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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWN6R BUILDER DET,CARAIION <br />I h@t!y amnn !.de Fn lry oaFjury thd I m q.mpl ftonr lnc Coitaclo6 Li.@ tn* for thc followi,S rmn 6e.?011.5 <br />BusinN md Prcfsio. Cod.) Any City or Counly rvhrh rcqui,6 a panil lo .onsltucl, altE, improvo dsmlish or 4on oy <br />srrcruc. pnor to ns isudcc. abo r.qonB rh. alplicel aor such Fmit lo fil. a sisn d slol@ol rhtl h. or sh. n [c6..d pGu l <br />ro rh. FovisioN olrhe Contrftrois Lic.n$d Law (ClE rd 9. Comocin8 wiih Serioo 7000 ofDivision I ol$c BusiflB and <br />Prof€sions Codc) or thar nc or shc * .xc6pl thEftor md tlE bcis aor thc ollcs.d cxmplioi. an, liolali.n of Sdion ?01 I 5 by any <br />oppltrdr lorspon subldsrh. app[cant lo tctr'lpcnalr) olnor no..rh fiv. hundrcd doll6 (tt00) <br />fz4r, * o** orrt p-rmr. or my cmnlo)6 Mrh tras6 6 lho. elc conpaE tion, sll do th. *ork ud lhc stnsluE s mt <br />ioldi.d or orded lor slc (Sa 7014. Bui.6s od PrcaBioG cod.: Tn. codtuois Lic€c l,u do6 .or ,pPly <br />'o <br />d omd oa <br />ihcprDp.n, who buil& or nnpB6lheor d who do6 st.h s* hims.lf or hcelf or lircu8h his or hd om mplorcB. <br />provided rhar su.h improvffils m mt intod.d or oft6.d for eL. I[ how*6. th. bildi.S or imFovml is 5ld wilhin on. ,w <br />oicompl.riotr. rhe Otrrs Duildd will ha!. lh6 b(rd6 olprovine rhd he or shc did not build o. ir+mve lh. prcpely tur thc pupo* ol <br />- <br />t, s osq olthc prcp6|y, e .x.lusivcly conr.din8 wilt licffid co raclos to consltu.l lhc proj<l <br />and PNfeion Code: Thc Co r&toi s Li.6r. kw do6 <br />and who contEcls lor such pmjEts wirh a Conl6cro( <br />.prly lo own€r otprop.ny{ho builds o <br />p06ua ro <br />'hc('onradois <br />P' <br />D.&CI.ABAIIO! <br />I ncrcby arm mdd pcnaly ol pdjury on. oathc follovins d(ldal io6 <br />I har€ and will @intad a Cdificlt. of Cohsr b S.la'INurc for work6 codFsarion, 6 Fovid.d tor by S4lion 1700 oflnc <br />lzbor Code, lor rh. pdfomm.e oathe ml{ for vhich thc panil is isucd <br />InN.mdwillmai ain wort6 co,npcNtion iNuran.., s Gqtncd b, s(lion 1700 oflh€ bborCodc. aorlh. pofolr@.cof <br />$. work lor * hich lhis p6mil is Gu.d My uort6 conp@srion iNumce cei6 dd policy nunbd &. <br />l'olicyNumb6: Lipt6: <br />I cdit) th.l in lhe pdlormanccorlhc worlt ror which lhis pdnir is issu€d, I shall not @ploy ey r.6on in my hend <br />e N ro b.:o6c aubjet lo rh. wortd' co,npdstion laqs ofcalifomia. md as@ that ia l should baome <br />worl6s' conlpdsrion provisioN of Sedion 3700 of lhc Laboi Cod.. I shall, fonhNilh comply wilh thoe <br />$ARNINC: railurc to sue No m'ompcNtion it unlawlul. drl shall strblEl an <br />ion ro rlf cos ofcomp..sat <br />t ?2U n <br />DECIdAAUA! <br />t h@by 6fam und6 leiahy oa pdjory thal I &n li@s.d undq p6vnion ofcha$e 9 (comming wilt Selior ?000) oa Division l <br />of lh. Bcirs sd PotNioc Code, md sy licce is in tull lor.c ed cft6r. <br />(OISIBICUOijI,INI)IIGrICENCI <br />I h@by afimundd p.nalryofpojoryOal tha. iso co.st clbn Icnding asdcy lor th.,rfoljM.. oa$. Mrt for whkh this Fnit b <br />iss!.d (Se 309?, Civ. C.). <br />artl.lcaNfDrc!4nallQ! <br />I hdby silnn uids Fnal'y oi pdjury on. of lhc following dclaalions: <br />DcnDlirion Pdmils-Asb6tos Noxlicalion Fedoal R.lularions (Tirl. 40, Pan6) <br />R.nutcd l.(!Y o I Norin$tiof, <br />f,u^o I agra ro conrply wilh allCiiyand Counry <br />aborc morioned prolEny fr <br />"(0 ZO <br />Site-Work <br />Underqround <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Life Safety /Low Voltage <br />Fire A|arm / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bonding / Grounding / 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 />Meter Release <br />Rough <br />Service [,4eter !,. r -1 <br />FINAL I ?t wu .t)7ilrtxrl 4tru <br />Notes, Remark!, Eto I <br />a trv'YlttR I <br />( <br />5' <br />Rev 0n-07-2015 <br />Transformers <br />'JrL! rbZi'\ilt ,\.)rlrlilv \V( <br />', {VUV rYl \+t(1 <br />r M oeTDl mJy'sE,rcn_-- <br />,"". allt (l zo l-t) ""*, <br />o.dinancs and Slat€ l,ass rclahry to <br />Appli.inl or.\Eenr Signirure <br />I