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ELECTRICAL{NSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS Own.FBuild.t D..lEtid <br />I n6cby arfim undcr Fn.lry of pcrjrry thd I n d.mpt fom lh. Co.reroE Li@n!. Law lor rh. aollowin8 r.6on Ge.703l.5 B4in6s <br />a.d Proi6sion Codc): Any Cily or County which EquiB . ,.mil lo construcl, ahdr, improvc, dcmolish oi rcprir ey structuE Fior to it! <br />isuecc, also rcqutE thc sppli€nl fd such pqri to fiI. a sisEd st rcm6t lh.r h. or rhc i! lic.nscd p6udt ro thc provisions of fi. <br />Coilradois Licci$d tiw (Chapi.r 9, ComD.ncing wnh S.dio.70OO ofDivision 3 oflhc Burins ud Prcfosiois Cod.) or th.t hc or <br />shc is cxcmpt th..clrom dd rhc b6is fd rhc allcg.d cx.mpiotr Any violadon ol scclion 703 L 5 by ay +plicmt for . lcmn iubjdrs th. <br />applidtto ! civil Fnllty ol nol norc th& fivc hun&.d.lolla (S500). <br />_I, a om.r of thr prcp.ny, m my dployG wirh qas6 a lhct soL cohpcNalion. will do lh. work ed lhc slluci(c is not intodcd <br />d ofidd fq salc { S.c.7oaa. BsinB qd ProfBsioB Co<h Tnc Cd!-a4or's Lic4.li* doq n6r.rply to& oMnof $c proFny <br />who buildi or ihp.ovcs th.aon, dd who d@s such work hiN.lf or harclf or orou8h hh d hd o*i.nploycB! piovidd $1l slch <br />ihprovddts e ior iilodcd or ono.d fo r.l! If, h@d.r. dc buildir8 d impov.frar ir sold eil1lin onc yd of compl.ron. fi. <br />Ownd-Buildd pill hav. dr bu.da ol prcviq lhd Ic o(hc noi build d ihprovc for dc puQ6c orsalc) <br />_1, 6 ow..r ol dr popcny, m aclcivcly connicing wnh lic.e.d cotrtrdcroG ro coniruct thc pojcd ( Sc. 704a, Bsin6 ud <br />Prof*ion Codc Thc Coir.rcbrt Li..nsc Law do6 iol apply to d o,i6 of Eopery who buil& d imp,ov6 rhcrm , ed who <br />coitrmi! rq ruch pbJ<$ with i Coni.rdo(, liorcd puB@r ro thc coorelofs Liens La* ) <br />_l cxc mpl undc! S.clion _,8 &PC forlhisrq6o, <br />WORKERS COMPf, NSATION DECLARATION <br />I hcrcby aifim under p.nalty ofpcrjury onc oirhc aollowinS d.cld.tions: <br />*lhav. d will h.intiin. C.nificar. ofConiml lo S.lfiElrc for*ork6 comp.ns.don, s provid.d forby Se @3700of$c <br />Labor Codc, for th. p.rfmdc. of th. *dl for which th. p.mn is ksu.d <br />_l hav. od *rll main[in vort6i comp.nsation inturecc,s rcqltcd by Scction ]70OoilhcL.borCod., for rh. p..a(mtucc ot lhc <br />sork iorwhich rhis pmir ii isrucd My *ortcB' cmpcnsadon insuse ceicr ad policy rurbcr ar.: <br />Polic, Numba E:pt6, <br />(This s..!ion n.cd not b. complct.d ifdc pmn is aor Onc hundrcd dollars ltl00) oi l6q <br />An*-,n.,f*. -U.a r",r'. <br />Labor Cod., I shall, fonhwnh <br />dollas (l I 00,000),i. addnion <br />LICENSI'D CONTNACTOi(s DICLAF,\ITON <br />I h.rcby afim und.r pcn!|ry of p.Dury filt I m lic.ns.d uod.. prcvisid of Ctrptd <br />ihc Busincs Md Profsions liccns.is in full lorc. and .ffc.i <br />ofpcrjury rhat thsc h a @n im.nc. of dc wo* f6 *hi.h rhir r.mn is <br />Civ C <br />APPLICANT'S DECL-dN-ATION <br />O.noliioo Pmi6-Arb6l6 Notificidoi t.dc6l R.SulBrios (Tirl. {0, P.n 6) <br />_ R.quiEd Lcncr otNolifqtid <br />Y9,*$c f.dd.l r.sulations r.sddms sb6rd <br />I h.v. rra.l this applic6tion dd narc to comply wirh.llCiiy md <br />ordinacG ud Stat. La*i r?lxing robuildine <br />abov. n.ntioncd prcp..ty for inrpatio, <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 / Grounding / UFER <br />Transformers <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 Rough <br />Ceilings (T-Bar Rough) <br />Meter Release E)IPIRED <br />Rough <br />Service Meter qatutc ti 43,290,55(, 667 <br />FINAL <br />Notes, Remarks, Etc. <br />rE ,- r {'ur, <br />= <br />I