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ELECTRICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS O\I'NER BI]II,NF,R DIiI,('ARA'TION - \ <br />I hd.by amrm rndd D.noliy ot psiury rhar I en crmpl 6o'n rh€ co,xFclou' I-i.m. tiw for th. aolloNins lwn ts( 7()1l .s <br />Busincss and Plofesion Cod.) any Ciry or Coudy *hich requn6 a pmnn to consrrucl. ah6. improvc, d.molGh or rqat !., <br />strudur. prior lo irs i$uM... als. ..qut6 lh. rrpli.d lor such pdri lo filc , sirn d $al6dl rh8l he or sh. i! Iico*d pu6o t <br />ro lhe proGions of lhe Connacloas Licdsed lrw (ChaDrer 9. Con.B.cihr {irn S.clion 7O0O of Division 3 ollhc BBin.s! and <br />Pofsions Cod€l orlhar hc or shc i! dcdpr rhd.frdr dd rhcb6L lor rh. all.e.d eronplion. Any violationoasdion 70115 b!.nr" <br />applicantlorapnnitsubjdsrh.applicanrroocnilpcnahyoln.rmorclhmfirehuadrcddolles(1500). <br />I. r osncr oalh. pop€ny. or m! c,nploys Nil h \ 0s6 6 thcn $E con,por3.rion, rvill d. lhc $ ort md lh€ nnElu€ i5 nol <br />inrmdsl or ofis€d lor elc (56 7044, Busi.6s r.d P(rbsions ( od. Th. Gnradois t.ic4s€ La$ do6 nor @ply ro an o$ner of <br />ll€ !mpd! $no h,ilds or nnprovG lh6 su. .nd wlF do6 strch $* himselfo' hsscllor <br />'htolsh <br />his or hd ow. cmploycB. <br />provid.d rhd such imFov.IMa de .or inrdddl or oftald for eL li ho$ 6 6. rhc hrildin8 or nnprelonfll Ls eld \ nhin on. rw <br />{tcorrlclion. rheO\rns Bu,kkr * hnvc lh. bordm 6fp' orinr that lEor she did noi lnild or impmrc thc pmpory ror rn. purF.* or <br />l. ar .\net .f th. ropdy. tun .xcnsn.t conlracl ins tr nh licdscd contacloE ro ronsrrud rh. Foj.( (sd 704,1- llusins <br />and hlf.ssionCodc:lh.(tnlracnn'sLiEoi.l-a$dosnoripplrroatroLvnsofflop.rly\hobuildsornnpr.vcsrhcren. <br />.nd who.o.rrdsa.rsuc[poj.cc$irha(hntm.k](rlicdsdpursulnriorh.(irnt.dorst-ic.ns.ljs). <br />I an.\.,nfl 0ndlr S(rioa <br />Dit.: ormr: <br />wORKF,R$ atOlnPENSAlloN <br />DES.ASAIIA! <br />I h.r.by ami,n undd pmahyoip€rjury one ollhc lollosiry d(l alions: <br />I hove &d will maintain a Cdia(.te o I ( onsctrt ro s.la- 160r. for workst co,np6srion, al ro\ id.d lor hy Sdion :1700 . rlhc <br />Lbor Codq ror lhc p6()mdc. o f lhc (.tt for \ hi.h rhe pdmir b isued <br />I hav. ,nd \rill 'naint.in soi{cu comp.ns.tbn instrranc..6 r.rttrirc<l br sdrion lTotroiih. tnt'nr Cod..lor the lElofrance of <br />lhc $ork for trnich <br />'iis 'Enn <br />il ir issncd My workds colnposalion insurinc. cdid md policy numbs de: <br />I cnify rh.l in lheD€rfonndtrce orlhc \rork lor \hi!h rhB ptitir is issucd. I shallnot employ any pcson in aiy mann.r <br />gj6roh.ro.$bjRrrorh.\ul6.orrpdrs.rionla"sof(alif.mia.ud4rrh irIshouldh.omev,bjcllothc <br />\o'kos comFnsalion Oo\isions ofS.clion 3700 olrhc l.ahn (ndc,I rhall. tudhwnh.omply { irh lho* prcrnnrn. <br />WARNINC: I€ilurc lo sdure $oilo! co,npd$.rion coreaSe is trnla\(fnl. and shau subjd d ntlor.r ro citrtual pdullie and <br />civil fin.s up io onc h!tuled rhousand JollaB (Sr0o.mo). in addilion lo rhc con or.omP.nsition. d{Mg6 6 ptovid.d for lh. '\.tr' {r I0-6.tirh.l ab^r abde. inro.{ ud ax.m\'s ts <br />LICENSXD (]ONTRACTOR <br />DECIjXAIIO! <br />I h6rby omm und6 Fnahy ofpojury Oal I d ltaE d u.d. Folision of Ch.pl6 I (ommdcins * ih S..liof, 7000) ol Dicisior l! <br />oa th. Blsin6 &d PotBioN Codc. ud nry licds. is in lu ll fotc and erFl <br />AIE!]CATLDESAAA!,IO! <br />I rcq,r1J amnn trnd.r tmallt olpdjur) one of lh.follo$in8 delaralions: <br />D.mol'ri.n Prdirr Asb.sros Norii.arion F.ddal Rcrularions ( rnb 40. Pan6) <br />Rcqutrrd lx(d of Ndrili..tion <br />I colili thal rlE federal rerular&6 rcladnr[ rsh.sbs,ono\alar. nor amlicablc ro thls proj.cl <br />Iceniryrharlh.vcdadthisappli..rionsrdslaierhnlthe.tueinfonnatrcniscorccrl.srcrocomply$ithallCnyandCounly <br />odinan.6 and Srare Lr$s rcl.rinr to boildi.s coBirucrbn. md ncrcby aul horn. r.rr6onaln 6 orrhis cnyed Counlylo dls upon lhe <br />.bo!€ n,.nrioncd poFny tu itupdion purposB <br />,\t'Ili.rtrr , ,\rmr \i,rnnrtrrr <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 />Communications Cable <br />Bu ilding <br />Under Slab / Floor <br />Bonding / Groundinq / UFER <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 Rough <br />Ceilings (T-Bar Rough) <br />NIeter Release <br />i .^ Z--a\ <br />Rough t'[6[tr I \y.44/-0t .qs9/ <br />Service Meter <br />FINAL L-tt-?.D a-l ,l', <br />Notes, Remarks, Etc <br />Transformers <br />l-i.dsc Numbn: _ <br />colirBl]cuo{r[lDlxcSc[Nq <br />I h@by afiid udr pdah, ol lnjurr rhd th6. is a odrudion LdinS rs6cy for lh. pnronnm. of rh. work tot $t'ich this Fnn b <br />issud (S( 1C97, Civ. C.). <br />=