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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE tD/stG.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 />Communications Cable <br />Building <br />Bonding / Groundi / UFER <br />Transformers <br />Torqui <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Ro u9h <br />Ceili s (T-Bar Rough) <br />Rou h <br />Service Meter <br />FINAL <br />Notes, Remarks, Etc. <br />OMa-Buildd Dccladoi <br />I hcrcby amm und.r p.ndty oapsju.y dar I m *@!'1lm lllc ConEacloE Liccnsc Lau for rh. followingBor (!c701t.5Bsincst <br />ed Prol6ioi Codd Any Cig or County vhich rcquiB r Fmn ro conntud, ah.r. impolc. dcholtn or rQ.t sy shcturc. rid ro iB <br />issudcc, ako EqunB rhc applicdt fd such pmn !o filc ! sign.d n.to.nt rh.t h. or shc i3li.cns.d pu6u&r to th. provilioi of th. <br />Controcior's Li.dr..l La* (Chapra 9, Coan.nci.g wnh S.ction 7000 of Division 3 ol fi. Buiindr Md ProfBsioB Cod.) or that hc d <br />sh. is.r.mF rh.r.from M<lllic bBh fdlh. allcSc! cxmpiion.Any violati@ ofS.dio.7011.5 by &y eplic t lor . pcdk subje$ rh. <br />applicsr to a.ivil pd.lty ofnor Mc d& fivc hun&.d dollss (tJ00). <br />_1, a ownd of lh. Fop.rty, d ny mploy.6 *i$ wagB a thct sol. compss.rion, will do lh. eo* &d d. smd@ is nor inmdcd <br />or oda.d rd srl. ( S* 70,14, Buins ud Prcfeion. Co{r.: ft. ConE@tor,i Lic.tu. Lnu doq nd .9p,y ro e ownd oi lhc prop.ny <br />who builds or ioprovd $.@n, dd eho dH ruch wdk hiN.lf or hdclfordrcuBh ht o, hcr Nn cmployas. prov'ddd ln.trlch <br />ihproycmqll rc not intdd.d or ofi.r..l iq !a1.. ll ho*.rcr. lhc building d imprcvm.nt ir sold wifiih onc ylu ot @hpt.ri@. $. <br />Ovr.FBuild.rwill h!v. th. burd.r of provi.E thal hc drhc nol build tr impmv. aq $. purpGc oi!al.). <br />_1, a o*nd of $. prolEny, d dclBivcty conE&tins vnn lictucd conn cro6 to consnacl th. p@j.ct ( S@. 7044, Buind ud <br />Prof6rion Codcr lhc Conr&toi! Li@ns. Le do.s nor .pply to d ow.!r of propcny who buildr or improvs lho@ . tud who <br />cor'acrs ao' such pojds enn a Coirr-&lo(, likos.d puEumr ro 6. Cont@roas Li6s. Lls ) <br />_l m .,.mpt nnda S.crion _,B. & P.C fo $is r.son <br />WORKXRS COMPENSATIOII Df, CLARATION <br />I hd.by amo unda pco.lry of psjury onc of fi. followii8 d.cl@io,5 <br />_l hav. ad will maint.in a Ccnificst ofCorsqr to S.lf,lnsurc for woit6' @mpcnsalio, s pmvid.d for by S.ctio 3?oo ofrtc <br />Labor Codq for lh! p!.fmdcc of $c wor| for which tn. p.mn k i$u.d <br />_l havc ddvill mrintlh utrt@ .mP..i.don iMufue, s rcquird ty Seri@ lToo oflhc Lsbor Cod., td tn. pdfmuc. of$. <br />work fd which lhi! p@il ii i!su.d. My work6' @hp.nFtion iEuma Fi6 Md policl numbq el <br />b. @mpl.Ed if ih. ,etuit h ror onc htndr.d ddl8 1t I 00) o, lB, <br />wo.k for which rhir p.mn is i$u.d,I shall <br />16Bof Califomir, ud.grc. rhat il <br />(h. Labor Cod., I shall, fonnqth <br />CF work6'.omp.nsation covcras. <br />doll6 (1100,00o),in addlon lo d2das6 s providrd for lhc Setion 10?6 ol <br />rh. hbor Codc, inl.r6t dd auom.yt f.6 <br />LlCENsrD cONTRACTORS DECLARATIOT_ <br />I hcrcby alfim undd p.n.lty ofFrl!ry lnat I m lic.nrd undrprcvisi@ ofCh.fla 9 (chm na with S.dion 7000) ol <br />!h. Businss ad Prof6sios Cod., md m, liccns. h in rull forc. Md.ir.cr <br />orpciury $d rh@ is a consrlca oflic wsk lor *hich lhis p.mit it <br />309?, Civ C) <br />APPLICANT'S DECI-ARAAION <br />Dmolilid P.mir5-Asb.$6 Notificalioi Fcdd.l R.8!l!lioi5 G c 40. Pan 6) <br />_ R.qdrd L.nd of Notific.rlo <br />rocomply vitt all Ciry ed County <br />abov. m.ntion.d prcp.n, for inrpetim <br />2 <br />Under Slab / Floor <br />Meter Release <br />tsxPl RED <br />Fh.U -I IUE <br />SAI\rc A-43 i <br />r-f -T------