Laserfiche WebLink
ELECTRICAL.INSPECTOR RECORD <br />APPROVALS ID/SIG.COMMENTS OWNERBUILD€R DELCATlA ION <br />I hdcbt amr unds poaltyof pdjury lhal I an.xcnDl fior rh. cont0crou' Li..m Lr* forlh. follo{in! rcen (Se70115 <br />nusinBs lnd Prol6sio, cod.) A., Ciry or counry *hich r.qun6 a psnn to construcl. ah6. inprorc. d.ftol*h or .cp.ir sy <br />srtu.t@, prior to its issumc.. als r.qun6 lh€ appli.anl for srh Fmil rD nl. a sign.d na(m.nl thd h. or 3h. ir licd*d lld3@I <br />lo rhc provisions ofth. Contr(lois Licos.d La$ ((haptr 9. Commocins snh Sction 7000 ol Division I ofthc Busi.6s and <br />ProLsiom Cod.) orrhar h. or sh. n crdpl lhacnom md lh. tosis aor ihc oll.g.d.rmpnrn Ant violario.ofsdionr0ll t bran,' <br />applica aor a Forn srbjris lh. ar9li.anr ro acivilpolllyolnol mo..th fi\. hundrcd dollds 11500) <br />I,6 ow6 oflhc proF.ny. or my.mployG wilh s.86a rh.n el. conpdsarion. \rilldo (h. \ort rnd rh. en'crm b mr <br />inl6d.d or olIdcd a6r salc (56 7()44. Burin* dd l\oi6sioE Codc Th. Contrictors l-ica* tiw do6 nol q,ply ro own6 ol <br />rh.FFly $ho hilds or imFov6lhdon. od vh. dc au.h M,t hins.lfor h.6.llorrhr.ugh hi! or hd osn.mployd, <br />Ftrovid€d llut such imlrormats e not iniai.l or oftd.d aor sk Ir, h.wad. rh. buildnB or trrymrc,Mr G $ld $ irhm .ft ltr <br />of co,nrrkio.. rh. oten6 Buildo will hart rh. hrd.n orpr.lins thd h. or shc dil not build or inrprov. lh. tirFty tor ih. purpoF oa <br />l. a osnd o f th. l'opaly, @ .\clB'v.ly .onradins r'llh licdscd conriacloE ro mnsrru.1 ttE p.ojcct (Sc ?0{t. A6md <br />and Pr.tusion Codc I hc Conn elors l,iccns. h* do6 nor amly r. an o\!nd o f tr.pmy rh. huil& or introv.s rhdon, <br />ind qho contmds aor su.h pbjmls \nh a Conrmclo(s) lrds.n puuunr lolhc Conlracrors ljcsc liw). <br />I m.r.bpl und6 sdlion <br />]t0B(DBl-(aUPTlSAltOr <br />DECI.AEAIIQN <br />I h6.by.fimr und6 p€.ah, oaFjurloncoathc aollo$ing d(lr io s: <br />I hav. ed vill min16i. a C.nifical. ol coBdr ro S.ll,l6urc for *.rk6 c.mr..etion. as previdcd for by Sclion 3 700 ol thc <br />tib.r Cod., lor lh. ldaomec. o t th. krt for whict lhc p6mil is isucd <br />I harc ond sill mrint.i. Norkds compdalion insuran ., ar r.qun.d bls<rion 1700ofthc lrbor Codc. for rhc p-fomancc of <br />rh. \rork lor rvhich this pmil is isecd. My worl6 conpo&r ion insurd.. cnir dd Ix icy numbs a€. <br />I cdily rna( ih ih. pdfarntnc. ofth. {ork lor $hi.h lhis !.imil is issu.d. I shallnol6ploy any psson io any n!nn6 <br />s slo b.con. subjer ro <br />'hc <br />*ol(qs comp.r6ation lass orcahromi.. dd asre rh.' ifI should tE om. s'hj(l ro rh. <br />$ork6 compcnsalionprclisionsofScdion 1?01)oarh. Labor cod..I sh8ll. lonhwnh .omply sirh rho* polisioB <br />WA|INING: r{ilurc ro sure sor[6 .onpoEtion co\qasc is unlasful. and shall sub]d Enplo)s lo ooiMl poaltE lnd <br />civrl lin.s up to on. hundr.d <br />'housnd <br />doud (5100.000)- in addilion to lhc cox of comp.Ntion. dmascs 6 rrovidcd for thc <br />Sdion 1076 olrh. tlbor ( od., imcd dd diomiy\ t6 <br />LICINSED-(()NTAACTOA <br />l)Egdaallo! <br />I hd.b, amm undn posxy oa pdju.y lhin I e lrcq!.d undq provision of Chaprd I (corndcins with Sed ion 70(()) oi Dn ision l <br />oa lh. Bsins ud Prcfsions Code. ed my licos. is in aull aor.. md .iIfrr <br />I 'c.cc Numbc' <br />- <br />COIiIAIJqTAII.ETDIIG-AG <br />I h*by a,Im undd Fn lty oa pdjury lhal the i! r consrtu.16. Lndi.s ,cfty ao. rh. p6fo1l@cc of rh. *orl 6. *hth dis Fnn ir <br />ilsu.d (Sa 1097. Civ C). <br />APPLICAN'I' I'fCL IATION <br />I ho*y alln, n.dd Fmlty ofpdjury one oflhc ao,lowinE dclratio.s <br />D.molilion Pmils-Asbdos Norificrtio. F.ddrl R.€uldio.s (TnE 40. Pan6) <br />Rcquir.d Lcll6 ot Nolificalion <br />I cenilyrhat rhc Gdsnl r.! ular io ns Essdin8 isb€stos rmoralu. nor opplicibl. ro rhie rmld <br />l cdriry thar I ha c r.ad lhG lppli.ar ion ..d aar. rh.[hc ahlr inlomat ion Lr .orc.l l asrc lo comtly with all Cny and Cou.ty <br />ordinancG 0.d St.r. LaM El,ri.g to boildidg .onsrucion. dd tmby aurlF iz. r.p.Mtalir6 otlhis Cny d Coulty to mlG uBr. tlE <br />abo!. matio.at popoly for inp<rion rnrposG <br />.\pplicntrl or Afc l SiA .ln'o <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 To p Equipment <br />Facto ry Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Rouqh <br />Ceili ngs (T-Bar Rough) <br />Meter Release <br />Rough <br />Service Meler <br />FINAL c/4/1? A ,/Afe- /6 / <br />Notes, Remarks, Elc <br />DATE <br />l.iceNeClas