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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER BI'II,I}ET DET-CARATION
<br />I turchy rlfi.h unilcr p.nalry of pcrjury rhar I am crcflrfr l'tum rhc Conrrsch l-ic.isc trw for rhc nnbwing rclron (Ss.70315
<br />Burincss inl Profc$ion C{nc): Ant Ciry or Coonry *hich E1tift\ . ,.rnnr t. cnn(rud. trlrcr. iryr.}c. dc'nolish nr Rnrir rny
<br />{4durc. prirro ir\ isumq,ls rcqun$ thc {'di.nn' for {.h F n i ro filcn si8red srlrcmnr rhur rror \hc i\ liccn$d pusuanl
<br />ro lnc frcvki.ns oi thc Conrrrtoas l,ic..kd ljw (Chaprcr 9. Connc.cin! wirh sc.tio. 7(x1o ol Division 3 Dfrh{ Burin.$ and
<br />Profcssions 6dc) or rhat hcorih. is.xcnpr rh.ramn and rh.6a\n for lh. dkgcd excnptiotr. Any vi{,lnri{]n.fs.{rirn 701I t by rtry
<br />applicrnr ttrnF.mil subj€.k th. aptli.d.t t,,.ivilFnalryornor frrc lhatr fiv. hundrcd dolhn (S5m)
<br />Lrsoqnrofrhct,otfny.ornrycn[loyccswilhw0scs.slhcir$Lllnnpcnsxrnnr,ailldorh.s.rkdxlrhc(ruclurchnor
<br />intcRlcd o. oltcrcd Lr slc lsa ?044. Blsims lnd Proiccsions c{'dc: Thc C.trtaclofs Liccnsc tiw docc nor !ppl, b an .qn r or
<br />rhc pnl{n, wh, bxilds or improvcs rhc@n. md all) des \uch wo* himsclfo, hcrcltnr rh'{,rgh hk or htr own cnfloyccs.
<br />poviJcd rhlr \uch impomiNarctur i.r.ndud orollcrd frtr sl. Il howcvc( rh hoil.lin8 or inDmrcnrDr is qnd wirhii .trc ,t.r
<br />olcomfhtiotr. rhc Owrcr tsuilder willhak rhc hr(k! ofptr,vinB rhar hc or sh. did mr build or iqriorc thc pmtcny lor rh. puqbs of
<br />-1.
<br />!s owrEr oi rhe propcnr. dfr cxclurivcly c. n r.ri'rg wirh lirnrd .onr.dos lo mnrlrucr rh. I,nFr l Scc. 7(!r4. 3u\iNs
<br />.nd Pnra\.tn Cod.r ThcCotrrractois l-iccrsc hq docs nolotplyn, rno$icrof olcdywhr) buildsor nnp$v6lhcrsn,,
<br />0d wrD conrBcrs for such pn,r..ls wnh a C(,nh.h( n liccn*d IUNuant to lhc Conrrockn s l-i.cnsc h*)
<br />-l
<br />amermpr undcr Selion-. a. & P.C. for tht Msn
<br />Irrl.: O*r.r
<br />u!.t8tr[&r:g8lSENsar.IaN
<br />IECLAMIII}N
<br />I hcrcbt xriird undcr rcnahyorl)crjDryo.c olrhc followin8 dc.lnmrions:
<br />-lhavcard$illNinrnioaCedificnrcofcun\cnriosclfln\urcfd*orkcs
<br />coqr.srion. ar lr'ridcd ftr hy su.rn lT{Doirh.
<br />lihor ('odc, for rhc rcrforrome ofrhc sort ao. which rhc pc..ril is hrrcd
<br />-l h0rc and $illnuinr3in s.rkcr\' cotup.n\Innr insrra.cc, a\ r.qrncd btSccrionlT00.l'rhc l.rhor Gnlc. turrhc Nrtunrr.col
<br />lhc wotk lnr which thk Dcmrir is i\\sd M y wortq e co ,tt(sri,'n i'NU 0.c .am ci d Policy truflrhcr lrc
<br />o ,
<br />gc?t
<br />_l ccdirrrhll in rhe Frf.hun.u or rh. *ork hr ahi.hrhis p.rni n issucd.l shallror cntpl,,yuny |fN'n in.nynunncr
<br />so Nro m\onr b]cd lo thc worlcn comncn\ bn h{s ofCnlilomia. and rgrc rh,r irl sltrld h.co'm slhr.€l roll'c
<br />woikli coqrnsdrion pbvisions ot Sccl io. l7(ro ol lhc tihn (xlc. I sh,U- t,nhwnh c.mtly wth rho{ fmvnions
<br />WARNIN(; r{ilun ro surc workcr' onpcnerion olslSc i\ lnla*aul, and shnu sublccr M cnqnoycr ro {in ml Ftulris lnd
<br />civrl lincs utr ro onc hundrcd rhourrnd dolla ($llx,.lxXr
<br />Scction 1076 ollhc bbr Codc- inrcrcdinJ art,my \ fccs
<br />). n, nddlrion b rh ro\ ol (onr
<br />/[.L- tlo
<br />DECI,AXAI]QN
<br />I hcoby {mrm ud.r pcn{lty ol pcrjury lhar I unr lians.d undcr Fovision ol Chlprc. 9 (comftn ing wilh Sdion ?uxr) of Divhion 3
<br />of thc Businessand Pmfcsrhns Codc,.rld oy lic.lsc h i. tullrixe md c{ccr
<br />n.
<br />1.C'/'b ('ay't'*.
<br />(:(INSTIIU(]TI(IN I FNDIN(; A(;ENC1
<br />I hcnby lrfirm und& Fnrhyort rjury rhdr thce n a.on{rudiotr lcndin8 ascmr lor rhd pcrfomun.. or rh. work lor Nhich ihi\ pcmir i\
<br />issucd (ss 1097, civ. c.)
<br />APPLICANT T}ECI RA'I'ION
<br />I lfthylninnunLr pcnrlryorprrjuryoncoirhc tnhwnrgdcclfialftrs:
<br />I)cmolirion Pcflnit Ashc(os Norificartun Fcd.ful RclulalioN I tirld 41). Pft6r
<br />-Rcquircn
<br />L.rrcr oiNorilicarbn
<br />9)"1t4,, ',',
<br />iryrhd ihc rcdcral rcgtrliliuN rcsudnr8 ashcn.r rcnx,vllnrc not ipdicrl,h k)
<br />l aSs toom,'lyqnh rI Cny and counilrh0r I hivc rcod rhisaprliarbns"d{,rcrhur r!.
<br />odirln.cs nnd SlalctiNs rclarinsh buildi hnr{rivcs oirhis Cirylnn Coury t, cdcr upotr rhc
<br />rhlvc mnrtJftd Dtup.ny lor insFrtion
<br />,\pDli$ l or ,\rrnl Siu"t0rc ?at V,A-?.443
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lile Salety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding / Groundinq / UFEB
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduil)
<br />Walls (Rough)
<br />Ceilinqs (Hard & Soflit Rouoh
<br />Ceilinqs (T-Bar Rouqh)
<br />lvleter Release
<br />Rough (//r l6 ,\5v
<br />Service lvleter
<br />FINAL vl?/rs it\tl
<br />Notes, Bemarks, Etc.
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