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APPROVALS DATE ID/SIG.COMMENTS O,oa-Buildd D.cltalion <br />I h.r.by,ifim undcr pdalty olFrjury that I M.xhfl fom fic CoE&tc' Licasc rr* for fic aollowinS rc6o. Ge 7031 5 BBil,$ <br />md Prcf.sion Cod.) Any City or Couty vhich Equir* a pdhit ro const uci. alra, improv., dmolish or Ep.ir sy st rchr.. Fid !o it! <br />issuac., also lcquiE $c appli@r for 3uch pcmir to filc a 3i$cd sraimot ih n. or shc is lic6s.d puGuet b tn. prcvisioni ol lnc <br />Conrador's Liccifd Law (Ch.pt r 9, Cmmmci.g with S.ciio. 7000 ol Oivision 3 of fic BBinds d Prof6ions Cod.) or $.r hc 6 <br />sh. is .x.mpl lh.rcliom ed thc h€sis 16 thc .ll.gcd cxdflion Aoy violado of Sation 701 I 5 by ry .pplisl fm a Fmn subj.ds tlr <br />.pplicdt to a civil pa.lty ofnot mdc lha fivc huid,cd dolld (t500) <br />_1, a oM.r dr th. prop.dy, or my cmplor.6 with wa!6 a dct $lc omp.ns.tim, will do th. work &d rh. structu. is nor inbd.d <br />tr ofi.rcd f( salc ( Scc 70.la. Businas dd Prcaeioos Codq Thc Cot c(or's Licd& Lap tto.s nd apply to o ovncr of $c prcpdy <br />who builds or improys thcrcon, dd who dG such vdt hitucll or h6.lf or rhrou8l bt o. ha o*r dplolc. ,(ovidcd rhar such <br />inp@lmdr5 -. nd int nd.d tr of6cd lor sal. Il how.v.r, thc buildins d inrrovdol is sold wdlio on. ycd of conpl.om. th. <br />ou6'auiB.r wiu hav. rhc budo oa proine $al h. or lhc nol build or improv. for rh. purpcc of salc) <br />_I, a o*nd of lh. proFny, m €xcluivcly cmrrutins with lia6.d €orr.clm to @srrud $c Fojccl ( S.c 70aa, Bcin6s Md <br />Proision Cod. Th. Cotnclo/s Li@nsc k* dG nol apply lo d own.r ofpropdty who build. d inprove ddcd , ed who <br />contrcrs aor ruch prcj.c1s wnh a CdE&to(, li@.d puR@r ro thc Con(.&tor's Li6!. L.w ) <br />I m .x.mpt und.r S.cton .B &PC ae tnis r.&n <br />WORI(ERS COMPENSATION DECLARATION <br />I hc,cby afim udcr Fnslry of pdjury onc of lhc following dftldions <br />I h.vc ed will m.int.in d C.nifical. of Consar ro S.lfinsur. fd wdlm' cmFnsalion, a prcvidcd tor by Setion 3700 oad. <br />l-3bor Cod., lo, th. p.rfoMc. of ft. wot fo wlich rhc pdhit is issu.d <br />_l hav. ud vill mainlain w*tc6 conp.nsarion insumcc, 6 rcquiad by S6tion 3?0o of th. Lab6r Cod., lor th. Frfm c.ofth. <br />wtrI for which ttis FEnit h isrucd My vork6' cmp.nsaliq ins@c. c.rid dd policy n@b.r e. <br />6-za/a / <br />WARNING Foil@ to scc@ *od(6 @p.i.aio covcagc ir @la*ful, dd sh.ll subjccl e oploycr ro eiminal poaltie ed civil <br />fin6 up to oi. hundrcd $oued doll4 (t 100,00o).ii .ddidon ro rh. cosi oi conFx.tioi, dMas6 a p.ovid.d 16 dr se{6 3076 of <br />rhc t bc C.d., inrdd Md rnom.y's fB. <br />LICEXIED.C9NIIAEIAEiDECLAE4IIQN <br />I h@by .film undr F.alry oa D.rluf lnd i m licos.d mdo prorisim of Chspld 9 (cmmocinS wnh Scction ?000) of Division 3 of <br />6c B8in6s &d Proa6i@s Cod., dd my liccnr. ir in aull forcc od cL.cr <br />CONSTRUCTION LENI}ING AGENCY <br />I hr.by afiim udd porlty of pqjury tn'r $G i! a @3tru.ri@ ladrng .gocy for !h. p..fmue of th. edt ld Bhich lhi! p.mir i3 <br />issucd(S* 1097,civ C.). <br />AIIUCAXISDECIABAIION <br />D.moliraon P.mil$Asb6r6 Nodli.aio. F.d.ol Rcslla{ds (Tirlc 40, Pfl 6) <br />_ R.quncd Ldr€r of Nolific.rim <br />I ccnify rhat thc Ld.ral Egularions rgddins ab6tos rcmoval c noi appli@blc lodris prqcct. <br />_ I c.lnry tnd I h.v. rcad thk .pplicario. dd sraE rhar d& aborc infom.rion is coner I aerc lo cmplr eirh rll City d C@nry <br />ordinucd md S'4. Ld*s Eldin8 b buildir8 conshclio., Md h.r.by ruinoriz. EprBot tiv6 of ihk Ciry dd County lo .nE. upoi thc <br />ahov. hcDlioncd prop.rty for insp€clion pur!c6. <br />..3i--,c4/a d <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 />Bu ilding <br />Under Slab / Floor <br />Bonding / Grounding / UFER <br />Transformers <br />Torquing <br />Sub-Panels <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Rough <br />Ceilings (T-Bar Rough) <br />Meter Release <br />trYDII )En <br />Rough <br />FEBOI ?0:9 <br />FINAL <br />Notes, Remarks, Etc.e 'v,v (re, .Err,, Itoi oo/ <br />ELECTRICAL-INSPECTOR RECORD <br />Air Conditioners <br />Service Meter <br />Policy Nuobe Expic <br />(Thi' sc.tion nccd not b. cmpld.d if lhc pdnn is lor oi. huidcd dolla ll l0o) or lc$) <br />_l cdi ay thal in lh. psfomb@ of thc wod( ftr which thh imn is issu.4 I shall nol cdploy dy p6on in ey nun.r so s to <br />b.@c subjat to lh. workq compdsrtion lawr of C.lia@id, ud agE. thar ifI should hccom subj..l lo thr vqlc6' <br />cmp.nsario. provisims ofs€rio 3?OO of(hc Lalq Cod., I shall, fordiwnh cmply with lhcc FovhiN . <br />ti.6.!m5q_ <br />Isd.r's A.ldrd <br />.2.>r-./ <br />-------T----- <br />=