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ELECTRICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUIIDDR DEI-CAR^TION <br />I hd.by altun undd poah, of p{jury thar I m cr.npr lrcm rh. Conlr0cloro' Li..nsc kp for th. fouowiq rcen 156.?011.5g6in6s sd Prcfdio. Cod.): Any City or Counl, shich Eluns r pcnni! lo connrucl. slts. improlc. &tolirh or tp,r ey <br />srucluc. Fior to irs isrllmc. also r.qun6 lh€ opplicet for such pcmir to 6lc a sisn€d s|a!.I@r lha h. or shc k li.m$l puNmr <br />to th. p.o!i.io6 oa th. Contrlclo.t Lic.ned Law (ch4(6 9. commdnS wnh Sdion 7000 of Division I oflh. BaEs ad <br />FrclNions Cod.) or rhal tE or shc is €xmpr lhEcfrom &d th. basis lor th..llcscd cxdplion. Any violarion of sdion 7011.5 by mt <br />0rplicani lor a p.mir subjc$ rhc .pplicdr ro acililpoahyofnor nor.rhs fiv. hundr.d dolles (1500) <br />_1. s omd of rhc pror.ny. or ny .f,pldyG virh s as6 a rhct el. comFMrion. \ill do d. wo ed tlE srul@ b nol <br />inrddd or ofid.rt aor eL ( Sd 7044. B$in6 md PmfaioE con.: I lr. (onrlDdois Lkmc Las do6 not apply lo e orra o f <br />rh. popsly *l$ buil6 or irp.ov6lhq@r aad {ho &< sch wrt hins.ll or h6.laor rhbulb hb 6r ha o*n.nploy6, <br />pIov il.d thd slch inpr.vma ec nor inlai.d or 0,160l tur el€ lf. hoqd6. thc buillins or iqrovcmot is srj * nhi. on. <br />'6oaco,rytti.rl rh. OMn Builda will ha!. thc htrdar of Fovins ih, h. or sh. did nol hild or inproE lh. Fop6ly lor lhc porIos of <br />l. aowndoarh. Iropdly, m.r.lu!iv.ly.ontadins wirh li.s.d co.lmdou lo connrud lh. prcjd 156. 704J. Bsms <br />ald hlfetion Codc: I hc Conlrscror s Li.6sc Law do6 not .rply lo an own6 olprop.ny Nho buildr u idptuvd rhdsn. <br />ond who.omnclsaorsuchprDj.ds*ithaContdo(rlrtucdpu6Mrrorh.ContracroisLiccNLav) <br />I m crang rnd6 Sdion , B & Pc for rhis rcMn <br />Drle: Orner: <br />!9asEAllll!!!E!l4rlo!DEC!A8^[uI <br />I hercby amnn und€r l-\.ahl of lsiua on. oilhc loll$\ i.! dNlmrtls <br />I hav. md q ill mhroin a Cdificdc of aoNor ro S.la-l6urc for *orksi cof,,pcnErion. s provid.d ror by sfrion 1700 of rh. <br />Labor Codc. aor thc r<aorlMcc of thc qoir for whi.h lh. psmn is issu.d <br />I h.re a.d sill naintain work.rr conp.Balion iBuin... s rcqun.d by SEt ion I700 oi th. Labor Codc. to, rh. Flol:@.c ol <br />rh. wort for whi.h rhn pnnt is isud My Bort6r comp..srion insuranc. ffi6 dd policy nunrb.r ec: <br />c*6, . rfruls uk-,tq <br />-l <br />c.nify thar in rhc p<rfomuc. ofthc work for which this D6nit h isucd, I shlll.or @ploy dy D.rson in uy meE <br />$ a to broi. subj*r ro lh. uort6j coopdE lion la*s orcalihnia, dd asrc ih8l if I should baon. 3ublat b lhc <br />sork6.ompoerioopovilio6oasalionl?00ofrheL*orCodaIslall,fodh*irhconpl,wilhlhos',ovisioB. <br />WARNINC F'ailurc lo su€ \orkm' comp.s.lion covcr.s. ir u"lavful. ad shall slbjd e dplold to ciniml p.sni!. md <br />civil fin$ up lo on€ hund.d rhousd dollss (J100.000). in addnion to lhc con of con!.@tioq dr@96 a provid.d for lh. <br />rh.l.it r a.d!: inrrnr ind <br />DESIAAIIA! <br />I hftby .rtrm undd paahy of pdjury lhrl I m liccru.d lnda pr.vision oachaprq 9 (commdcins wnh S.crion 7000) of Divison 3 <br />or thc BEin6! $d Pofsioro Cod., ud my licG is i, fuu fore .nd cficl. <br />Czo bb7?3 <br />L?".",-",..,*)7s 4/c <br />(alilallcrloNt[lullclcENq <br />I hq.5y ailrm undd pdralt, of psjury lhd lhsc ii . consrucrion kndins ,stry for lhc p6folr1@c of th. srk 6r $hict lnis p6nn t <br />isu.d (Sa.1097. Civ C.) <br />AITIICANLDICIAMITA! <br />I hort, ofrm undr poalty of pBjury on. of thc fouowing ddlqd ions: <br />D.,nolition PmiteArbdtos Noiificdion rtdml R.*uldiom (TnE 40, Pd6) <br />-Rcqut.d <br />Ldrd oa Notificaion <br />i,nN'L!in'lnrg :lrn \r.m\il,trrr.rrpt,l'txbl.hrlristn!Nr <br />fic abov. infonnarion i.s cotrEl I asa lo conply wnh all Cnt dd Codry <br />r dd h6cb, ,uthoizc r€lrMldiv6 of lhis Crty ud Co <br />aboe. mBtomd pN!.ny aor <br />'\pllirrn( or Asenr Signtrttrr! <br />,"*U*...",rn*,, K a <br />4 <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 Rough) <br />[\,4eter Release <br />Rough <br />Service lvleter <br />,TtztFINAL q PbAfz r otJ' <br />Notes, Remarks, Etc