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ELEGTRICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS <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 <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 Metef //,' <br />FINAL i//UL/ )4?L /<1ffq0-/ <br />(Notes, RerhErks Etc. <br />OWNER BUILDER DELCARAlION <br />I hd.by amrm undd p.nalry olp.rjury rhd I m dcmpl fi.m rh. Conrr.cloE l,ic€e ll* lor lht lollo*ing nlsn (54.7011.5 <br />BusinBs md Proldsion Code): Any Cily or County Nhich r.qur6 a pdnir lo .o6tod, ahs. imProvc &rnolish or tp6n ey <br />slrudurc. prior ro ils is$ancq ilso r.qun6 lhc applicor for such p.flnir lo 61. a siln.d statndl th.t hc rF shc b licms.d p@ul <br />ro lh. provirio.s ol rh. Contracrois Li.cns.d t w {Chaprs 9. Commencins s'llh srrion 7000 oa Dnhion 1 oflh. ItuinB md <br />lrolstuns Cod€)orlhat he o. sh€ is €xempr lh6c{io'n &d rhl basis aor tl. all.!.d.rmFioo AnyviolalionofSedion 70:r1.5 byany <br />aptli.anrr.rap.mnsubjdsth..ptlicanrto.civilp.iahyoanolmorelhmfilchund,cddollas($500). <br />l. a o\ ncr olrhe roFny. or n, .frplorB wilh $ar6 a rh.i $le cornp€nsalion. will do the work dd lh. sltudm ii not <br />inrodcl or orn d lor el. lsd 70,14, Busin$ md PmtBioB Codc Ine Conlraclois l-iccN Li* do6 nol tpply b an oNnB ol <br />th. p.lp€ny who hrilds or improv6lh@n. dd rvho do6 such \s* hins.ll or h.6.lf o.lh oush his or h.r oNr €mployc6. <br />proride{ rh.r such nnlmvffits e frn idod.n or oll6.n for slc If. ho\'-.s, rhc building or impFvoEn is $ld *ithin on ]a <br />ol ronplctiotr rh. o,d auilds will have thc htrdm ofp.oviu fid h. or slE lil not trild or ior'ov. dt l,$pdr lot fi. purTrr of <br />I. sosncrofthe,Iopcny. n crclusircly conlra.lins rvilh licenwd coilr.d.'s to .omtrud drc pNjar (S<.7044, BNd* <br />ad l\rksnn Codc, Th.Conta.lor's Liccns. trs do6 nor altlr ro an osn( otp,opely Nho builds or nnprovd ihdon. <br />ond who conrrrcrs lor such proj(ls Nirh a Conrmcro(s) li.mse{t pu^u rtorbecont.doasLi.cnscL,s). <br />I am cxempl undd S(tion Il &l( ,nrrhisrruli <br />D.r. or.cr: <br />woRKERsiaomPENsATtoN <br />DICIdEAIPN <br />I hdcby amm undd paalty oi p€rjury onc ollhc tollo$ios dalaalioA: <br />lhi!€dd{illmainrah0CenificateofCo6oltoSela-lnsurcforrvo.t6iconrd3alion.arrovidedforbySelionlT00oflh. <br />LaUtr Code, for nr pdfonnanc. o f rh. \rod( for *hi.h thc pdmir i is!€d <br />In.reand$illmainrainsorlm compcns.tion insu.ancc, as r€quircd by S(rion 1700 oarh. bb.r codc, for th€ psfomancc ot <br />rhe \orl aor shicn rhir p€mil is issu.d My vork$ onrposalion nsuran.. .sE Md poli.y dunbs d. <br />ty rhal in rhc psi6man.. oarhc $orl( nr shirhrhis pmrn is isstr.d. I shall not flploy any pedon in any mmnd <br />; s ro b..omc subjd ro lhc \ o.km' conptralion la\rs o I Caliromia. ed alm rhd if I should taomc sobjel lo rh. <br />worlrl compasarionprovbionsofs.cltrn1700orrltIaborCode,lshall.iodhwnhconlplyrilhrho*pro sions.. <br />WARNINC: Failue ro s,e worlds co,npo$rion corr.8€ is unlarvful. and shnll subjd d dnplotG ro dimin.l po.ftts and <br />6n.s up kJ on. hundrdl rhousand dollG l$l )), in addirion ro rhc co$ of c.mpc6dion, <br />io.:1076 ofrlELa6orCode. i cr6t and <br />Dre!l&!l]!]! <br />I h(cby amrn und.r poalty o f p.rjurr rh,t I m li.ms.n undd povision oiChrpl <br />ol the lrusinsifld Proisions Codc. udnryliccNc is in tuU rorcc aid dlTdr <br />tonnrocins *nh Scclo. 7000) of Divinrn 1 <br />L1t)t3202o <br />I hocbt amnn md.. IEnahyof p€rjurylhal h6c is a coNnulion lodrB ar lorlhe !6lomM.e ofrhc *ork lor ehich lhis p6mit is <br />isu.d (se 1097. cir. c.) <br />I cdifr rhar rhe l€deral rcAulilions qdin-! absros rcmoral ae not apphcahl. kr lhis pojc.r <br />icartunad $.r.rld r,rahJ\e inlomari.. is(I atre io comrly qilh all Ciryand ( ounly <br />.onsiudion. dd hmqr an 6dlali!6 o llnis Ciry d Coum, tr 6rd upon th. <br />4-?..-. -*-d.//)t AkZLtar? <br />,7ozo <br />Communications Cable <br />"^,.0t 1'f'zrLp <br />(o 3 tz- <br />"",'ol l4 <br /> IIIICANLDEC].AAAIIOI <br />I H,, alfm u6d$poalltoapdjuryooc oithe fouoRin8 declMtions <br />D.molirion Pfmirs-Asb6los Norificarion F.dfr I R.gllalion! (Tnl. 40. Pan6) <br />_Re{uircd ljltd of No1ifi cdio.