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APPROVALS DATE ID/SIG.COMMENTS OWNrI BUTT,DER DET-C]AI fi, <br />I rEEbt rfrtrm uftrd p.Mlly of tE,lury lhd I fl .r.r0 fn,f, rrt Coffitn Li.nc tiq lot lrf, fdh,in3 Bstr (5.{.?011 J <br />Buri*$ dd P.oli$i.n C(xL): Any Ciry 6r c.unrt whah EtuiEr . FnDir to o rln.t. rlid, idphk. &mlnh or qE y <br />dtu.rm, tm, b nr frud.. .h, rquiB rtE rlplaMl for st Fmt 'o <br />6l. r \i8tr! dd.md rhd rt tr dE ir li.u(n PoNrn <br />n' tlE pmvi\ions ot rlt Conra.tr r Liftnsrl ta* lch.tr.r 9. ComnEEinS *ith S6ridn 7Ur).f Divisitn.l .r$. alriBs..nd <br />Phr.rsio.i co&l o. rh.r h. or rtr n .rcnv'r rlmtum un rlt blii for rtr .lh8.d crnprbn. Any virhlion of Sarion 701 I 5 6y uy <br />!t li. nn ! Fm'i ut'J.<rr rlE {ipliur kr I civit ,xulry ol m' frrc <br />'ha <br />fiv. hundEd dolL^ {S5(n) <br />_1. s ovmr olrlr FoFny. n my 6q,t'Fd wnh *rg.s ( rrEn $l otrqrB.lbn. Ei[ & lli {rc* &n ltl rnnft 6 or <br />inr.irlcd {, ofrcad l( {L ( Sa.7oaa. AusiE$ sd Pmf.srbnr Codcr Tll. C,ntddt tiaE Le dc! mr tapl, ro u ovE of <br />th.Impcly *b hiktror Lrpoh rlEtutr. iwhodcsshft hnB.lf or h.elf or rhftr8h hk or h.t own .mtlor.r. <br />Fovd.d thr sh lrgDwn3 e d irdLd tr .nEtld fd qL. lt hoEw, rlE trildii c inr.Gm'r i! $E urhtl d lar <br />of mrykb( rL O*M Blildi eill IEE r,E hftr.n ol Fori,ts thl lr tr rlE dn f,{ t!i! .t inlmE 0t F rqt, nlr dt IElrE of <br />-1, <br />ar owfr otrlE FoFdy, mcr.tuirclyodrerms *'lh lkcnsi comrEt^ ro &!nnM dE FrFr (Sa. ?oail. Bulixs <br />id Pnltsirn Codc, 'rhc Conracroir Liccnrc trw de! mr ippl, lo un owncr of prulcrly who hrild! o, imlrriwr lhcr.nn, <br />rnd w,b 6ildi for rrh FtrFds s t r Co Ero(il lie'Ed pu^rr ro E C.drdd r tirtrE l,v) <br />-l <br />m.rc.rpr uE cr sdr <br />lt!8f,EIN:lOMtAtAIlll! <br />DECIdt Uq! <br />I lritb, trmrm ulld.r pc l'y or Frury or ol rlE folh* hs d(ls!rk,B: <br />_l h*. ,n *ill midrin . Cdiror of Con*nr ro S.la hsrc fr u,ls on+.ndhn. ri tmtircd for by Sdtior l7(D of rlE <br />libd Cd., ld rtr lEfrlrjm. of rh. wrt ti, l,ri.h th. Fml is i$Ei <br />_lhrBrd*iltm, rin wnln mrp.ndbn iNrr.,.! rcqurti by S(tbn 17fi)6filE t bor Cod.. fo. rh. F.lolrrIR ol <br />rh. *orh fd ehih rhn Fmi is ir$El. My *od6 odpcnr.liotr iEgl..K ceE {n polky numlEr r. <br />P.licyNunfi..,- <br />-l <br />rcnily lhll in rhc p.rlorruE-c.f rtrc *ork fin *hrh rh'r I.rnir r isx*d, I snlll nor.nlrbr ry PcBr i..ny rurcr <br />y, N ro lx{r.E subj.ri ro Ih. wo.k6 co.{Enernrn hws ot C.lifomi!. ud lsr thd ir I dr,uld }E oft bjrtr L' l,r <br />*r!*6 .o'qrn€rsn pnrrniJ.s or Sdi'n :tr(L of rlE L.tior Co&. I {Ell. tdh* h nrtry tnh 'rrc tovniflr <br />WAI(NINC PntuE lo su. wl.B'oi{rtrt lbn NtBsc lr !.LBfuL ,rl rhrll rubJ.d d crf'bltt to nin l lxflli6 rn <br />.N'l fiftr un lo oE t[dEd rhou!.t'd dollB 1,10.000). in dd hn ro rh. .or of conlEnslion. d.nlrlr .s Fv'{kd fr rlE <br />Sr.rion :ll)76 nfrh.lrhn (ixl.. inr.rc{ xi{l rnonrvt- /l-L ( <br />D.ri rL L: Appuor <br />DeqdEaM <br />I lErby rr,m uBL. Fflh, of Frrury lhrl I m lieNcd uid.r F.vni'n or CrLBd 9 (tunmmin8 wnh S.nitn 7(ml oa Diiiion l <br />of $c Alrift* {*l P6fc$io6 Crxh. !d nry ltcns is in rull fora rtl cfie! <br />B-aro 16 Zcq, vLLl <br />(f -ct' contndor / <br />Q!EIA T:E8.IEN]A!jJiEMA <br />I h.rcby rmnnudcr Fmlry ofp.rrury thrl ihcrc k ! cinsluli'tr hndins,seL..y r.r (h. FrrolruBT orlh. work nn shth lh Frmir i\ <br />irtuad lsd. 109?, Civ C.r <br />APPI ICANT DECL IATI(IN <br />I hdrht rtrm u .r F..ny ol Frrury om of llE folh*ins <krlr6rbn.: <br />l). nnion P.rnirsAsb.{d Nolincr'ion F.dcnl RcSuhlio.r(Tnt 40. Pdln) <br />_RquiEn t nd of tadifErirn <br />_I dify ihi rlE fcLrd rc8lL'rrs rc8d{in8 .rtE!!n icm,vd u. Ln lpdrlbk b rhn pNFl <br />I (cn it rhrr l lur. crJ rh'\ rtth(iri,,n dl nrrc ihlr rh. rh^r inri)rur nnr r\ (ore.'r l rsrr n, .omnlt wirh nll Cny afrl counry <br />ordiNrs rnl Srarc liwrc&r'n€ro h'U'n rtr{Mi8 rn h.Eby .urlr'ria EF.Edd ol rhri Ci! t rnl Coudy ro .rtd ulFn tlE <br />d)vc nE nmd pmFn, for <br />ADrli.mt o. ,tr.nr sisMroR Zcli, J dlr', <br />Sile-Work <br />Underground <br />Pole Bases <br />Lioht Standards <br />Spas, Pool, Fountains <br />Siqns (monument) <br />Life Safety /Low Voltaqe <br />Fire Alarm / Dampers <br />Buildinq <br />Under Slab / Floor <br />Bondinq / Groundinq / UFER I Ur X.\t\tffi\'l <br />Transformers <br />Torqueinq <br />Sub-Panels <br />Roof Top Equipment 1_11.1,1 bA&t1 1 <br />Factory Wired Unit I <br />Walls (Conduit) <br />Walls (Rouqh) <br />Ceilings (Hard & Solfit Rouqh <br />Ceilinqs (T-Bar Rouqh) <br />Meter Release I 4u L,l \ttVll I <br />Rough <br />Service Meter l <br />FINAL \\'k#s, <br />Notes, Remarks, Etc.I <br />Rl:v 08-O7-2015 <br />ELECTRICAL.INSPECTOR RECORD <br />,,*!-4r I <br />Communications Cable <br />Air Conditioners