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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE tD/stG. <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 />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rouqh) <br />Ceilings (Hard & Soffit Rouqh <br />Ceilings (T-Bar Rough) <br />Meter Release <br />Rough <br />Service Meter <br />FINAL )t )t?fi Glrr'Pr rJ i '7:' -) <br />Notes, Remarks, Etc ulI <br />-) <br />OWNER AUILDER DI'LCARATION <br />I ncr.by ailm ond6 pcnalty oaFrjlry tb,l I o cxcnrpt &om lhc Cont,crots Li..nsc bw aot lhc followi4 lw, (Sd 7011.5 <br />lrxsitrBs d Prolsion Codc) Any Cily or Counry $hich r.qun6 a pdnil ro conslnlc1. ah6, nnprovq d@oliih or repair M, <br />slructuE. ptur ro irs issudcc, also r.quir6 lh. .ppli.et lor skh p.frn 1o 6l€ a sisncd slah€nl rhal h. o. 3n is lic..s.d p6uot <br />!o rhc FolisioN of th. Coorra.rofr Lic.n*d Law (Chaoo 9. Codn.ncing wnh Setion 7L\00 of Division I oalh. a6in.s dd <br />Prcf6sions Codc) or lhat h. or sh. s crmfl th@6om nd lh. bosis lor thc allcBe! cxsnplion. Any riolalion ofs..lion 7031.5 by aoy <br />appli.d for a pdsil subjdls ihc spplic l1oacivilpcnaltyofnolnoGlh&fivchundr.ddollts($100) <br />l. s ownq ol the plopcay. oi 6y employ$ with *ar6 6 lheir ele .o,rp6slion. will do lh€ wort atl lhc shdu. is nol <br />inroxjej or ofts.d for salc ise ?o4,1, Busins md B ofsioN Cod.: ltc co.tddas Lictu. La* do6 not lpply lo s o*no o I <br />$c poFny s,ho buil.6 or ihpms rb.r6n dxl *h. dG soch $rrl hi,B.lf or h6.laor rhreugh hi or hd o*n drployc. <br />provid.n lhar such iDprcvoBls e nol inlsdsJ oro,Is6.l ror ela Ir, how66. $. hildins or i'Ilpro\@ol i..old lvnhin.n. tm <br />.f.omplciion, thc Os nd Buildd will h.v. thc bud.n ofprcving rhd h. or shc dil nol build or inFolt fi€ p,opsly lor the prqre ol <br />I, as owner ofrh. propdy, an cicluiively & radina *ilh lic@d .o 6dou to corstrucl lnc projel (56 7044. Busns <br />dd PbaBirn cod.: The Conl,.cror's Lic€nsc ks do6 nol applylo otr na ol propd, who builds or improrG lh(a'n. <br />ald sio coDlrrcls lor such prrjet with a Comr.dor{s) licdsd pursn! lo thecontaddrs Lic.N taw) <br />I an.xc.rF undr secrion .ll & l'C aorlht raso <br />Osmr !aa[s8ll.]r!t!!l^.Ilo!UEgllallllQl <br />I h&cbyrmnn und.r poFh, oapcrluryone ollhc follosin8 dsleations <br />I hav. od u ill mainlaio a Cqlillal. .lcon$t ro scl tuu. aor erk.G @mp.n!!lion, s prcvided lor b, sdlion l?00 ot lh. <br />Ijbor Codc, for thr pdaonnMcc o I th€ wod( for which lh. Fni i! sued <br />,I havc and wiu naiorai. workeh' codFBario. iBuia.... s rcquned by SElion 11700 or Ihc Laboi codc. for rhc pqfomucr of <br />lhr q'o lor wh'ch rhis pnnir i5 isu.d. M, workds co,np.salion iNurancc c i.r ad Flicy .ombd e.l <br />PolicyNudba:-Etpir6r <br />I cditythar in rne p€rlormance oflhe uork lor which lhis pFrn is isuen.I shsllnol mtploy any pNn in tny mend <br />so 6 10 bccomc $bjd ro <br />'hc <br />wo.l6' comF6ario. laws of Calilomia. and asE. lhar if I should b..o,n€ subiEl to lhe <br />work6' onpeelion provisioB oasetiotr 1?00 oaltc I ibo. Code. I $hall, rodh{nh .onpl, wilh rno* pmvisiod.. <br />wARNINC f{ilure to $curc \orkc6' coDpmalon coleRlc rs u.lawill. and sh.ll onployd ro dininal pdDhi6 ond <br />ion, damard e prolid.d aor rh€cilil an6 op to onc hondr.d thoMd dou6 (3100.000). itr addnion u rh. <br />Scr'on 0?6 ofrh. Lahr <br />a <br />inr66l d anorrcy s ls <br />1l-l-l <br />I hereby omrm undd pmlty ol pqjury thar I m li6sl undd povbion ofCh.pl6 9 (com qcrs*illrSdlirn 7000)olDivision I <br />of rh. Busins dd Profsions Cod.. md my licm. is in tull forcc a'd clrd <br />7q <br />CONiIA.IJCIIANJ.INDING.ACEIII <br />I h6cby alrm undd p.nax, ol p.rlu.y that rha. is a coddclion kdins asdcy aot rh. pdaonnec. olih. rrcrt li'r *hich rhil Fdnit is <br />issucd (S{ 3097. Civ. C.) <br />APPLICAN-T DECLARATION <br />I ho&y alfim undq pqaXy ol pqjtry o.. of rh. aollowin! del{tl ioos: <br />D€molirion Pmnirs-Ashcros Nolincdion Fcddal Rcsularions (Til. 40, Pd6) <br />-R€qut€d <br />L.ll6 of Norifrn@n <br />I cdiry thar thc fedcal r.gulrioN reS&ding Bb6tG rqnov.l ae ml applicablc ro this Fojd. <br />-l <br />crlify rh.r I iav. rcld lhB applicalion ed stllc rhar thc abovc inlonnaion i! coEal I osre lo comply wi$ aI Cny md Couty <br />ordinancG and Starc ljws r.lari$ to bu h6.by aulhorn rcprGqlaliv6 ofthis Ciry Md counlylo ol( uponlhe <br />ar{!e,nmrion€d !,ropen, for <br />,",", ,K- I- lQ <br />COMMENTS <br />Sub-Panels <br />D,," J -(-[6 <br />I .ndo's AJd,s <br />tt