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ELECTRICAL-INSPECTOR RECOHD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUTI,DER DELC IATION
<br />I hcrcb, ,tfirm undcr pcmlry ,n Frjury Ihar I tun crcinfl lmm rhe Conlractor' Liccn* ljw fo. rb. t,uuwing reao. (s*c 70ll 5
<br />Businc$ md Prcf.ssion Codc): Any Cily or County shtfi requncs ! Finir k .6n{rru.t. nlr.r. imProvc. dcnnlish or NNn .ny
<br />srrucrurc, prio,ro irs h\uancc. olso Equids rhcrppliclnr ror s.chlrrmir ro nbasiSncd n,kftnl thalhcor shc il licci{d pununl
<br />b lhc pmrilions oi dE Cont!.xn s Li.cnsd tiw lchapt.r 9. Commcncins wirh Sccri{'n 7OO0 or Divnion -1 oI llr Businc$ trnd
<br />Pmfc$nns c{dc) or thar trorshc isexcmpr lficrcfronandlhc ba\n f(trrhcallcgcdtrcnfln,n. nyviol ionofsNli,nT0ll5l,yony
<br />amlic,nr for ! I'cmn slbjNt rhc ,ptlicanr t, , .ivil Fnalry or nor 'm( rhan fivc hundrcd dollas I $500r.
<br />l,.s owmr of rhc tmpcny, or nrycmpk,yecs wirhw0scsaslheirn,lcco.f€nsarion. silldo rhc *olk nthcNu-.-rurcismr
<br />inrcn.Ld or o,IcE.l fitr elc (5<.7044- Bu\incs d ft{,Icsaion1 C.d. Thc Conra.lols Licctrrc Law docs nor lmly b ar .wncr .i
<br />rhc p,!p.ny sho build! or iq)rows rhcMn, nnd who des sEh wo hn.sclforhcr{lrorrhioughhhorhnowncmlloyccs.
<br />,'rov idcd rhar such impmvcnrnn m tur i cnddl or olIcKl ftr sk ,l h,wcvd, itE huildiry nr impmvcnEnr i\ v,ld *irhin om )au
<br />of con{,lction. rlr O*rcr BuiU.r will haE thc hdcn of pmvi"-q lhlr lE or sh. did B t ild o. inlfnJR thc pmFny fo! ltE puq,$ oa
<br />l,.sowrcr orihc pml'cny. anrcxclusivclyconlmcrins wirn liccoscd co.rrack,^ b coniru.r rh. t'rulccr 1scc.7044. Businu\\
<br />and P!trli:shnCodc: Thc Coikacttr\ Li..nsc Law doc\ nor nptly k, r owncrolprot^-nywhob!ildso,tnn(ntrrhcrcotr.
<br />and who co mcb lor such pm]ccls with r Conrftcr(trG) liccnscd pusuDnr t,rh.co ra.ktr\ Lic.nsc La*)
<br />I rn cxcnpl und$ S(l
<br />][of,trE8S:1:OMt[NIi rQX
<br />DFCr dR,l rl0N
<br />I hcrchyrllnmundcr pcn!lryolE-rjuryorcotlhc loLl{,win8 dcclarrri{'ns:
<br />-l
<br />h0vc old *ill Ni.rain 0 CcnlkaE ol Conenr t, Scltlnsurc rin sorkdr' conD.ns,rion. .s providcd ntr i,y Ssrn,n .1700 of rhc
<br />t bor Cnlc. lor rhc pc.lormEc of ltc work for whi.h rhe ll(mjr is nsucd
<br />I hnvc rtrJ willmai'nrin work.rf c.nrtrn\rri( i0{rrn.c, 11 rcqutcdhySalifl:l7lX)o,rl[lrborC.dc,ntrrh.PcrloirrEnccol
<br />rtu work lnr *hich rhn It,nrir 's
<br />i\sul. My wo*crs'.o lncDsriidr ir\mNc crtricr mi rni.y ntmhcr ft:
<br />L L T,,To
<br />oo ol I
<br />_lcc iit rhrr in rhc pcrfo.nbkc of rh. *ork fd whkh rhis ,r nir ir h\ucd.I.n!llnor cmlloyliy t o.inlnytnmncr
<br />{, s tri h(.om subjccl lo lhc wortcs' compcn\lr ion laws ol Colirorni!. rnd icN rhd il l \lniuld tEconE suhjcc o rh.
<br />wortcs comFnsrtion tmvnions ofSccrion.lT0Oofrhc Lltnr Codc.lrhflll. rodhwirh cunDly wirh rhos provhions
<br />WARNING: FnihE t, {.ure worrcs onFns,rbn svcr,8c is unhwlul. and shall sohJ.c( an.mPl,rrrr ki ni,ni.!l Dcmllts lod
<br />civil nncs up ro one hondrd rhousanrl dollas (tlm.ooo), in addition lo lh€ cosl .fconFn.srio.. drm8.s 0s Pt vided for lhc
<br />\mrii,n I07hol rh. tihr aol. tr crc{ andanonEy.lccs
<br />6,1u /r I
<br />Llt Dllu-!aNrx]l(l!11!
<br />DECI.AB{UA!
<br />I hcrcby rliirm undcr p.n0hy,f pcryury thlr I om liansd undc. F.visidn orchaplcr 9 (smrrcncin8 wilh Scri,n 7(xx)).fDilisbn l
<br />.r lhc Busiftsr alld Pmftssiorr Codc. an my ,icens is in tull forcc aDd cll€r
<br />z4 60?zt 6
<br />o"", 6/ztltg s,4;4-+91 894.y *4r
<br />IONiIBIJETNIIjNDINC.AGENCI
<br />I hcrcby trltflnundcr lEnrlty oa t'crjury rhlr lhsc h " conslruclion lciding rlcn.y lor rhc nctfotrrurcc orrhc *ork ror whi.h rhn Frn r h
<br />i\skd (Sc. 1097, Civ C.)
<br />AIILICANfITECL/8A.II0N
<br />Ihcr{,yafinnundfi pctr0hyolpcrjuryoneollhclollo*in8dcchr ions:
<br />Dcnbliiidr P.rnirs Ashesos Noriication Fldcr0l Rc8ul0lio.s lTillc.t0. P0n6)
<br />Rcquircd t ltcr of Noriltotbn
<br />I c.nilirhar rhc rcd$al rcSulalions rc8lnlin8 a$.so\ rcmvll c nor rnrlicahk rorhi\ pioj.{r.
<br />l.cnly rh.r I hrvc rerl th s lpDlicari('n ml {nrc rlulhc oki! itrr,mhioi t..r(t. I l'8rN lo romrly $irh trllCirynnd Couiry
<br />odiMtrccs aM srorc rjss rcl ilrsrobuiHn'-!c.nsrrucrion-andhc.chytrurturi2cr.prc*nrdnc!inrhisCilylndG'!trrykrc .rtrti rrt
<br />rholc nrn(nnrd nn,tcny for $sttr.lnnr
<br />,\Dplicnnl or,\[rnl Si,rnnlun cq4', s J46o
<br />e&,Ls
<br />Site-Work
<br />Underground
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Life Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueino
<br />Sub-Panels
<br />Air Condilioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Solfit Rouoh
<br />Ceilings (T-Bar Rouoh)
<br />l\4eter Release
<br />Rough
<br />Service lVleter
<br />FINAL l/ 11/rv .-rl\6b
<br />Notes, Remarks, Etc
<br />Pole Bases
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