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DATE ID/SIG.COMMENTS OWNER BUII,DI:R DELCAR TIoN
<br />I hcrchy aflinn uDdcr pctrrlry ofFrjury rhar l on crenrpt fmnr rhc OnrractoF Liccnr Lr$ for rhc n,ll.wing r.4rn lsc.70rl5
<br />Blsinc$ flnd Profcsi(,n Cdc): Any Ciiy or Counr, *[ich rcqutcs r lf,rnir n, fl]nnrud, 'lr.r. inrt,!., dcnrlih i'r rBln any
<br />$fl.rud. trri.r n' ir\ n\xrn... rh. rcquirc\ rh.+plicrir r.r srh F'nir k, filcasiSncd {dcmnr rh0rn orshcnliccncd Nmanr
<br />h rlE rlrvi\iors ol rhc C.nlracrair Licensql 1,tr (Chiptcr 9. Commcncjns wirh Sccri.n 71fi, of Djrirtun I .rrh. Busn'c\\ Md
<br />Pn,Icssiotr\ Codc)or rhat h.orrhc iscxcnrpr rlrdfionrJM the b$i\ f(r rh. nllcS.d cx.mprion AnylnnarknolScclionT0.ll.5hyroy
<br />lpplic!trr f{tr u pcnilsuhjcchrhc lprlionlt, acivilDcnllryolnolnercrhxn firc hrndrcd dolhB i $5m)
<br />l.rsowncrorth.rrolcny.ornlycnDk,yc.swirhw,g.\asrhcn{,h.onrr.nsalion.qilldolhcoo*andthcrltocr!rei\nol
<br />intcndcd m oficrcd lnr st lse 7014. BusirEs ond Pr.lc$iotrs codc lhc Conrocrois l-i.cnsc ljw docs nor aprly ro !n owncr oa
<br />rhc In)trdy who hilils 6r iqftB rthdn. a'rl *ho dff\ \kh n)rl hiis.lf or h.r{lf or rhftugh hk or h.r own cmploy.cs-
<br />In,ridcd rhar su.h iDpmrcmnts rE n.l irlcnd.{ or oflcEd fin $L. la hoecvc. rlE buiuiry or inumrqr n bU *irhin onc )!0r
<br />of roryrldi.'D. lh. Osmr Buildcr rill Urc rhc burdctr of FnlvrB thd h. or shc dil n.r buih or inplorc ttc l)$pcny fo. lb. puqx,s ol
<br />I rnrqcnrpr (ndcr Sdi{in
<br />lrnrc Osr.r:
<br />.SI)ArI&I]!.o}ITENIAIIQN
<br />lztil:Ltts uar
<br />Ihcrchy rlrim trktcr rcnirryoitf,rirn oN.irl[ lnl[nviff d..r rri( r
<br />I hrlc Md will mrnfuir dCe nl.dlcofConsctrrlo Sclll'trurr fitr Nok.rs conrEnsdnnr. rs DrovnEd lor bySccri{rn lTlnrolrh.
<br />LntxrCodc,turrhcpc.aormnn..orrh.sorkror*hichihcnerinir isisxcd
<br />I hoa rnd willmrinlain qorkcr'cnrnN
<br />thc trorr lor trhi.h rhismrmir x 'r(?d Mv
<br />"""' 61"4' ('-'
<br />nsation insuoncc. ns cqliEt by 56l ion l70o .f rh. rrh.r Cod., for llrc Frfomncc ol
<br />/ sork6r' oa{rcnslion inrlmnc. catrtr d polky.umb$ dcl
<br />4Z1L4t Y Frnncs: €iq
<br />l.cnifyrhri ii rhc pcrtunnr cc(,frhc q.rt f.r whichrhh p.nnit h itsucd.l shr!1..r cnrrloytrnyrcnon in anymatrNr
<br />si s
<br />'o
<br />hcconE $hid ro thc rorkoc conrEnq(ion hws of Cnlifor.h. ond i8rcc lh ifl should brcoft subh.r
<br />'orhcwoftcrs conrFnurion lrovisionsofScdin 37(D otrhc l.h, Codc- I \hrll.lonhsirhco'nply wnh rh,{ pntli\ions..
<br />WARNNC: t{ilurc r, *curc Eorkcs .onrFnsatiotr c.\cmFc i\ utrl.stul. $d }hall s'blc.l i'r cnDloycr ro aimind lf,Mhic(,nd(ivil lin.suproo huDdR{ rhoulnnJ dollrrs (Sloo.llflr. ir rddirn rorhccoll oi coml)cnqrion, dlnug.s us tnrlid.d f.r rh.
<br />\dr'o 11176orrh.l!t r {'.Jc inr.r{ rlrtrrtu\ (Lrc.,., ;p;'"'" "';,,,*l 2\
<br />I.1clsT,5l@ItIIm.*
<br />t hcEhyamnnundq peMlryolpcrjuryrhlr I !r licensd udcr povisiooorCh+rcr9(.onn ncirg wirh S.ct'Dn 7000)oiDilhbnl
<br />of rhc susiDcsrnd ProicsionsCodc. md myliccn\c h ir lull lorce o.d eftccr
<br />I boLl 6 P 7
<br />AfILICANI.IIEIIdBAIIIN
<br />I h.Rhr dllm undg rcnalry.rp.rjnry.n. orthc rollosiot ddclamrions:
<br />DenDlirion Pcrmih'Asbcslos Norinc ion rcdcrcl Rcsultrrions(-lirlc 40. PlnO
<br />-Rcquncd
<br />Lcllcr ot Nolilicalbn
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safely /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Bondinq / Groundino / 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 & Soflit Rouoh
<br />Ceilings (T-Bar Rough)
<br />[/]eter Release
<br />Rough
<br />Service ltrleter
<br />FINAL tdtoltQ fr tlryr.t, s/7))
<br />II ulNotes, Remarks, Etc.
<br />ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS
<br />-l-
<br />aso!mr oilhe pml,cny. amcx.tusnclyoniraclinB wilh liccnscd conrracloF ro condtu l rhc pmFr lScc,7Or4. Bueftss
<br />ud lttrfsibo Gdc: Thc Codrr&rof\ Lic.nsc l,sw iloc\ lor applyio !nosncr of nror.dy (ho bxilds or i.Vrotcs thcrc!tr.
<br />ond wM $Drmcts ror srch pmlrls sirh a Co m.e,(r),i.enscd pucMnr to rhc Conrrlcrois Lie.sc L,*)
<br />O
<br />C-a*r".,
<br />\
<br />CANIIBIJCIIONI.ENDINC.ACENCI
<br />I hccby aiirm undcr l. lryofFrjuryrh,r rhoc ha.\'n{rrucrion hnding d8cmy for rh. p.rforiMNc ofth. $oik tuuhichrhh rEmi n
<br />hsued (Ss. 3097. Ci!. C )
<br />Lcn'lcr\ Na'rc
<br />-
<br />Lcrdcis AddEs
<br />-
<br />I.cni! th,r rhc rcdcmlrcgul0li.ns rcgrding osbcsros rctrD!,lor. or applic0blc lo lhk pojccr
<br />-l
<br />ccnifyrhal I hrrc .ead rhis q,llic ion end sr.rc rhor rtc ai.rr inf(rrorion h coft.r. I agd ro 6mply whh all Cily ond Counly
<br />ordin0tuciandSrarcL!$srcbringrohuilding.onsrucrio..sndhcrcl,,axrn rnc ,.tr.*.ralitrs .l rhh ciry md Counly lo cnler upo.ltE
<br />rh.rc !rcntnn d nmmnv r.r in.*ri"/.,*.2<_--) /^*,;"--^":;,"*.,:'\'k *,", ?rr1
<br />P.mir*nom.(!rro,,: er'+'Cr
<br />Under Slab / Floor
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