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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS ID/SIG.COMMENTS OWNER BT,!LDER DELCARATION
<br />I t6cby arm u.dr Fralry of pojury rhal I @ empr 6om thc Conlrscr66' Lic..s. lrw lor !h. lollo*in8 t@n (5(.7031.5
<br />BBi.6s and Prof*ion Cod.): Ary City or Count, whkh r.qut6 a psnil lo cosrtud, rhd, imProve d.nolish or ..?an M,
<br />studue. Fior $ ns isuece, also requt6 lhc eplicanl lor such pcmil lo 6L a siln.d st.tmdl lhal he ot sh. i5 licos.d puMel
<br />lo lh€ pr.visiod ol lh. Contrcro.r Lic.trscd llw (Chapr6 9. Comcrcins wnh SElion 7000 of Dilisiot I olth. B$inB dd
<br />Pofcsio6 Cod.) or (har hcorsh. is cx.npl ltqcEom d lhc b6is lor rh. ail.rtd ddplion Anyviolalionotscclion70:ll5by3n,
<br />applicant lor a pmit subjcrs lhc applical lo a ciril pdally o t not oo.. rhh five hun.tred doll&s 1$500)
<br />-1.
<br />6 oMcr of$€ pmp.nt. or my cnployG w n sa86 6 $.n sk co'npenlalio.. Nill do lh. Nolk ad thc sl,Buc ! @l
<br />i 6ddl orord.d aor sl. (Sa 70,t4. BBin* d Prol*ioB Cod.: Th. (ontrlclois l-ic.M t w do6 not tpgly lo e oMn ol
<br />rh€ prcpsry wbo hril& or improvG ihdo.. dd who do6 such vo* hnns.lfor h6.laor rhmush his o.hd oM€nploy.6,
<br />providcd ttat such ioFovomrs @ ior i qd.d o[d!d ror sL lr, bdw66. tE blildins or inll,lv€@l 6 su *nhin o,. y@
<br />ofconDlcrion. thc Owcr Buildg will havc th. blrda ofproling rhd h. or shc did nol build o. idpmrc tn. rtopoly lot rhc pupos of
<br />_If, - "*,- r,n. r"-y, m.\!l6nc\ cuntrd6s wilh licdrd coflrB.lo6 ro con$tu( th. Foid (sa. 7(x4. BBin6
<br />I -f, pon o"n c oa. j[ cJnra<or s t-iccirsc L.a* aol oor apply ro o oMr or ropeny who uulias or improG rtramn.
<br />and who conrdcls tor such projdswifi. conhdo(s) liclGd puBuul lo th€conractoas Lics. rjw).
<br />_l @ er.,npr undosd(ion . B &
<br />** to/z.r /nt K
<br />I hdcby aflim uidd poDXy of pdjory o.. oflh€ aollowina deleatios:
<br />I havc {d sill mainrain a C.nificarc ofcon$t ro S.lfiB(. ao. rcrkdr @mpcnsario., a previd.d for by Sdion 1700 oilhc
<br />t bor Code,orln pdfo,rrr4cof thcwo tor which thc Fni b Bu.d.
<br />Ihav.andwillmai ain *o.k.rs' compoMlio, icordcc, s requtcd by Sdlion l?00 oa$. t bor Cod.. lor lh. p6lor1@.c or
<br />rhc work for \hich lhis pmir 6 6s.d My workdi co,n!@lion iBumc. ffiin dd policy ,!mhd el
<br />cDo
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<br />PoLcy \umbr
<br />-trPtr6
<br />-.,' Lfi cair) Lhor in rhc perom ceotrh.{orltorshrhrhispdniriristu.d.Ishallnoroployuyp.6oninmyDms
<br />s 6 ro baomc suh(l lo lhc * orrd' onpodion ls*s ofcalifomia, 6d .sG lhal it I lhould b..om. subjel lo thc
<br />wo*6' compq&rio. prodsioN oasdion I700 oflh. rjbor Code I shall. lonhtr nh comply s nh thos PmvtioB.
<br />WARNINCT FailE rd su. Norkm comp€Nrio. covms. is !trLvful. ed shall subjd M 6nploy6lo dilrinal FnaniE ard
<br />civil fii* up t6 o.. hundr.d thousd dollds ($100.000). in addition to thc .o$ of.omF,etion. d4.gd d prcvid.d lor lh.
<br />Codc. intd6l dd anorney s ae
<br />D[C!d8AIIO!
<br />I fiGby amm undd pqulry o a poj!ry {hat I @ liceN.d undd Foriiiotr otchafl6 9 (o,mocine wnh S.clbn 7000) of DMdot l
<br />of lh. BNirs ed PmfsioB Codc, a.d 6, lk.N i5 i. axll aor.. dd .ff6t.
<br />LiccnseNunbd:
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<br />-tcdr't)rhdrhcle&'alprul.r!06re*edrndbberosreNrarden!tp.abl.roIhBprojd.7-6caih ru r rrar c roa rrs cppl'car'on and sr'r. ,hd rh. abo!. inronnarion L, cortd. I asd ro onDly w h all c y dd ('ounry' ordinancd Md Sral€ lixs rcld 'nr
<br />tu bu,ld'ns .o6hd iotr ei h*by .uthonz. Epr6dtlriv6 of thn C y md County lo 6ld opon th.
<br />abov. mmrio.ed popeny for iNp€clion
<br />Appli.rnl or ASrnl Signrlure ^,,,P/z,c/zrr!
<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 />Bondinq / Groundinq I UFEA!-
<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 Rouqh
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough
<br />Service lr4eter ,J lz-lt -t9 J/,G{I w.
<br />FINAL |lrlo'Ti ?/'1)
<br />Notes, Remarks, Etc | 't UV
<br />DATE
<br />Under Slab / Floor
<br />*t*
<br />CONSIBIJCIIQNTENDIIGJCEIS
<br />I hdcby .ffm undd poahy of p6j[y ltrl lh6. ij a oNlruclion loding agd.y for lh. pufommcc of th. worh lor whi.t $is pdDit i!
<br />isu.d {36.1097, Civ. C.)
<br />L.ndcir Add6
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<br />AITI.ICAXLDIICIdAAIIA!
<br />I hed, alrm !.dd paahy of p<jury onc of lh. followin8 dcclratioosl
<br />Demolilion P.rmils-Asb6ros Norilicatio. Fcd..al R.gul,liom (Tnk 40. Pun6)
<br />-R.quncd
<br />Lctlq ol Noificdion
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