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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUII,DFJR DEI,CARA'I]ON
<br />I n.rcby armn undd paalty ol pejury that I m excmpl frcnr thc Co tracion l.icss.ljv for lhc aollowi.3 r6on (5<.?011.5
<br />&6in6s md Proassion Cod€): Any Cny or County which ,.\ui.6 a lnnil ro conslrucl, .ho. imprcv.. &noltn ot rerat dy
<br />stndur€. Irior ro its sudcc. also rcqun6 rh. aprlica lor so.h p.nni ro fi|. a sisn.d stncmc lhat hc or shc is li..Nd p6umt
<br />lo thc prlvisioN of th. Cootractois l-ic.ns€d l,a{ (Ch.prs 9. (onn.n.ins Nnh S€dion ,01{ ol Dilision I oalhc BLrinB dd
<br />Prcf6snrns Cod.) or rlBl h. dr sni is er.npt rhftE.m ed rh. basi! for rhc alle!.d ermFlion Any vn,lalion oasrtion 70ll.s by an!
<br />appli.ant lor a pmir subjdsthc applicanl to acivilpcnahyolnol mor.lhan 6vt hond.ed dolles($500).
<br />/ -- ff. o" ".. nr,r.. po1*"r, or m, mplo) 6 s irh \ aB6 s thct sl€ comp.roarion. vill do rh! {dl dd 6e slrucluc is norI intrdal .roitd.d forsl.lsa.7oa4, Busins d Pm t6ioE Cod.: 'I'hc Comr.cldas Licm. riw do6 nor .pply ro d ovn6 or
<br />th. p.op61y who buil.b or nnpmrB thdan. dd sho do6 surb {ort hnrscll or n6.lt or rtroush his or hn o$n .mplot.e.
<br />prolid.d lhar such tnFo\EMls @nor i o& orofis.d ror s?n ll ho*ad, rh. tuildi.B or inpm\mr t $ld *irhinon )a
<br />.f.omlldiotr th.(nv.d aui&la willhrlrlh. hn{k of Fovins lhal hc or $c dd nol hrikr or L.Fov. the lrtrFly for lh. puryoF or
<br />I. s ownd of rhc propsry. m crclusirely conrraclins \iri licosd contdd.6 ro.oNnd rhc projEl (S(. ?04r, aN.a
<br />and Pofishn Codc Th. contdors Lic.nlc L.w do6 not apply ro m o\yns ol prop.ny tr lN btrild! or imprc\ts lhdon.
<br />md Nho conb.os aor such proj.crs with a CoolFclo(s) licmFd puNdr ro rh. conrerol-s Licae L,N)
<br />,."'.^
<br />"'
<br />"W" ;' / - t q Jo, F"' i44'o"'D "\I ORXEfS' ( ONIPENSA TION'
<br />-ugatalut
<br />I hd.by amfln undr paahy oapslury one of the lolloNins dEleations
<br />f t Cl
<br />-J'
<br />u (ro
<br />I h.vc d rvill maintain a Ccnificat. or Consd lo sclH6u( lor \!0116' conrmsal ion. s providcd for by Sstion 1700 o f $e
<br />Labor Coda aor th. p6fom ce of lhe work for vhich th€ p6mil is isu.d
<br />l hav€ and will Daif,rain rvorli.rs co,nFrsarion i'surince,6 r.qun.d bvSecrlon lT00oflhe tnb(r Cod., for rh. pdfomtnc. oa
<br />rhc $ork for Nhich lhis penn ir i$ucd My*ortds'comt 6.rioniNorancccanis ud,.licynumhde:
<br />1rlfi^r,,n. a,n. -anname or rrorrro,shichrhisp6,nirisissucd.Ishall.or.'tploy.ny,cBonrany,nannr/ Lo'^ m to-" -uL*io rr,e su,t6 .nmrntt'.n laqs olc;lifomia, dd.,!r.crnd ilI shroldh.conc subjdt ro llt
<br />Norts conDoslion p6visio6 oaS.diod lT00 ofih. L.bor ( odi l shall. fonhNilh co'nply wilhlhos. povirioN
<br />WARNING: Failuc ro kur work6' conD.,slion covmrc is onlaslul. and shtll srbjd M dplord Io ainrinal FEhi6 dd
<br />civil nn.s up ro one hun&ed rhoB d dollm ($100.000). in addnion ro rhc con ofcomp.neln,n. dmagB 6 provid€d forlh€
<br />s.\r,otr 1076 oathe kbor (nde inrsBradaitome, s 16 r<ft- lt ol U d
<br />I,ICI'NS[D CON I RA("II'R
<br />D[E! A{rO!
<br />I hscby amm undq p.naly ol pdjury rhar I m l'.Gsai u.d6 Folirion ol Ch.p16 q (commd.ins *nh SdtFn 7000) of Divirion l
<br />ol lhc a6in6 d Prcf6sio6 Codc. d my li.d* is i. tullro...dd.lldr
<br />CONSTRUCTION I FNDING AGENCY
<br />I h*by .[tr,n unds p.nalty of p€rjury lhal lh6€ ir , onslruction Lrdus asdcy hr rh. praommc. oalh. uort for Nhich this psnn is
<br />isuol (Sd 1097, Civ. C.)
<br />4.ETJ.!CANL!I'(!AAAIIO!
<br />I lEtb.! afinn under !€nalty ofperjury on. oflhc lollowing dNlaralions:
<br />Dqnolntun n6nih Asb€ros Norificarion F.deral R.B(lalDns (Tillc 40. Pan6)
<br />Ral!trd LetldoaNorifi catidn
<br />I cenily Iltal rn€ federal resulations l€ssdins asbGtos rnDlal u. .or appli.,bl. h rhk pmjd
<br />l)/rfi, n,
<br />'n^
<br />, r^, ,-u,nE amr'c.non r*r qar. rha, rh. ahov. i.aomorion ie co el I aBra ro .o'npry wirh arl ciry and comry
<br />old{an(6ind\r e I{$ s el, ins ro huiLLlins .narrurr ion. tud hrcby aurhoriz rqr*nlalivB of lhis Cily d Cou.ry lo dld upon the
<br />au,ve rneDlioncd propeny ror Elr€crion puFrses.
<br /> prli.Nnl or Arenl Si[nnlu.e \a
<br />(frs
<br />u(ro*.
<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 />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment t,
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />Ivleter Release
<br />Rough
<br />Service lrileter
<br />FINAL t?,/L//l4 -.r,k.il)
<br />Notes, Remarks, Etc. I
<br />Li.. $ cl.s:
<br />D.r€ Conr.ctor
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