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ELECTRICAL-INSPECTOR RECORD ID/SIG.COMMENTS Site-Work Underground Pole Bases Light Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Voltage Fire Alarm / Dampers Communications Cable Building Under SIab / Floor Bonding / Grounding / UFER Transformers To rqueing Air Conditioners Roof Top Equipment Factory Wrred Unit alls (Conduit) Walls (Rough) Ceilings (Hard & Soffit Rouqh Ceilings (T-Bar Rough) Meter Release Rough //?/zo f/-le1 dLt Service lvleter // FINAL 3/z/zo,z:.Mr" ) ) Notes Remar(sl rtC 2'\-) - Ea7 OWNER BUIt,D}:R DEI,CARATION , haeby .rm utuid paahy ol pnjury lhar I an .r.npt ftom rh. conr.dou Lic.N rj$ lo. lte follo\vin8 r.e. (SR.70l L5 Busin6s trd Proasion Code): Any City or County {hich r.rtuir6 a Frnil ro conslrud. alts, improle dmolnh or rqnn my {tu.lurc, pior kr iri isstr&.c, also rcqunG rht apphcant forsu.hEnlil ro 6lc a sisncd srrrdd rhar he or shc ts licos.d p6ua ro rhc prolisions ollhc Contracrois l.icc.sd I{w (Ch.prd 9. (omnrcncins Nih S(tion 7(100 oiDivision I olrhc Busins and PrcLsionsCod.)or lal h. orsh. L.r.mtr rhaltom &d rh€ ba\is aor rhc allcg.d c*mprion Anyriolarionolsdion70ll tb,a., applic. aor r p€mi' subjeclstne applicantto.civilpcnahyoanoimo.cthmfivcnundrcddolltrs($500). L s o$ nd o I rh. potcny, or m, .mpLrc *ih r ar6 d lhcir elc cofrpe$alio.. (ill do $. (ork and thc slndm is our intgd.d or ofcr.d for sL (Se 7044, Busins md Prcf6ioB ( od.: 111. ('ontadors l-i.m. bw doB f,ot .!tly ro .n own6 of rhe pmpdy wl$ hd& or inptuvG rh@n. dd $ ho do6 such m* hinrs.lf or hd.ltor rhbu8h bi or ha oM.,nploy.6, provided rhal su.n i'npreErcnls dc nor inr6{ll,J orofield lor $le I[ ho!v6,o.lh€ buildirs or i'nprevofll is sold wilhi. o.. )Er ofcompklion. th. oNn6 Buildd will hav. th. hur&n of prelins fi{ h. or shc did f,ol build or nnpmv. lh. ,op6ry ao! th. purpos of I 6own6 olrfu Fropdy. m ercl6iEly.o F^rresion Cod€: l hc Conrrrcrois Licosc nkrdingNirh licss&l ..ntadoh ro .ocrtud rh. rojdt (S( 7o4,r. BEin6 l,a\r do6 not apply to o orva6 olprop€ny *ho builG or impo.s lhq@n, onhdo(s) li.@d pu6td' ro rh. conka.tois LicN l,w) i I hscby amnn undo poalryof DECI]IAAIIO! lhc followirr d{larartnr I havc dd sill maintain a C€niaEolc of(oMnt b SeltuBrrc aor qortgs co,trp.Garion.6 Fovided lor by Sdlion 1700 oflhc Labo. Cod.. for lhc pafom&ce oalh. wor* lor which ln. pdmit i! isu.d. lhartand*illosinlain*ork6s.oop.nsdlioninsuEnc€.sr.qutcdbyS*ion1700ofth€Lab.rCod€,forlhcpdlomeccof rh. worL for*hich rlis Fmn is isucd. Mywo a conpasation insur cc.dicr drd policy numbn sc: I ..iify rhar in the laa.nnancc oarhc rork lor whi.h lhis psnrir is issued, I shallnor mploy any p6on in dny mannd $ 6 lo b€.on'€ srbjst to lhe workm' composation laws of cnlifomia. ind arr that il I snouu becomc subj.d lo lhe *ortsJ comDeretion Drovisios ofScclion 1700olih€ Labor (bdc.lshall.lonhNith comply wilh lhos proyisions WARNING: Failor. ro suc $orkds .o,np6$rion .ovdasc is uila*ful. Md shall subjd d mplo)6 ro siminal lcEni6 dd .0o0). i. .ddiiion r. rh. con of.omt a.rion, dm.86 6 a,oridcd for thc I hr'.bl dm"n undcr pflalty olpdiurythnt I dn undcr Fovision ofChaptr 9 (cornmcnciq $irh S.dion 7000!ofOivision:l of rh.Businsand Pmf6io6Codc, ed $y li.ff€ is in iullloremd€frsr COIiIBUCIIOT-LII0BC-ACEICY I hd.5, srtrm uid6 F..alr, of Fjuy ihd rhd. n a coisrucrion lc.dins ,so., lor rh. Faomu.. oarh. mrt for which rhb Fsir ir iso.d (ss.3097. civ. c.) AEELICA'NL.A&CIAIAIIQ! I hdt'y amm undd paalty oaptrjul on. of lh. foll.Ning dddal ions Dcnolirion Pdirs'Asb6los Norificarion Fcd@l Rcsularioas ( I irlc 40. Pan6) R.qriol tJllr da Norin dido e ledqal r€-lulalioN qdin3 asbesos renNv0l .re nor spplicablc to lllis pmjqi iti I lhc abovc infomdi.n is cord I a-!r* lo codply snh all Ciry !.d Coury iotr and hdeby aurhoriz. repr6dlaliv6 olthis Cny md Cotrntyto ml6 upon th. '- D*-4" f6p5r,,",", u ,\2-Fr APPROVALS DATE Sub-Panels