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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE COMMENTS
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lile Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildanq
<br />Under Slab / Floor
<br />Bonding / Groundinq / UFER
<br />Transformers
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilinqs (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rough)
<br />Ivleter Release
<br />Rouqh
<br />Service lrileter 1
<br />FINAL bfLA\
<br />Notes, Remarks, Etc.
<br />OWNEI( BUII,I}f, R DELCARATION
<br />I hcrcby rom undcr p.mxy of pcrjury lhd I m cxcnpr torr rh. q)nraclos Liccns L{w lbr rhc follouins rm{. lsc.70:ll 5
<br />Business and Profc$ion Codcl: A.y City or Counry which rcqutc\ r p€lnri ro coo\ro.r, !lrr. inDovc. rhrmlish or mFltr .ny
<br />srtu turc. prbr ro its nsuutrce- !l$ rcqutn rhc q,plics for such ocmn ro 6lc, sigftd i cmht rhar lEor sh. h li.cnscd lummt
<br />ro rh. povisnnr ol rh. Conr.ctols Liccnsd Lnw (Ch0prcr 9, Com,ncmin8 *ith Sc€rion lu)o ol Divnn,n .l oa rhc Busincs ud
<br />Pmicssions Codc) or rhar lf, or shc is crcmtllhcrcrrcm lnd rhc lusis lor rhc alhscn ci€qrion Any vid.lio.olS.dhn70ll.5 bya.y
<br />applicrnr lor ! Il(rmir subjccc rhc applico.r ro acilitpcnalryo{not morcrh nr hundrcd dollds (S5cn)
<br />L as owftr olrhe po!.ny. or mycmlloyccs wnh waScs.s lhcn $[ compcNlln,tr. Nill do ltr wo.*,nd rhc nturm is mr
<br />n'lcdct or olttrcd lor elc (Se 71N.1. Arsir$ snd Prorc$ion\ Codc Thc Conta.roi s l-i...s. ti* docs nor ,I)ply lo an ownc. of
<br />rh. pbJrny sho builds or in{,mB rhc6n, and who dei rn.h wlk hnnsclf o. h.Mlf or rhrcugfi hh or hcr o*n eq:hyccs-
<br />F)vidcd ihar suct inpru@ s@rcridc .i orou.En for slc lihowcvcirrrt iEing or irptuvcrd h eld wiihinom FT
<br />ofcon{,tlioG lnc O*ncr BuiH(,iU halc lh. trrdcn ofFovine rh,t tr or shc dil nn hiB or inpmvc dt pmFiy ror rtx px4Ds.f
<br />-l.oso*ncrolrhcnmpcnr,!nexclusivclyconrracrin8wirhliccnsdconracru!h.on{tocrrhcr.id(s..7Ol4.Bu\iRsand Pnfcrsbn Cod.: Th. ContucroC s Liccns. tl* dcs nor artly ro dn ownfi of !rct'. yBh. buildsor inlrovcs rhcrNn-
<br />rfJ qlD .onn&rstu \u.hpr{,jc.r\*i(hr o)nrr .ron\) lic.n\cd nur\urnr ni rh. c{,nr
<br />:al
<br />I hcrchy rfllrn utrdcr Nnnlryufp.Jjury orr ol rhc l.lkrNirg dc.hrrrnr{
<br />I hav. axl *ill nDinhin 3 ccnl_c.rc of Consn' b sclf.lnsuo tu wnkcn conllcns0r inn. as lovidcd for by Scctio. 1700 ol'lhe
<br />ljhor Codc. for rhc p.rfortunc of rh. work for which rhc Fmn k i$ucd.
<br />_l have rndwill mlinrain \qlcrr cooDen\?rion i0suramc. as rcquircdhysccri,,n.lTmofrhcDhitrcod..forrh.pc.lonMNcoi
<br />lhc work lor *hich lhis pcnnil is n$d M,workss conrpcnsalion insurrmc r ricr rnd,r'licy mn$cr c:
<br />I.. ify rhar in rhc pcnd(mmc of rh. work for whi.h rhi! p.rmir n hsu.d.I shall noi cDploy any ncron in any ntrnif
<br />$ ,s t, tr.!m subF.t ro
<br />'h.
<br />wortcs {nrlEnsor im hws of Calibrnia. r.d urr llftl il I sk,uld tEconr sxhj.{r ro rh.
<br />w.tur .onF.s.rionpnr visirnrs.lsccriotr:lTuJolrhc trtrr c.dc. I shill, lanhsirh..n,dy wirh rho
<br />\lARNIN(;: l,rilun: lo \c.urc *orkrrr coDrpctr\rriitrr covcrugc is unIqrul. rtrd \hrll
<br />ro onc hundrcd rhotsnd dollars {Sl(x).(XX]).
<br />l.t(ENsIat) ( ()NlR,\ctoR
<br />tlt:cl,axarlgN
<br />I h.6by.rtr6uodfi p.n.liyofpcrjnry rh.r I Mr liansd u.dcr rrovisn,n ofCho
<br />ot rhc Bu\i'rc\r rnd Ptuf.s\ionr Cod.. ,rd nry liccnr s h hrll f(r.r {ld cfL{l.
<br />sii
<br />('oDlrador
<br />CAdEIBIJCIIQNIENDINGICE!!:T
<br />I hcEby dnrn undcr Fnrliy of p.rjury lhar lherc is s onslMlion lcnding agcrc, aor Ih. t.rfi,,rr1I@ .t rhc work for enicn rhn Pcrmi n
<br />hsued (Ss, 3097- Cir. C ).
<br />AfILIIANI.!&CIdEAII{IN
<br />I hod,y afm undcr rcnalry ol rrjury om 6rrh. rollusins dc.ludrions
<br />Dcmlirion Pcrmits.Ashcstos Norificorion Fedcml Rcsulorions (Tirlc 40. Plfl a,
<br />-Rcquncd
<br />Lcllerof Notifi calion
<br />l.Lnify rhi! rhe fcdc.{lrcaularions rcBding
<br />l.cn'lyrhd I hrk rci rhn lllnlLcrlotrrtrd (rtrhrr rhr tlonDly wiri lllCiry rnd Cou.ry
<br />onll'nm.\ rftl Srrrc I r$\ ruLt'ng n,bu,l tr,g.{
<br />rvc nEnliorcd proti.dy lbl nrl]cclion
<br />Appli.rnr d Aa.nr si*nrron:
<br />!/a/-rLK-Y/4 ^r,L 7
<br />f.lltZlllISEl
<br />a;
<br />ID/SIG.
<br />Site-Work
<br />1e
<br />Lrndei\ Addr$
<br />I
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