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ELECTRICAL.I NSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS Oma-Buildq D.cl&ation <br />I hd.by arlim und.r p€nriy oip.dury thd I e crnpr fom $. C@tracl6' Lie.s Li* lor 0'c following @6 (s8.7031 5 Bcir6 <br />dd kofesion Cod.) Any City or County which equirB a pcmn to co$tru.( sllf, i6prov.. d.noliih or rcpat oy slrucluE, pdor b iaisme, rlso r.quiB th. appli@l ro sah pdair ro filc a signd sr.tcmar lhd h. tr ih. k licft.d plFusr ro $. FovhiN of rhc <br />ConFador's Licas.d l.iw (Cho/d 9, CMmodng wiot S*rion 7m0 of Divisi@ I ol rt. Busin* &d Prcf*ioB CodG) o ddr h. q <br />sh. is .x6pi dd.aion dd ihc bat f6 $c .llcgcd cxdptid Any violarion of S€rion ?0, I 5 by Dy appliol fd . ponn subjeLr L\. <br />appli@r to a citil ,.nalty ol nd m@ $6 fiv€ fiundr.d dollm (t500). <br />_I. 6 ouq of rtc FoFny, q my oployd witn *.96 a 6.ir $1. @np..snioq will do rhc *ort ed rh. ntutE i! nol inbdd <br />or oftald fc sal. ( S8.7o44, Bain.sr od PrcfBioB Cod.: Thc CotEclors Li.ds. LN do6 .d lpply ro m Me of thc prcp.dy <br />vno buildr o imFov6 th@o, dd *ho dG tuh wdi hiru.lf s h6slf or thrcuah his or hd @. cmployG. p.ovirLd rhd luch <br />imp,ovmdts e nor intcndcd tr ofl.Ed lor sal.. lf, how.v.r, tnc buildin! o inprov@ar i3 sold wirhin onc yd of cohpl.rio, rh. <br />OMd-Suildd will hav. lh. burda oa p.oving dur hc or sh. nol build or ihprov. for t\. purpGc ofialc) <br />_1. 6 oMn of $. poDcn . h cxcluiv.ly @nE .rin8 wi$ li.a.d drer@ ro c@eruct ttc Drcjccl ( Se. 7044, Bqir6s ud <br />Prol6si@ Cod.: Thc Com.dor's Licm. Law <tc nor lpply ro omd ofproFry {ho builds q imprcB $aM , &d who <br />corr&Lr ftr such p'ojEB vifi . co.E .ro(, lihscd p!6ud1 to rhc coElcrors Li.dc bw ) <br />_l d d6pl udd Scclion _,8 & P C f6 $t r6on <br />WORI(ERS COMPENSATION DECI-ARATION <br />I hcEby arfim undd Fnaliy of FrJUry onc of lh. following d4l@tioni <br />I hav. ed will n.jnl,ain a Ccaificar of Cosal ro S.lf lnrurq ao. wuk6 comp..sari@. s povidcd ld by S6tio 3700 otth. <br />bbor Cod., lor thc p€rf(mdc. of rfi. work aor qhich th. pmn t i$u.d <br />_l hav. Dd will m.inLi. *ort6 cqrFuati6 instuc., a rcquirEd by S..lid 3?0o of rh. t$or Coda fn $. pdfme of $. <br />work fm wti.h lhir psmil ii isu.d M, *oil6' cdpasaris irolm@ 6id bd policy nmb6 4: <br />Policy Numb.r: ExpiG <br />(Thh serio. ncc! not b. cmpld.d ifln. p6nn is for Orc hun&.d dol16 llr0Ol o,16c) <br />_l diay $ar in rh. Ffo,fu@ oa <br />'1G <br />*ort fs which thk Fdmit is isu.4 I shdl nd dploy dy F6d in &y nbnd so 6 ro <br />becd. sublet to dc wo 6'composatim las ofcalifomir. &d.gE rh if I3hould bccmc tubirt to lh. wod(4' <br />compasalio provisimof Senon 3?00oltu Labor Codc,I shall,aoniqith comply wiln d6. provi.io.s <br />*-la,/a / <br />WARNING FailuE lo s*urc wdk6' cmp.nldim covoa8c ir ulawful, ed shall subj.cl d cnployf lo niminal pcoahi€s sd civil <br />fin6 up Io ooc huntlr.d lhoaud dollm (l I00,00o),in addition to thc cd of @np.nsadon, d.hag6 6 prcvid.d for rh. Setion 30?6 of <br />ih. kbor Cod.. int r6t ud afiod.yt fc <br />LICENSED CONT*ACTORS DECLARATTON <br />I h@by amm u.d.r paalry of pdjury th.t I m licchs.d u.di provision ofcha,ld 9 Gohncicins wirh Salion'7000) olDivhion 3 of <br />thc BBin6s dd Prcfsions Cod.. ud ny licas. it in lull foe drl cflel <br />CONSTRUCTION LENDING AGENCY <br />I h@by afim udd p.n.lty ofpdjury 1h01th@ i. r @n tucti@ lc.diig ardc, fd rh. p.rfmM. of th. wd* fs,hich rhir pcmt is <br />is@d(s.c 1097,civ.c.). <br />APPLICANT'S DACLARATION <br />Ddolitio. Pmn!-Asbi$6 Norificalje F.d.Bl R.gulario! (Tnb aq Pan 6) <br />_ R.quiEd L.tto oaNodt.tdo <br />_l ccnify lhal thc fcd.ral r.8llations rcgading sb6lG tmovd ec ror lppliebl. ro lhis proj.cr <br />_ I cdn ay rhar I hav. rcld rlis +plicdion dd sd. l1)al ttc sbovc inlomadon n coret I aA@ to @ply wilh atl Ciry ed Counry <br />ordinMc6 d Surc Ltws .cla,ling ro buildjnS @Ntru.tim, od h@by aurhori& rcpenrstivB of this City ud Count, to dr.r ulon rhc <br />ahovc mcntim.d prop.ny aor inlpdtion purrsd <br />Site-Work <br />Underground <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 />Torquing <br />Air Conditioners <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 E#r 38€D <br />Rough FrtEs U I ZUIg <br />Service Meter ^. .s.aMC 84a . 290 ere . <br />FINAL tad6 s Addrar: _ <br />Pole Bases <br />Sub-Panels <br />Notes, Remarks, Etc.