<br />of th. B6in6r dd Prcf*ioN Cod.. md my lkft. is in tull fo,cc erd cfiel.
<br />cal[rauqlloNrxrollc_dcllg
<br />I ha.5, arm u.dd p6,llyoIp6ju.yIhai lhqc is a coNtruclion lddins agdcy a.r rhc F lommc€ ofihcwo* for $hi.hlh6 p6on 6
<br />issucd(s< 1097, ( ir C )
<br />aEtuG.NfDEC!4&tIlO!
<br />I hcdr, afinn und6 pdalty of pe.lury onc oflhc follo$Tg ddld.rions
<br />In6olirio. PanriB-Asbdros Noiificarion I,cd6ol Rcrulations ( I irl€ t0. Pan6)
<br />R.qun.d Ldr* oaNolifi .arior
<br />I cdity rhal lhe fcdEol r€sulalions rcard'n! 6h6ros rsnovalar. not applicibl. r. this pmicr
<br />lc6rilyrhar I harerqdrhisapplicahonedslatctharrh.ahrv.tumrlion iscond. I aala to complyNirh dll Ciry and cou.r,
<br />I odinarcBMdstir. l,\s'€hrinrro hu urhori2. reoMrariv6 of this Cilyud Counry ro dd urrn th.
<br />abo!e metrlilrned pNpd, lor inspd .,,,,"/o-\o -tt,,\ppli(rnr or ,\qetrl Signrltrre !\^O
<br />.a &P( forrhisreaotr Qvr.\"*
<br />""., v/0-3o -17
<br />)t4
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