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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE lD/srG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Sions (monument)
<br />Life Satety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Groundinq / UFER
<br />Transformers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rouoh
<br />Ceilinos (T-Bar Rouoh)
<br />Meter Release
<br />Rouqh
<br />Service lVleter tn tv /iA,n.1
<br />FINAL fiq /
<br />Note e S E
<br />Lt."Lll 6- NAT br.Ar
<br />OIlNER AUILDER DI]LCARATION
<br />I hcrctr, uriirm undcr pcnohy oi pcrjury lho' I oD crc'nB no'n nrc CoffackF Ltrtrs L3$ ror rhc foln,$ins rcxy,n (sLr?0ll5
<br />Busincs trlxi Prolcs ,n Cslc) Any Cir, or Counry {hi.h rcqlirc\ r If,rnlir n, ..n{rucr, rlrcr, nnptuvc, d.nDl$h or r.nar ,try
<br />sru.ror., |tri(rt, ih ii\uamc, also i.quirc\ rh.q,Ilkn iu \!chljcnnirrJ lllca rign.d slatcmnr rhar tEorshc is licc.scd tusu t
<br />ro rhc pmvtions ofltr Conlmcror's l-iccnscd ttrv (Choptcr 9. Comrcncnrs wilh Sccrion 7O0O ot Division:l oi rh. Busilc$ and
<br />Porcsrion\Codc)o,rhar tf, or shc is€rerur rhcrcfronand lhc basis fu rhc nllcsd cr.mrrn,n Anyvn ari{,norscri.nT0ll5byrny
<br />itpli.nnr f(r a p.mrir suhjdrs the dmli.nm ro a .ivil Fnilry of nor frrc rhm fivc lrndrcd dours ($500).
<br />-1,
<br />!s o*ncr of rhc pnrEdy, or my employss airh wa8c\ a\ lhcn sb Fn{an\ar ioo. will do rhc lqk ail rh. iturm ir mr
<br />inr.fth, oroficnd for slc (Se.7O4.l. Busincs d Pmfc\sionr Codcr Thc C.nkF&tr\ La.ns trw docs not Errrl,to anosmr of
<br />rhc pml*ny w,n hilds or irym6 lh.pn. uxl wh. des un wn( him\clf or herclf or rhmlBh ht or tcr D*n .nfloyc.r.
<br />ptulidd rh.r such inobrm s m m( inrc icn oi offcrn fo, {h. lf. tsw.r( rh. britlin8 or irproBmnr i. sld whhin om )rr
<br />o,qlllllbli.n.rhcOwmrBuil:lswillhawrhcturdcno{Droliryrh.rhcor\hcdid,rlaiBorinrmwdctqdyfoitr!uq.{or
<br />I.r\owicrolrh.pn|xny,r'ncrclu\ivclycontr.rin8rnhli.cn\cJconh.nn\hcondtu.rrhcpn'j..r(Sd.704l.Auencs
<br />0rkl Prr&sh. Codc: Thc Conlrlcror's Liccnsc Lrw docs nor.rply h atr owncr ofI'loncny who
<br />rnJ sho c.nrn '\ ltir \uclrrujrcr\*ilhr Co.ercdl \ r li.ctrscd ptrr\urnrbrhrc(rirrc
<br />DESdAAIIAN
<br />I hcrchylltnmu sp.nrllyoipcrjuryomofthctullowinsJc.lnmtn,ns
<br />Ih.vcddvillmainr.itr.C.niicarcofConrcnlroscl nsur. r(r rukcra .omFnsd ion, us pmlidcd lor by Seclion l7(r oi rhc
<br />titxrr codc, fitr rh. pdrfnrncc of rhc *ork i(r which rh. pcrmir i\ hsucd
<br />_l havc axl{illnui rin *orkcr' conDcnsarion insuraNc, as rcquircd $y Sccrn,n :r7ul ol rhc Labor codc. fff rhc
<br />'ltrroIr11mc
<br />or
<br />rhc *ork tur khich rhi\Frmil is ksu.d MtworlcF .omnens!,i,nr insuflrc Qrio dd F,li.! nu'nh.r ml
<br />l!.niftrhrr i rh. t^-^rformn( (,f rhcwo lnr tr h(h rhn Frrnir ir r\trc . I drll Dor cmdoy rtry
<br />$ rs
<br />'o
<br />hrsm subjd to thc rcrtcts'onrlEtrsition llws of Cllifomia. md rsN lhol if I shoold
<br />workds mnlr..elion lrovisions of Scclio, l',0o of rhc t2bor Codc, I shall. fonh*irh coq)l
<br />WARNIN(;: I:!ilurc lo c.urc $orlc^ .r'npcn\rrim c.vcrrsd is unh$rul. rnd \
<br />*: a'i'i'r
<br />-'*r:l1l l:l](x).lxxr). i| rddr
<br />DECI,ASAIION
<br />I hcrchy uffirm hder ocnulty ol Frj!ry rhar I an liensd unacr pDrision olChsfl( 9 ((,hnrncinS wirh Scdion 7000) oioivision 3
<br />o, lhc susincsr Md Profe$ions Codc. and mr liccnsc is nr full n,R und clltcl
<br />b FAV
<br />COXIIf,IJI]rcII.BDIIGAGEICI
<br />I hcEhy afim undcr tEnalty of frjury 'Ia'
<br />rhft n a coisrocrion lcndins ascfty for rtr FrrolrMcc of th. work for whth thn lrmil k
<br />issred (s(.109?. civ c.).
<br />AIzuCAILII&CLAAAIION
<br />I hdrny fllmr und.r p.nrtry of p.rrury orc of rhc foliowine ddlr t,ns
<br />D!nmlirion Pcrnrirr A\hcsl6s Norificrri(,. Fcdcr!l Rcstlalt,ns flirlc,(), Pan6)
<br />_R.quircd Irncr of Norili.utn,n
<br />-l
<br />ccnilylhd lhc rcncrd rquhtions resudin8 ashcslos rc
<br />l..nifyrhrr lhrvc ru rhi\ m I ure lo conDly qnh all Cnyrnd Counly
<br />o'dtrr .cs rtrd sorc l-rw! rcldiriBro huiknrg ncs.flhn Citynnd Counrr ro
<br />rb(rvc tr{nti(nrJ pn)pc'ry l(r i',!If,cr
<br />.\pDlnMt o. ,rletrr Si*nHltrr.
<br />YN
<br />il'ilrgsEt
<br />NZ
<br />l- r
<br />tr ., . A,urr r
<br />tt
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