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ELECTRICAL{NSPECTOR RECORD
<br />APPROVALS DATE tD/stG.COMMENTS O*M'Aoikk Dcclorion
<br />I h6!b, .ffm 6.ls pqdry ofpajlry rll.r I e d6Pl fm lh. Cdtldor' Licc.ro t* aor $c follo*in8 r6d (re.7031.5 BEh@
<br />&d Prcfarlio cod.)
<br />^ny
<br />Ciry d Coury slich rcquiB . F,nit lo 6Bt!.1 dld, inrrcvE, danolith { rcllir rny etrucrucr piior io itt
<br />i3r@c., .!o Equic rh. .rdi r fG rud FBil io fil. r riF.d.t tar6r ttd h. d 3h. i! li@d pl6wt !o tb. lrolirids of tic
<br />Conturor't Li@rd Le (Ct.prd 9, Com@in8 wilh Scdio ?0Oo of Divilio 3 ol rn BuJ.4 ud Pof6ri@ Cod.) or thlt hc or
<br />rhc h d6pt lhmam ad lh. h{ir fq ti. !I.!Gd q.mplin .any viouion of S.crin ?03 l-5 ty My .ppli@l fd . P.mn tubi&E 0i.
<br />lppllcr ro ! civir F.lt, of r.r ,!@ l,'D IiE tu&Gd &llB (1500).
<br />_1, s lm.r of $. FoFny, d ny ddoya qih s!96 e dEir role cdpcsatio, ,ill d! lh. *ot ed th. !trr&l@ h not iit .&d
<br />d otra.d fa .J. ( Se 7o.4, Bqr.s ed rofaid Cod? ft. CdEIld'. U@sG Liv dc no. appl, to u Md of dE prlFy
<br />who tuikh d imprDu 6d6, sd *lto dos luch ro* hrm.lf d nadf 6 dlq8n lli! d ha dn mploy6. Fovid.d lh. ,uch
<br />imFdmdtt & rct i,r6d.d d oftcd fd.rl. If, hw.w, rh. b{ildjng d inp@.lMl it sold within @ )r{ of c@rlaiqt d'c
<br />oma-Buil.Lr *ill lErc lh. bdd, of loving thil h. d tlt. nol huild d ior.oE f- $c purpc. of.dc)-
<br />_1, s ffi of th. FoFry, h qclEisly @nldira {irh li6a.d 6E .td L M.l'a.t tlt. p.oj.d ( S4. 70411, Burine$ 6d
<br />?ofcdo Cod.: th. Cdlrldor'r Licd. Le .106 nor .pply ro r omd ol Foraty rh. blildr a i,'p.oc dr.@n , ud eho
<br />6r&i. fd t!.b Dni6E rid! . Cotrdd(r) li.4!d pq@t to th. cdtEla'' Li6!. rr.)
<br />! e !rdp( uda Sdrion
<br />WORKEtrS COMIENSATIOI{ DECLARATION
<br />I hab, fim urda Fdry of Fjury d. of lh. folldins <L.ldiidl
<br />I t.w ud will milnin . Csrifior. of Cdlst !o S.tllosE fc wrlcB' wipcrrtior a r.ovid.d f6 br S..lid ST00 ofd.
<br />p6f(l'me of LrE w6r fq *ticn $. pomil i! isu.d
<br />,td vill @inllh vqt6l' .dnp6rii6 itl!1jrc,4 Equi!.d hy Sati6 1700 of th. hbo. C.d., rd $c Ffolfur of $c
<br />' .drFBrtio isE{c. ciri6 od policy nunbd e:
<br />/2-3 t-O2-
<br />(Thi! rdjo n..d nor b. .odpl.!.d if rhc Fnit is fo On. hw&.d doll6 {l 100} d lq)
<br />_I diry tll.r in !h. p6ltu of rlE wk fq whici rhi! Fnit it isu.4 I rtdl oor mploy &y FM in xy Ilea s
<br />bae. tubjcd lo tlE *dk6 ' cdrF $ri6 h*! of C.,if6a!, ad,gE th.l if I dlold t@rE rbjet lo rn.vortc!'
<br />codDa!.ti@ porrri@ of S6rio 3700 ot d{ L.hd Cid..
<br />w INING Frilw 1o rer sqt6' cmF trid @vda. it urhvtul, dd shall tubd e ddoF to
<br />6E up lo w h6&!d tholld dolE (t ! oo,mq.in ldditi@ lo t! @t or qnF !.rid. dtll.td a
<br />ttc L!D.r Cod., inr.rlr ed tlE*rt f.€.
<br />LICEN$ED CONf RACTORS DECLARATION
<br />I h@by !fiim udd Fdty of pajury lh[ I m Ii6rd a&r Fovijd of Cnlpl6 9 wth S*lion ?000) ofDvision 3 of
<br />th. Buind sd Prcfeid C.dG, 6d my li@sc is in tull foe ad
<br />7
<br />I h6!b .f6nn un.l6 Fdty of Fi'r, dtil dE ir .
<br />iG!.d (Se !09?, Civ. c.)
<br />6. F.fo!rM@ of 6. mrt fn whid lhir p@ir ii
<br />AIPLICANT'! DECLAN AION
<br />D.molnd Pmne^3b€tc No.ifcadd F.d.6l Rcsul.tid (Tid. 40, Pln 6)
<br />q.rdi.8 6b6ld tlmvd e nor .rrlieblc !o thir Fojdt
<br />infm![6 ii @@r. I !€re to mply vi[' .ll Cir, qd C@nry
<br />o.di@6 5d SEr. b$ Elstin8 lutnqirc Eprlhr.ljv4 of tlis CiV dd County io ora up6 dE
<br />&oE h6tid.d F.9cny fd
<br />fr,(out
<br />4-t?-oz-
<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 />Bonding / Grounding / UFER
<br />Transformers 'l
<br />Torquing I
<br />Sub-Panels b 4zJ;>-nf/- -
<br />Air Conditioners >t-t
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)alpalo>@tw ^h4-\Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)<116lo>-761'a ,LA))
<br />Meter Release
<br />Rough
<br />Service Meter
<br />FINAL sleoln>7l,JzL 7tL\L46/)
<br />Notes, Remarks, Etc.tl
<br />A)
<br />Communications Cable
<br />_4
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