|
ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS
<br />_I, a owncr oi tnc prop.ny, or hy mploy€ *i6 waacs s ti.i! sol. compasarion, will do rh. eork ed th. lhcruc is nol inradcd
<br />or off.r.d fd salc ( S.c 7044, Businc$ ed !rcf3sims Cod. Th. Conreror'i Licse. Law des not apply to o os* of lh. uopary
<br />who builds o! improv.s rhqcon, dd who d@s such york hituclf or hcE.lf or throu8h his q hcr oBn mploy..s, provid.d that s!.h
<br />inp.ovo.nt5 d. nor intnd.d or offdcd for salc Ii bow.vd, rh. buildi.B or improwmdt is sold wiinir on. ycu of cohpl.rion, !h.
<br />Own+Buil.Lr will havc lhc burdn oi provine thar h. or sh. not brild or imprcv. lor $. pue6. oi sal.)
<br />_1, a o*n6 ol tn. proFty, m.,.lEiv.ly cotur&titr! wili licm.d cdseros to consmct th. pojer ( S.c, ?04a, Busins mtl
<br />P.of.$ion Corlq Th. CdE&1d's Lic6!. Lae dG not lpply to u owod oa prop.ny who buil& d improrcs d'crcon , &d who
<br />cdEs.ll lor such projet' wnb . conrEd(, Iie.rd pusumt to ln. Cdtr&ror's L;cms. Law )
<br />_l m dmpr undd Sedd _,B & ! C for lni. r.sm
<br />IoBTEBS-COUIENSAIIOT_SESLAaA!A!
<br />I her.by afiim unda pdalty olp.rjury mc of$. followin8 d.cldations
<br />_l hrv. Md *ill mintlin a C.nifidc of CoB. 10 SdHnse fd vorkc6' cnpensadoi, 6 providcd ln by S*tion 3?00 of$.
<br />Laboi Cod., for th. pElol@.. of th. wdl fd which th. Dmn is i$ucd
<br />I hsvc ed will hainllin wor[.6' comp.s.tim insumc.] B Equtcd by S.ciion 3rm of tn. Lib6 Cod., lor $. p.rfomdc. of 6.
<br />wolk aor whi.h rhis p@n is i$u.d My workcB comparado. ins@cc ceir dd policy nunbd e
<br />(Thir s.ction ic.d nor b. cohpl.t d if6. pdnit is for Or. hundr.d dollm {tl00l d les)
<br />_l ccdfy lhal in thc pafofrme of ln. *o
<br />bc@c subj.cl b th. wortd ' c@p.nlation I
<br />for which 6is pcnt b issucd, I shall oot cnploy e, p6on in &y mMn.r so a ro
<br />aws olCaliamia, Dd ag.cc th.t if l lhould
<br />conP.nsatid pbvisions oiS.cion 3700 of thc Labo
<br />to ..curc work6' conp.nsatim covdaS. is Md shall subj.d e.mploycr to siminal p..alii.s dd civil
<br />fitrd up ro m. hu.&.d Ooued dollm (1100,000).in addinoi lo thi co$ of cdp.ilanon, danas.s d provid.d fd 1h. s.crior 3076 or
<br />thc Labo! Codc, irlcrer dd attm.y t f..s
<br />LTCf,NSf,D CONIAACTOf,S DECT.AXATION
<br />I h@by affim bde pdslq oi pqjury lhar I e licd.d ud.r prcvision of Ch+6 9 (commocin8 *ith S.ction 7000) of Division I of
<br />Cod., &doy liccnscn in iull fdc. ed.lfe!?/>"2<
<br />o Z_
<br />I h@by afrm uda Fnalry of p..j!ry $6l rhdc is . cmEuclio lddin8 as.icy fG ln. Frfomuc. of $. wo ( for whth lhi! pmn k
<br />isu.d (s*. 3097, Civ. C.).
<br />AIIUgd!f,f,D&qlAEtrIIAN
<br />Dmoliiio. P.miri-Aib.stos Notifi@ti@ Fcd(al R.gul.lid3 (Tnlc 40, id 6)
<br />_ R.qutcd t nr of Norification
<br />_l ccdiry l11 lhc fcddtl (Suladons lcssdins sb.sts rmovsl r. nor spplicablc ro this proj{t
<br />I ccrtiry ilal I havc r..d this applicarior Md sai. thal lhc abov. i^fomadon i! co,.ci I l!r..(ocomply
<br />ordineccs Md Srarc La*s r.lr,lins to buildins coNdctio., ad r.pr.sdiariv.s of tht City
<br />.!ovc m..rioncd prop..ty
<br />Z>
<br />Site-Work
<br />Underground
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Torquing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rou gh
<br />Ceilin s (T-Bar Rough)
<br />Rough q/26/o>lblL,a ^47)Service Meter
<br />FINAL <1*4 a2 altu "-14/,,'Notes, Remarks, Etc r \L.-
<br />DATE COMMENTS
<br />Pole Bases
<br />Transformers
<br />Meter Release
<br />Ow.6-Build6 D.clda on
<br />t h*by aflim odd p.nalty of pdjury r'ral I m .xdPl fdfi ih. ConEetc' Lic.ns. kw aor thc follo*irg rcdon (scc 701 I 5 Busins
<br />dd Profsion Codc): Any Ciry d Couty which r.quiB a Fmir lo co.sslcr, alGr, ihprovc, dmolish or rcpdr my sruduE, pntr ro n!
<br />&uec., .lso rcquir.s ii. a+plic&r lor such p.mn lo filc & sip.d siar.rndl rhar hc d shc i! lic.nscd puBuer ro rh. provi3io.r oa tn.
<br />Co.n'&lort Li6$d Law (Chaptd 9, Ctuad.8 witt S@do. 7000 of DvtioD 3 of tn. Auir.$ ed Prol'$ioos Cod.) or lh hcor
<br />sh. is d"mpt th.rc{im ed th. b6is fd lh. all.g.d dmption Any violarion ol S.ciion ?03 L5 by dy appli.anl f6 a pmn subj*ts $.
<br />applicel t a civil paalty of nd morc thM fiv. hud!.d dolld (3500)
<br />De Owr
<br />:
<br />[ --T------
<br />I--+-
<br />--_____T_____-
<br />tD/stG.
|