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ELECTRICAL.INSPECTOR RECORD / <br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION <br />I h@q" amrn udo p.naliy of pdjury lhar I en .r.,npl f.om ih. ContEclo(' Lic.nse tj* tur llE lollowi.g rwtr (Sc 7011.5 <br />Alsin6s md Prolsion Codc) Any Ciry or County which rcqln6 a p6nn ro coGrtud. alr6, inprovc. d.holish or Epar y <br />sLaclr.. pri6r ro irs isudc.. ako rcqun6 rh. rpplicdt for luch Fml ro iile a sisn d sralonsl thol hc o, sh. G licms.n pNanl <br />lo rhc ForisioN of rh€ Conlracrois Li.en$d trw (Chatr.r q, Comm.n.in8 airh Sation 7000 of Division -1 oflh. Buin* ed <br />Pmf6sions Code) or rhal h. or sh. ir €xcmpr thr.from ed th. bsis for lh. all€scd ddplion. Any riolrtion oasdion 7011.5 by any <br />applicanl for a pmil subjak rhc applicant !o a civil pcnalty of not nor lhd nlc hundred douds (1500). <br />-1, <br />as oMo oarh. ,nrpenr. or dy .mplorG wnh was6 6 rh.n eh conpe.elior. will do lh. so.t ad lh. srMuc is ml <br />inrmded or olred for sal. {Sa.?044. Lrosins dd Pro f6ioN Code Tn. conlhdols l-icmc liv doG .or apply Io an 0*16 oa <br />llr pFtisry who tulds or idprcB rhdatr dd s ho do6 ech so'{ himsclf or hm.lf or lhrcush his or h6 oM @ploycB. <br />provid.d rhat sucn impsrEmls e. rct inrod.d or olIdld lor sl. I L nov6s. rhe huildinr or i.Fovd.dr a! $ld *ithin on. r@ <br />olcompldion. rh. o,nd alildd will have Ih€ budo of prcvins Lhd h€ o. sh€ did .ol tuild or inFoE thc pordy lot rl'E purpos. oa <br />l,6 owndolrhe !rop6ly. mcrclusivcly contraclins silh licos€d.o r!(106r.codocl lh. Irojel (S4.7044. AB16 <br />a t Prnadir Cod. Th. cotrt.crols Licms. l-r{ dos n.r ,pply lo d o\rod of prop.ny rho builds or improv$ rh6.on, <br />and sho contmcrs lor such roj..ls vith a Conrado(n licds€d p6Mr lo rhc Conrrocnn-s Lic.N Law). <br />I an€reDpl under S(t <br />*,",. t|n <br />I hcrebr amfln !nd6 p6ahy oipsjuryoncolthe i)llosins d* <br />-l <br />hav€ ad will neint.i! . Cdificar. ol Co6or to S.lalBur for wo,k.6 onDoerion, s Eovided lor by Serion l70o of rh. <br />Labor Cod€, tor th. pglomoc€ of th. por( lor which the p6nil is isu.d. <br />_l ha!. and will naintain wo*.ii conpftation iBurmc., I requtcd by Sdion 3700 otlh€ Labot Cod.. foi rhe palofln cc oa <br />rh. *o* lor *hich $is pdnit is isal My worlm compdslio. iNuarce cad6 rd policy nuob6 ec: <br />I ccnily rhat in lh€ psformuc. oflhc vorl for *hich lhi5 p.mn is irstr.d, I shall,ot anplo, aoy p€6on in any nmnd <br />s a b bdo,ne subjdl <br />'o <br />the wo.t6l onrpas.lion laws oi C.litonris. md qE rhal ir I should bsoftc srbja( ro lh. <br />$0'{6 corpr.erionprovisioN olsdion lT00 oflhc Labor Code,l shall. tonh*ilh cohply wnhrhos pioli3ioB <br />WARNING: Failorc lo Buc rorkos, comp€nslion covtrase is unlaNtul. dd shall subjd m anployd ro ln'nmal Dd E od <br />cnil fines up to onc hundr.d thoGtrd dollm ($100.000). in add(ioo lo rhc .ost doMls d fiovidal lor rh. <br />Serio 1076of rlE t-atirr <br />I hercby alfinn trnd6 rcnahyofpqruryrhd I d mdo arolirion of Chaptg 9 (m,nmmcing wilh S..lion 7000) oa Division l <br />ol thc lrusins ed PrcfsioNCode. ard Dy <br />I-i.cnseclas: Lice.se Ntr.rb€r <br />Drt.: conlnctor <br />CONiIBIJqIIAN.I,EIDTIG.AGEICI <br />I holny arrm !f,ds Foahy of pqjury thd lh6. is a @islrudo,lddin! agdcy for th. pafo unccofth.work lor which lhi pdnn t <br />i5!o.d (Sd 3097. Civ. C ). <br />AIIIICANI.DECI,AAAIIO! <br />I hsrry alfns u.dr paaly oa pdjury o,c ol thc followinS d(l-alions: <br />Demolilion Pmils-Albdros Norificarion Fedoal R.lulatiom Gnl. 40, P.rl6) <br />-R.quircd <br />lrlt6 of Noinca6n <br />I cdity rhar lhc icddal r.sulalioN resddins 6b.stos r€'nolal d. nol appli.abl. ro rhG projecl <br />I corilr rhar I h3vc r€ad lhis applicatnrn adslar€ that thc ahr\€ i.tr iscord.l asr to comply rvilh ,ll Cily ed Coumy <br />ordinancenndSr0r.I-awsElalinr to buildinsc.nnrucrioo. d iv6olthisCily d Counry lo 616 upon rh. <br />abolc nmrioncd pmp.ny f inspdion pn,pos <br />ADrrli..nl or ,^rml SiEmlure: <br />6t ,,n H41z*rLLA <br />Site-Work <br />Underground <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 />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 Rouoh <br />Ceilings (T-Bar Rouqh)t"5-l-x )L{td <br />Meter Release <br />Rough <br />Service lvleter <br />FINAL .-Utd#z @9 <br />Notes, Remarks, Etc <br />LMdff s <br />^dJr6 <br />1rlsl[\l <br />/4a-l