|
ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE COMMENTS
<br />Site-Work
<br />Underground
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />t^^Rough I t &Mar _l W'1
<br />^dE
<br />-/@ t/ld7dt1_Service Meter ,q\h)
<br />FINAL Dt\.]iwn ,*g3
<br />NotBsl Remarks, ftc ll'
<br />z\111,O -r fttt
<br />-+
<br />OWNER BUIt,DER DELCARAI'ION
<br />I h€rcby amd undr p.nalry dlp.Dory th.l I m cxcmpl iion rh€ Cod4cto6 Licft. Las for rhc lollowins r.&n {Sd:7oll t
<br />io6s a.d ProfBion Cod.) Any City or County which requtd . ldnn lo cotrnod. allg, inprotq &solGh or Epor uy
<br />pnorlo tu issoance. also ,equn6 rhe appli.anr lor such pdmir to lilc a sis.ed sr m.nr thal hcor shct licsMd pu6udl
<br />rh. pmvisioB oa rhc Conaidois Liccnscd Lav (Chapt6 9. ConoocinS N"ith Selioo 7000 ol Divi.ion I oflh. Brsind ed
<br />ions (ide)o,lhal hcordE ise\ehpi I hu.lroh dd nt bsis n! rheallescd e(c'nflw' A t \ioldionolsdon 70 1 5'hyany
<br />a pcnnir subjecrsrhc applicam ro acivilpcnahyofnot mor€lh$n 6!.hon&ed dollas($500)
<br />otuh€ prop.ny. orry eBtloyc $nh \e86ac inch $l€ comp€maltud. villdo thl work dlhenrucl@i nor
<br />or oftrcd tor sL(sd 7044, B(,sin6s d frcfsions Code Thccodticro.s Licds.l,s do6nor apply b e o\md ot
<br />, $lE hilds or irproy6lh6Fn. dd rvho do6 nrch {orl finDselfor hmclforlhrcueh his.rnd o$n cmrLves.
<br />ided rhar suct i,nprerddrs N nor d6ded or ofidcd lor elc I L hovss, rh. buildi.g or nnprov.mt h sld wirhin on. ,a
<br />ofompldion. lh. Osrd Buildr will hr!. tE hrd6 oaFovins lhd hc or sl'c dd 6t hild ot idprtv. tnc FoFly fot ll. puFs or
<br />l. d own6 or rh. ropdy, an cxclusively conlracrios $ irh licdqd .ont.dos Io onerucl rhc p.ojel (Se 7044, Dsms
<br />..d Profsion Codc lheContack,'. Lic.N. Law do6 nor apDl] ro atr o$nr o f prop.t, rvho builds or imprcvd lhd(n,
<br />ud $ ho conrE* aor soch p,.jats wirh a Conrmck (t licGdl ptr6u ro ihc Conl,aclois l,icc. Lrs i.
<br />I m *dnpr md6 Sdion
<br />Osncr:
<br />tlaatsfal'-(Dlrf!$rlor
<br />ull(l"1aalto.r
<br />I hocby afim undd porly of pgjury on€ oflhc rollosins d(ltuarioa
<br />I hav€ dd *illoairran r ceniarcar. ofco'Edt to S.lf-lcurc tor {ork6- .o,npasliofl. s pro\ided lor bt sdrio.1700 oflhc
<br />libor Code for lh€ pofonec. oalh. worli aor which lh€ psnil G issu.d.
<br />f .. t ,'1.t ,r'.r-'r,/rFr..'\r\.. 1..r^'
<br />t;';',(Yffi lff1qffit ffi p /, ? a
<br />l.enirylh{r in rlr p(tuDanccoflh. wort for rvhich lhh psfrir is rsu.d. I shall nol dnploy any p6on in ont nMncr
<br />sostobeconrsbi..ltothe\orkEs.onpdsationla$3olctlifomi..aadasre.lhalillshouldb.(o,n.subjdlolhc
<br />$ort6' compc.stion pre\sioG of sdion 1700 ollh. Labor Code. I thall, fonhwnh .omply wirh thos prelisions
<br />WARNIN(;: r.i[trc lo s(u'e \frkc's compqs.ton ..\dagc is tuI. d shdll subjd mplord lo sininll poahi6 trd
<br />lo thc coe of .omp6,tion. dmas* 6 provid.d for th..nil lincs up io onc hundred thou@d doll6 ($100.000). in
<br />\lrrtr , r(r7to lrhe l:h,r('oLl. 'nrsddndairunkv
<br />,,,,".bl *uf10 ^,,,"*1 Dr ( l.\R\ll()r\
<br />I hmby amnn urdo pdalry of pqjury that I un licds€d urdd l,mvisionolchapld 9 (com,mcins Nith S.clion 7000) olDivision l
<br />of rh. Busifls md Profsiod Cod.. dd my licde L in lull lorc. sd e|Id
<br />t>/a t47d I '--------------1--*.(l?.7/ f ?.,o
<br />c0.Nsrauquou.Elarlc.AcrNrI
<br />I ho.h, amrn rndd paahy of psjury lhrl lh6c ts a onsrtocrion kndin8 .-!flcy for lh. Flomd.. oalh. sork fot whi.h lhir !E{n is
<br />issucd (S< 3097. Civ c )
<br />AtEJ,ICANLDECLAEAIION
<br />I Hy afrm unds p.nalr, ol pajury onc of lhc lollowin8 delmxo6:
<br />D.noliriof, Pmnils-Asb6ros Norilicarion Fdlcal R.Eulrtions ('lnl. 40, Pdl6)
<br />R€rluir€d L€rlq ol Nolfcarion
<br />'na
<br />dtnos rrtrurla,f Nl {fphcal,Le lt) rhL\,r(r.(
<br />ion is.oft.cr. I arre lo cor!Dly sirh all Ciryatrd ( ouflry
<br />hoize r.prcdlrtivB otlhis Cily dd Co!m!
<br />a.oxoo", IApplicnnl or Agenr Sisnrl"re
<br />t'"mire,rn,e tp,inO,:K re\k;Trw<
<br />ID/SIG.
<br />Pole Bases
<br />Under Slab / Floor
<br />2lt \tzt
<br />,B &P( forrhisrcson
<br />L
<br />------r-
|