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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS <br />_1. 6 ovnq of lh€ sDp.ny. o! ny cmplolc wirh !aa6 a rhcir elc conp.nsalion. ruill & th. {ort anl $. end@ n oor <br />inrddql or offdcd fo. sE (Sc.7044, Bsin* ud Prcl6io6 Codq The Conradol3 Licc6c La{ do6 nor apply to d o$ nc. oa <br />lhc propcny qho tril& or nryiore lh@a dd *ho ilti6 sch \wrk him.lf or hdsclf .r (h6ugh hir or hd oM mplor6. <br />provd.d rhar snch inpmvdmts ft nor imai.d or off6.d for Fle I I ho*6s, lh. bildiry or imFqvo,El ir FH *irhin on. )a <br />oaco'trpldion, fi. om.r Btrild6 *ill h,ve th. htrd6 oaFovin{ lha h. or she did el tnild or imarov. rh. p@pdy ror rhe ptrpo$ oa <br />l. 6 ownd oflh. Fopsly, dn qclusivcly conlmcrine wnn licasn .onl.a.tou to conslnci lhc projd (Se 7044. BbiI6 <br />ard t\oissbn Cod.: Thc Conradof ! Licdsc Law do6 not apply lo o o*nq of p.opqry s,ho buildt or inprov6 rh6@.. <br />rnd who conrds for su.h pmjats wirh. Conra.ro{, lic.nsed pu^@r ro rh.Conrractols Li.dk ljw}. <br />I n er.mrt undcr S{tion .a &PC aorrhis.cdon <br />Drr.: O*trq: <br />.EAB(E8l.c9[ttErSArq! <br />[EC!AaA!!O! <br />I h6eby afinn und€r rBahy oI psjury ofle ollhc lollowir8 deldaliosl <br />I hav. ad will n:aintain . Cdlifcrtc oaconmr lo S.lf lNurc ior qorlns' cDnrposrtion. 6 prcvidql tor by Sed nrn 17C{ o f lhc <br />bb.r ( odq for rh. palomdc. o f rh. sor{ for {6ich lhc psnil is issu.d <br />_I harc and Nill nrainlain wo*e6' c ation insu,ancc..\ Eqtrted by Sdion 1700 ofthe libor Code. for lhc perromdc. ot <br />k6t conlp$erion iBurmc.dicr dpolicynumb6se: <br />() <br />Ir.nilrirhal,nrhcternn ancc.flhe \uk for shichrht lrenn s 'ssucd.I shillnor enrpkl y nny Dtcon ,n any n'mnd <br />$ ato be.omc subj.d lo th. Mr{ds comp@tion la* ofcrfifomia. ed 6s@ rh.t ilI should tE om. subjer to thc <br />Lvori6' conpssl io. provisioB oasdtion I700 of rh. Labor Codc I 3h,ll fonhtrilh .o,ndy wnh tho* polisioE.. <br />WARNINC Failu.c ro su. work6' compe@lion covraCc is orloye b dnnin.l Fnahb dd <br />bn, d,mag6 a !ro!id.d lor rh.rhousd dall6 ($100,000), <br />'n <br />-,. J I K <br />!rct.!!uua] <br />I hd.br amn. und6 p6ahy ofpdjury rld I dn licaE d ond6 Fovisiod oacn.pG 9 (coomdcing $nh Sdrion 7000)ofDilisionl <br />oa rh. a*in6 and Pdl6sions Codc, dd ny lictu. is in tult lorcc e'd c,I(r. <br />Ci CL <br />I hd.b, altirm undd D.n lty ol pojory lh,l rh6c is a corsrucrio, L.diis 8g*y for $c p6hlr@cc of rh. $orl lor trticn $a Fnir ! <br />i.su.d (s6. 1097, civ. c.) <br />ATTLII:ANfDICIAAAUOT <br />t hmib aftim unds p6ahy olrErjuryoncollhe lollotrinlr dEls ions: <br />Dcmolition PdnriG-Asbdtos Notificarion F.ddal Restrhtun! (Tnk r0, Pan6) <br />Requned L.tln olNolifi cation <br />-l <br />cdrilyd10t nE Lderal r.Sulalions rc8.rdinr Gbenos rc'noval . not arplicahlc to rhis ptujcc! <br />V lcd'h,h, I hae,..1d,hs,n.li. <br />/F.m$ d sHe Lais,ctaiu; bli <br />oho\\ c mononed prcFny lor Gpdnn <br />), <br />l( <br />^ppliccnr <br />or <br />^smr <br />shmrurc,K <br />"*.r**.",0n*,, EK <br />Site-Work <br />Unde rground <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Life Safety /Low Voltage <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bonding / Grounding / UFER <br />Transformers <br />To rquerng <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Roug h ) <br />Ceilings (Hard & Soffit Rouoh <br />Ceilings (T-Bar Rouoh) <br />Itileter Release <br />Rou gh <br />Service Meter <br />FINAL Z,-l-19 tLcz) <br />Notes, Remarks, Etc <br />-.{ <br />OWNER BUILDER UELCARATION <br />I hdcby amrm undd p.mlly ol pdJury lh.l I m cxcmpr 6om thc ContracloN Lic.ns. tjs aor ih. followinS rceo (5<.703 L5 <br />a6in6t an<l P.of*ion Cod.) Any Cny or Counly Nhich r.qun6 a psmit lo con$ru€1. .116. inpmva dcmolnh or'rqan &y <br />sd.rr., prin to ils isuoc.. also r.qon6 $c agpticd for such rEoil lo nlc a sis..d srar@d |har hc or sle b licds.d pusBln <br />ro rhc provtions oflhc Co.tra.lols Licenled Lsrv (Chapt€r 9, ComnEncin8 with S€clion 7000 ol Division I ofth. Busin* dd <br />Profsiotu Cod.) orlh he or sh. is .rcs9l rh6etioo dd rh. bais for rh. all€s.d .r@fl'on. Any violado. of Sdlion ?01I 5 b) any <br />applic.m ior a p*on subjdrsth. applice' ro a civil lBalty of not Dorc $d nv. hundrcd dollds {$50o) <br />, fSOlk\) <br />o*", . ll q .*,.*".,( <br />l,eDde' s Addrcss: