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ELECTRICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS <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 />Torqueino <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rouqh) <br />Ceilings (Hard & Soffit Rouqh <br />Ceilinqs (T-Bar Rouqh) <br />Meter Release <br />Roug h <br />Service lt4eter I <br />FINAL , </.2 6//r/ fL <br />Notes, Remarks, Etc <br />OWNER BUII.D&!I DELCARATION <br />I hs€by amm umler lEnahy oa pGjury rhal I m .rmpr aF,n lh€ CoorEcrou Lic.ns. La{ aor rhc aollowins r.&n (Se ?tr l .5 <br />BBin6s and P.of6ion Codc): Any Cily or Coutrly Nfiich r.qun6 a FDi ro coNrrud. 31t6, imprcv€. d@blish or Epot Mv <br />(tuduq prior lo irs isuanc., also rcqun6 lhc apDUcer aor such pdni <br />'o <br />lil. . si8n.d slalool lhd h. or sh. is licds.d p$udl <br />lo rhe FovisioB ollh. (.onlriclorr Liccn*d t w (Ch.pld 9. Conoocins wilh Ssrion 7000 of Divilion I of lh. B6in€s od <br />Pol6s,ons Cod.) or thar hc ar sh€ b ci€mpl lhqefio,n ed lhc bdi! for rh. allcS.d exdnption. Any tiolationoas.dion 70llJ bv anv <br />applicad for a pdnn subjets lh€ rpplica.tro acililp.nalllofnor mor. rhe fiv. hun&..1dotl&s ($50o) <br />I <br />-1. <br />s o$nd ofrh. pruFny. o. my enplqG wilh u"se 6 rhcn $E comp.rodion. vill do lhc $oA ad fi. slnEluc i5 nor <br />inlod.d or olt.cd lor ele (Sc.7044. Busi.ss ed Prcadions Codc 'rhe Conlrictoi s Lic.M Ltv d.6 nor apply ro o own r oi <br />rtrpiopdy $,ho t ildr or in!,oE lhsec and who {to6 s.h s.& hims.laot hsslforlhrcush hh orhd om.mploys. <br />providcd rtsr such inpovd@is e nor inrad.d or oftrcd tut eG. I[ how, dE t{iHins or inprcldrenl b $U unh'n on. }e <br />ofcompkion. Ihe (\T6 ltuilds MII haw th. h{dd olFovnB lh, h. or shc dil trol build or impm$ rh. pmpqty f.r lh. purpo* ol <br />l. 6 orvns ofthc pmp6ty. e cxcluivcly conlr..lin8 s ith lics.d contrado6 ro conntuct Ihc Projel (S<. 7044. BGin6 <br />dd Pl bsion Code: Th. Contraclors Liccnsc Law do6 nor appty $ M o{nd ofl,rop€ny s ho build. or improvB lhdsn. <br />and who enlracls fo, such Foj.ds wirh r Conimdo(, Iicctrscd pu6@r lo ln. conlradois LicN L!s) <br />WORKERS' CO[IPENSA-NON <br />DSCI,ASAIg! <br />I he!€byamn. under p.nall, oapdjuryoneof rh€ tollowins dtrltuattrns <br />I haw ud NiU <br />'nainrain <br />a Cdiarcar. ofcoMnt to Sclf-lnsuE lor w.rl.6 conrp.nsoiioo, 6 Previdcd for b, sRrio. l?00 o t thc <br />tibor Codc. for lhc Dslomec. ofrh< wort aor whi.h th. p6nn ir isucd <br />-l <br />harc and sill nai.rain woikcrs co'nr€realion i6uranc€. 6 Equnol hy Sdiotr 1 700 ol Ihc Iibor C.dc, aor rn€ psfon.uc. of <br />rhc work aor * hich Ilis p.nit is i$u.d. My sorl.rc' cortF.Mtio. i6!rec. caEi€r ud policy nudbd d.\ 19V-t <br />'\NL bv4 (a(tn,zl 1a I <br />-l <br />cslily Ihat inrheFaoma.c.0f th. wo* for which lhis p€mit is istu.d, I shall.or mdov.nr. tE6on 'n <br />any nrnnd <br />er s r. b.com. subjat ro th. worl6 m'npdsnion las s ofc.lifomia, ed aar lh.t rr I shoutd b.r.nE subjd <br />'o <br />th. <br />$0l{6r comFerion prcvisioN ot S.d ioo 3700 of rh. Lrb.r Codc, ! shall. aonfivith &nply *irh rho* pro sioN.. <br />WARNINC: Failurc ro sd(. wo.km compc"Mion covmsc is unlawtuL Md shall subjel an E.ploys lo liminal p<Eti6 ad <br />civil nn.s up to.n. hun&.d rnoMd d.llffi ($l in addn6. ro th. cost olcomp€r*nrn, ddn.8.s 6 provided lor lh. <br />sErion lotalgglnbor Code, inrdBi md alromey s <br />IIECI,AEAIIO! <br />I hacby amm unda p.nahy of pdjury lh.l I m li.6s.d uod6 Fottiof, oach,ptr t (omm*ios sirh Salbn ?000) of Division l <br />of rh. Busin* d Pof6sios Codr, dd my ticcN is ir full forc dd elfet <br />Li.ssccl6:C s-L\t'1 <br />I (\^^tv,+ <br />COISIAIJqIIAIIENDAG.ACEICI <br />I hnby ar$n u.dd F.lry oi psjury thar rh6c is a oldnrlon kndi.g a8acy aor lfic pqfomecc of rb. vort for rvhich lhis p6in b <br />issu.d (Sa 1097.Civ. C ). <br />ATII.IIANLDICIAAAUON <br />I h6.t', sttun undd Fnahy oapdjur, on. oalhc lollowinB delral ions: <br />Danolition Pmirs-Asb6rd Notincarion F.ddrl R.Bularions (Tnt 40, Pd6) <br />-R€qut <br />d ttu-of NodnMlion <br />-l <br />cdliay rhat th. aeddal r+ulalioN csedins dbcl6 rdoval dc nol eplicablc lo lh! piojdr <br />-l.dify <br />thar I hlvc red lhis <br />ordinances md slalc l-a*sElatng <br />abov. nmrio..d prop.ny for <br />Appli..nl or Agsrl Signnt <br />V a, <br />Transformers <br />L&v <br />y1s(6 !_ <br />I