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ELECTRICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUIT,DAR DELCANATION <br />I h6€by aMm u.do !,.Mlly oi psjury lhlr ! d d.'npr frou rhc Codraclo6' I-icme tiw lot lhc fouo*ing r@n (S( 70115 <br />Busin6s a.d Profsion Codc): Aoy Cily or Counr, Rhich r€qnns a pdmt ro coffiruc1, all6, iry)rolc, donolish or reD€n et <br />sroclli.. prior ro ils is@cc, aLso r.qoir6 lhe opplic.nt ior such p.n.il ro file a siBned sl.londr rh.l hc or she b li.m.d pcudr <br />ro rh. previsioG oa rh. Contr.lors Lic€nsal law (Chaprd 9, ('onrmcncinS *nh seiion ,000 ol Division I ollhc Usincs dd <br />Poacsrions codc) or thar h€ or shc is cr.npr th6.liom and lhc bcb lor rhe all.8.d eronption 4., viol.tiotr olscclio.703l 5 bv erv <br />applicanr ior a Fmil rubjdls thc applicsl ro a ciril p@ll, or not morc lhu 6vc hund.€d dollus (1500) <br />l. as ownr ol rhe FoFny. or my €'nployd rvilh va!6 6 rheir sl€ cornpdsd ion. qill do tnc {o* ud th. srudu! is nor <br />inrdd.d or olte.d for el. iS6.70.14. Butins dd ProfKions Cod.: Th. Conttcro.s Lic.N ljs do6 nor spPlv lo o o*nd oa <br />the pmtdy who builds or impr.v6 r@n. od vho do6 such *!lt nins€ll or n6ell or lnrouEh his or hd oM cmptor.6. <br />p'.vide{ Iha( such improrsMt trc trol inldd.d orofiirdi lor elt lf. ho!v6-s.lh. buildinE or nnprorcDot is$ld \ithinon }q <br />of colnplcl hn. I hc O$nd aoiils sil ha!.lh€ h!!o oa8ovins d h.orshcdid nor t ild or improw tt€,rDpsrv lor th. ptrpo*of <br />l. 6 oq .d oarh. u oD€ny. m ex.lusiv.ly co.tadi.s $ ith liccmcd co.rrtrou lo coNtNcl lhc Foj<l (ss 7044. ABmB <br />md Poftssan Cod.: I he conk crois l,iccnsc l-as d.6 nor apply to ano\or orl,opdt sho builds or iiprors $6Nn. <br />and \rho conhcls lor such ptuje* *nh a conlmcro(, licosc{r pBU.d ro lhc Conlra..ors LicG. ljw). <br />I tun.x.nrpl unds Salion <br />"",", /Z- /2-/ 7 """", <br />DIiCIAAAII9! <br />I h6.by.mrn $dd paally of tqjury o.. of rhe lollorvins declralioB, <br />I hav. ..d will ,nrinrain 3 C6lificar. of CoMt ro S.lf-lBur. for \ork6 .omrdation.6 p.ovidcd lor bySelion 1700 ofthc <br />L{bor Codc, aor thc pafommcc of ih€ Mrk lor Nhich rh. Penn is isucd <br />I have .fld sill m.inhin *orkqs' conpsarion iGurancc. 6 rcquncd by Sd ion I700 oi lhc tibor Codc. aor the p-r"_'""' "rnr wort aor \rhicfi lnis p6nil is isued. My NorkdJ conpmsdrtun insurd.. ..de! sd policy nunbs d€ <br />t cqlifylhar in lh€ pdfoflnanceofrh. vork for which rhis lEnnn is issr.n. I shallnot dnplov.nv psson i. nnt manncr <br />$ 6 b hdonE $bjrt ro lhe sori6 .om!6er ion la\$ ot Calilodia. d +eihol ilI should h€.o,n. bjEl lolh. <br />*o&6s.omprerioflprevtsnrmofsdlionlTL{olthcl,aborCodc.lshnll.forth\iltsmply\virhrhosPmvisiod <br />lvAR lNC failurc ro surc sorkds compcNrion co\6age is !trla*ttr1. ud shall $6j{t m Gnpk]F lo lnminal pdrhiG and <br />ro.nc hundrcd rhousand doll6s ($100.0( ). in addnio. ro lh€ son of.6arp.roation, <br />S(tion 10?6 ottheL!hr.codc, i er6l and alkr/-tz--t <br />DECIA8dIIO! <br />I h@by arm !.da p.i.lry of p€rju.y lnll I d lic.tu d undd provision ofch.ptd 9 (enmocins \ilh S..rio. ?000) oi Davisio! l <br />of the Busin* dd PrefNioN Codq dd nry licftc is in fuMorcc Md cfiEl. <br />Licecc Numlf <br />CONSTNUCTION LENDINC AGF{CY <br />I t*b, altm u.ld Fn lry o t pdjury thal thqc i! s coNlrucliox ldding aeocy for th. p6fomd.. oflfic wort lor shich rti Fnh b <br />isru.d(S€ 1097, Civ. C.). <br />L.ndE s Nrm.' <br />- <br />AIELrcANLDIC!.JIEAITQN <br />I hort y airm !.d6 parhy of pgjury o.c oalh. aollo$ ing ddlesl ions: <br />Dcmolilion Pmns.Arbdos Notitrcalion F€dml R.8llarioni (Tnb 40. Pan6) <br />- <br />Requaed Ldrd ofNoilicltion <br />lcdlialrharrhcfcderaL'.rula{ionsrcBsdnrsasbesl$renofalarcnor.rplic.blck,lhit!'oI(r <br />I c€niayrhar I hav.r6d(his.pplicalionmdnalerharrh.alDv. infon.arion s codd la*relo.orplvsilhall(ilvandCountv <br />ordinancd lnd srar. L!N* rclaiins io boildins con(tucrion. J hcrebyauthoriT. rqrNsrarivs ofthis Cilvdd Countvto old upo.lh€ <br />abov. molioncd p,orEny lor icp..rion purros6. <br /> pplicrnl or /\psl SiXnllure:,^,"/2- /2-/ 7l\14 €S <br />Site-Work <br />Underground <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Siqns (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 />Torqueinq <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilinqs (Hard & Soffit Rouqh <br />Ceilinqs (T-Bar Rouqh) <br />Meter Release <br />Rouqh <br />Service Meter ,- - lt -2,D€'7?(4 <br />FINAL 2-{. -24 It-.€ la) <br />Notes, Remarks, Etc.