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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE tD/stG.COMMENTS Owna-B!ild.r Ddl@tion <br />I hq.by aftm urd.r Frry of p.rjury lnd I m cx.mF fom 6. C@ra.t6 LicG. tjw for llt. followi.S r.ao. (c 7031 5 B6ins <br />dd Prcfdsion Codc) Any Ciry or Counly which EquiB . p.mil ro @.str!.t, .ll.r, improv., d.molish d r.p.ir 6y shcte. !.ior !o ils <br />issu c., also Equncs th. applic l for such p.milto filc a siBncd slalmmr lhal h. or shc i! licdscd pu.suet to $c provisions oa $c <br />C@t *tor's Lic45.d trw (Cnafld 9, Commoci.e wi$ Sccion 7000 oi Division 3 of$. Buin6s dd Prof6iions Cod.) or lllal h. I <br />shc is d6p1 th@ftoh ad dic baL fs $c allcg.d .x prion Any violarion of S.dion 703 I 5 by dy applicer fd a p.sn ,ubj.d! rh. <br />applic l lo a civil pcnahy of not mm lhu fiv€ hun.lrcd .lollm (1500) <br />_I, a own.r of lnc Fopdy, d my 6doy€ wirn wag6 a rhci, rclc @mFG.rio. *ill do fic wort dd ih. si^cr@ is not int6d.d <br />d off.rd ld sal. ( Sa ?044, BEi,6 dd Pml6io.s Cod.: Th. Contra.tor'. Li.tu. Law dB noi arply io 0{6 of tnc prop.ny <br />who build5 or imFovd tn@m, dwhodc ruch eo.[ hia.lad h6.lf or thrcu8h his o. ha oM mploy.6. proeid.d thd s!€h <br />imprcvdai5 4 .or inrad.d or ofid.d a6 s.lc If, ho*crcr, tl. buildang o inpJovcmdt is sold *idin onc yd of cmpl.non. th. <br />Owod-Builda *ill hrvc th. bud.n ol provinB $.r h. or sh. nol build or inpovc for l.l. purpc. of sde) <br />_1, a ow"dof $. FDp.nr, m.rclciv.ly otutine w licas.d @.hct@ to @Nlruct th. projcd ( S@ 704a, B6in6e d.l <br />lrcfdiM Codc ft ContB.rqt Li@. l:* dc .or lrply ro u oMa of prcpsry sho buildi a impror6 $o@n , dd who <br />corrers for sch projets with 5 corero(, licaen puBusr ro rh. cmEeror', Li@. l:w.) <br />_l m cxdpr undd S.cdon _,8 & P C fd thir lqm <br />lyoaxE8llor4ttrNt fIoN_DECLABAIIo! <br />I hdcby amm und.r pcnalty of pcrjury on. of lhc aollowim d(!d.tions: <br />I h6vc dd willn.inlajn a C.niflcarc olCoB6r to S.lllnsurc for uortdr.mpa$atid, a p.ovidcd fd by Srclio 3?00 of$c <br />l-lbor Codc, fs tfic p.rfdu€c of th. *o ( for which th. Fmir is isu.d <br />_l havc 4d will mainlain vdc6 compqNarion iBUEcq N rcqut.d by S.cdo. 3?00 of rh. L.bor Cod., foi th. pdfmuc. of rlE <br />wdt for *hich lhis p6mil h hsu.d My wo*6' omFm.tion iBum.. trid ed policy.umbd a. <br />b.@.3ubj"d ro d'c worr6 ' conr.nsaio. las otcalilmi4 &d asc $.r <br />conP.nsation Provhions oi 700 ofth. L.bor Cod.. I thall, aonhwnh <br />o <br />WARNING Failur. to r.curc worL6 c6p.nedo covcrasc is unlrwful, <br />fin6 up to onc hu"&.d inoBdd dolla (l I m,ooo),ii addirion ro rhc c6t of <br />thc Lahd Cod., inl€l od dtom.y s fc6. <br />on, d.mas6 a provid.d for rh. <br />LICENSI]D CONTRACTORS DI]CLAR'\TION <br />I hcr.by imm unds paalty of p.rury tnal I m li.Bs.d udr provision oa Ch+6 9 ( <br />thc Busin6s ad Prof6sio.s Cod., dd my liccnscis in fullforc. &d.ficcl <br />z/-//-o <br />I h.rcby altm und.r p.nalty of pdjury thal the is a conslrucrio, l.nding ae.n.y ftr <br />issucd (s4. 1097, civ c) <br />p.rfmm.. of th. w6k t6 which lhh p.mn is <br />APPLICAI{T'S DECLANATION <br />D.molirio PcmiE Asbsld Notificdio Fcda, R€sul.liss (Tirl.40, P3rr 6) <br />R.quiEd Lcfts of Norifi c.dd <br />I @nrtd <br />1,,n* <br />thc fed.ral EAularions rcaddinA ab.stos <br />I havc rc.d rhis ipplication da sbt tocmply sirh allcny Md Couniy <br />ordind6 ud Stalc Iiw! r.htins to building of rhis City dd county ro or.. upon 0E <br />abovc m.nrion.d propcny for insp.clion pu a-Goi <br />Underground <br />Pole Bases <br />Llght Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Life Safety /Low Voltage <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <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 />lvleter Release <br />EXPIR ED <br />Rough <br />Service Meter FEB I 20t9 <br />FINAL <br />Notes, Remarks, Etc. <br />Site-Work <br />Under Slab / Floor <br />Dai. Own.r: <br />n.cd nol bc compl.tcd iflh. pmil is for Onc hlndr.d doll6 1ll00l or 16, <br />lh.t in th. p.rfomdcc of fi. *tr* fd