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ELECTRICAL.INSPECTOR RECORD <br />COMMENTSAPPROVALSDATEID/SIG. <br />Site-Work <br />Underqround <br />Pole Bases <br />Liqht 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 />\Mttt*1nBondinq / Groundino / UFER ?.z'FX ,w <br />Transformers <br />Torqueing <br />Sub-Panels <br />Air Conditioners l-,..) <br />Roof Top Equipmenl lVhr 4:*lo ).o i66 <br />Factory Wired Unit / <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Roush <br />Ceilinqs (T-Bar Rouqh) <br />Meter Release <br />Rouqh <br />Service N/eter p <br />FINAL 'J' .t"X74 0b/r*ttr,. vl) <br />Notes, Remarks, Etc. <br />OWNER BT]II-DI]R DELCARATION <br />I hd.ty artrm und6 paahy of p.rjury lhar I dcmpt lion lhc Contradou Li.o* hw lorlhe follo*ins reen {Sa.7oll.t_ <br />BusinN and Prolsion Codc): Any Cily or County *hi.h rcqun6 t p6:nn lo @Nlrud. altd. inrrolq ddolirh .r r.p.n My <br />rto.ruc, Fior ro ns isuscc, also r.quir6 lh€ .pplrcmr for such Fnnil lo liL a sign.d slardnol lhal hc or shc b licqs.d p6udf <br />ro rhc p.olisio6 of tlE Contracrors Lkcned Law lchaprd 9. Comnmcine wilh Selion ?000 olDivision I ofthc ausinN &d <br />Pmi.sions Codc) oi lhal h€ o, sh. is .xespr rhecFom ad rh. hasis aor rh. .llcscd cxoPlion. Any liolarion of Sdion ?01 I t by oy <br />applicdr for. pmn sxbjd8 rh. applicanl to a civilpcnahyolml morc lhd five hu.dcd douas ($500) <br />L s ow.d ol ltc prcpenr, or ny mploys wilh rear6 6 $eir el. cohp.Mrio,. will do rhe wort e'd Inc nr*luc n nor <br />idddal or ollq.d for sl€ (Sc.7044, Busins dd Ptursio6 Cod.: Tnc ( onlraclols Lics. t w &6 nol apply lo d oMr of <br />rhc popsry eho buil& or ir,r*o!6 rh6n. md wno do6 sucn *!rI hims.lt or n@llot lhoush hi or nd ost mployce. <br />provid.d lhal such inprolsn ,ns @ rcl i qni.d or ofis.d lor ek. tL howRs. lh. hoildins or ir.lro@ol 6 $B wnhin on. ,6 <br />olcompldiotr $. O{nd Buildd will harc ln budt ofprovins $?n h. o. shc dil mt boild or improw lhc p'opoq lor lh. FrFs oa <br />. - I, s osnd ofrlr Fopdy. m .rclrciv.ly .ontaclins will licsed coilrado6 lo cohnncl lfi. Foj.d {Sa. 7044. B6itrs <br />md PDftsio. Codcr Th. Contr crors Licas. Iiu do6 nol .pply lo & oma Df ptopd, who builds or implovB lh6o.. <br />and who conr6.rs for such Foj..ls $tt a CoMdo(, licdsd puEUUl lo thc Codraclor's Li.ft. Lrw). <br />Ianrerempl urdcrseclion .u & P C.lorl[isteGon <br />D.rc: Orner <br />\(x[!&::coMEdsallo!Dfcldaalla! <br />I h€r.by ailir( undc' p.naxrof,oluiyoncofthc aolloeinBdclu iom <br />I hav. ed will minl.in a Ccrliliqt. of Co6or ro Sclf-IEU. lor wort6 compdsal ion, 6 p.ovid.d for b, Saiio. 3700 ol th. <br />Lab.r Cod€. for lhe psfol]Mcc of th. polt lbr which rhc pdtrit is i$u.n. <br />V hrv. ad will nEinrain work6 correrealion iNuenc., d Bq.irat by S&1ion I ?OO oalh€ Labor Codc, tor rh. Faorl1@c oa <br />n!.@rio. iNrrdce.mi6 ed p.licy nun$q ae <br />N-"b*,71 o E/i- AA A Aa- L- <br />_ I cdity thar in rhc Frfomnc. of thc * ork for which this psnit is isued, I shau .or mploy any Pe6on in any manns <br />s d ro hdom. ubj*r lo lt. worlss compen ion la$ oicalifomir, dd atE lhal ial should baonc aubjer lo tnc <br />workql compcmalion plovsions ol Sdrion 3?00 o I lhc hbor Code I s\all. fonhwnh onply wilh thoe povisioB.. <br />WAITNINC: IjailuE ro su. wort6' ooFqrion co!@C. is nnl.wful. od shau subj€cl d @ploF lo siminal FElrts ed <br />civil linrs up to onc hundrd lho@d dolld ($100,000). in addition to th€.ost of .of,p.Ntion, dam86 a p.ovidcd tor thc <br />S€crion 1076 orrh. t,h, Codc, imdd ed dbmcy s iccs <br />o.,. 2/a12 u_.r_ <br />I h@by arm u.dd p6.lly of Fjory thnl I e undq provsioo olCh+r6 9{codmdcins vnh S..lion 7000) olDivision 3 <br />.f rfu Businss rd Prof6sio6 Code, dtd nry licc.sc is in tull aor.. dd clId <br />a",,r"",".( <br />3//za .ookii,on r"nrrn.'n""n.t <br />I hq€by amm unda FElr, o aDqjury lhit rh@ is 6 co.rruclbn kodins asocy lor lh. Fao@c€ of ln mrt for vhich lhis pqnn b <br />i$u.d (Sd. 1097. Civ. a ). <br />AITI.ICANTDESAAAIIO! <br />In !8 arm unda pa.hy of pdjrry oD. oflhc followins deldalioB: <br />Dcmolition Pmirs'Asb6bs Norincarion Fcd.ral RcSulal io.s (Tille 40, l'M6) <br />Rcqui,ld L.rl6 of Nolihcalion <br />I cdtily thar rhc ledsal r€-lulatiofls rcstrdlns ab6ros ronolal de nor @plicabl. ro lhis pmj..l <br />_- I .diry did I havc r.d rhis applicdion md earcrhat thc abor€ inlomation 6 cor.d I asre to complywnh all Cnyand Counly <br />ordinanc6 d Srarc krvs clarint ro building co nruc1io., .nd hcEby aulhorte rcrrsdali!4 of this Cny ed Couoty lo o16 upon thc <br />akn€ Dcnrioncd lrorrny loi icf(rbn <br />.\Dplicint or ,1Bcnl SiBmrur.: <br />Rev.08-07-2015 <br />,IYWA <br />a <br />)r