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ELEGTRICAL.INSPECTOR RECORD <br />DATE tD/srG.COMMENTS <br />Site-Work <br />Underground <br />Pole Bases <br />Light Standards <br />9pas, 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 />Iqqueing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough)/3//7//8 74{LAA <br />Ceilings (Hard & Soffit Rouoh -t/ <br />Ceilings (T-Bar Rouoh)l/Un <br />Meter Release <br />Rough <br />Service Meter <br />FINAL \o\\ <br />Remarks , Etc <br />OWNER BUILDER DELCARATION <br />I hddry amm unds poahy of p€rjury lh.l I m .xcmpt frlm lhe ConlracloE l,i.ensc t{* for the followinS I@n (5(.701 1 .5 <br />Busin6s and Proreion Cod.): Any Ciry or Counry f,hich r.quir6 a pslnir lo mnslrucl, alt6. i prove ddolbh or Iq y <br />slruclur., pnor lo ns i$uec., abo r.!ui6 nE rpplicant for such rEDnir to lilc a sign.d starddr rhal h. or shc is liccNdl puB@l <br />ro rh. Fovitt're ollhc Contacio.s Lic€ns.d tiw (Chaprd 9. Com.ncins Rirh S4rion ?000 oa Dilisio. I of th. BusiN d <br />Proa.sioc Cod.) or thar la or sh. is errmpr lhftfioo ad rhc b6is lor rh€ aucs€n croflion. Aay violario. ol S.didn 701 I 5 by a.y <br />applica aor s pflnit subjsB lhc appliconl to r civil pd.lry o f not morc lhe 6r. hun&ed douars ($5110). <br />!, a oNnd olrhc p opedy. o ny c,nployc wirh was€s 6 rhen sb conrpdsation. will do rhE so,k and thc sldlt@ is q,r <br />inls'ded or olTded for slc (58.7044. BGin6 Md Profsi.B Cod. Th. (-onlftclor'3 Licas. kw do6 .or .pply lo u osr ol <br />rhc l}trpdy *ho b(il& or inpmre thdo( and who dos su.h s& hims.llor hmlf or$roqh hh or hs .w. cmplor€6. <br />providcd rhar such im!'ovmrs d. rci n rdd.d o olldld to, slc Il ho$6 6. thc building {r nq*orEkn i! eld *iihi'r on. ,a <br />otcd.rpldioG rhe ol,!q Build\r will havc lh. hrdcn of provinS th,l he or shc did nol build or inpor c tnc pmp<ty for thc pu,loE ol <br />_1, as oMr orlh. rropsly. d cxclusi\ cly conradiq with licdsed conrmcroG ro conrrucr rh€ I'oj$r (Sd.704.1. BBnGs <br />and PrDfisi.'n Cod.: The Co rado.s Licm. L.( do6 not applr ro d d\qn6 o apropdt $ ho builds or nnpro!6 rh(en.and sho.onln.lslorsuchlrojcrls*ithaContmclo(s)li.cMdpusuflnrrothcContrcrofsl,iccmcLaw). <br />_l m cr.n'pt under Secrion_. tl & P.C. lor rhis r6on <br />.!!oBrEBS:!O!llEX!A1ll}! <br />D[Ct ASAm]! <br />I hd.by amm undd p.nalry ofpoju.y on. oflhe rolb* irr dElaralions <br />I fi.vc d will raintain . C.nifical. oacoost lo sclf-thstrrc for vorksi ornrpenrarnrn, a previd.d aor by Sdti.n 1700 of th. <br />Labor Code aor th. pdfommcc o f th. worl foi {hkh ih. pdnir n isu.n <br />_l havc rnd s,ill mainlaifl work.rs compeMtion ireumnce. 6 requn d by Sd ion 1700 oalh. Labor Cod€. for the rEraomecc of <br />ihe r$rk r(tr r,hich rhis tcmnt Ls issued <br />a-I <br />iNurucecuis d policy nu'nber se: <br />,6A <br />Ooo I q <br />I c.rlify thar in rh. Ffoi,Mc. ofrh. woik fo! *hi.h rhi! p6'nn ir i$uol, I shrll60r mtloy my p.ren in rny mon6 <br />so ar ro b..odc subjccr lo rh€ *ortsd compdsarion laws ofcalifomia. and osre lhar il I should b..one subjd ro rhc <br />wo*6' enpcEalion povirioa ofsrlion 1700 of thc Libor Code I $all. forrfiEilh comply with lho* pmvisioN.. <br />wAltNlNC Ijaihrc to sure trorlets' comp.nsalion co!ch!. is u.lawful. md shall sobjdt cnploya to oinrin pdtrhiB ond <br />civil fines up lo on. hund,ed lhorend doll.u lll in addnion to ihc cos! ol co'nD.Ntion. dmo*6 6 provil.d lor lh. <br />I h@by arm und6 !.nalry ot psjury lhar I m liMs.d undr provision of Chaprq <br />ot thc B6in6 ad PofsioN Code. ed my lk@ b i. aull foE. dd.llat. <br />ins wilh S.dion 7000) oaDivision :r <br />43030 r <br />G (> <br />t..J <br />'u'[4r.k <br />'1' <br />co!$&rc[qr]ErDlltiacE!(r <br />I h@by a,Irm undd Fn.lty o ap..ju.y thal ln6. i! . .oBttudio. l.nding aB6ry lo. ln. pdfoflmc. of rh. sort for which lhis psnil is <br />issu.d (sft.1097, civ. c.). <br />AITIICAII.DIS,AAAIIO! <br />I harry ,Jrm !.d6 pcnahy or pdjury onc of Oe followi.s dalerioN: <br />Donolilion Pdnils'Asb6ros Nolificslion F.dnal R€8ulalioB Gnb 40. Pd6) <br />-R€quircd <br />Lctt6 o I Noincali,rfl <br />-l <br />crl il, lhal I lEv. rc.d fiis applic.lion dd slar. nEl rhc .borc infodn.rion i! coftd I a8rc ro <br />odinanc6 atrd Stale ljws rclalins lo <br />abov. nmtioned propd, for <br />,\ft)liri r or '\scnrSiSnir fu:r E!7 <br />comply wnh aI CilyrDd County <br />tis City tud County lo al6 upon thc <br />",,,LL4t8 <br />APPROVALS <br />TMO <br />Notes, <br />I cd ily rha rhc a.dddl r.sdariom aledi.s 6bdos rsnoval e nol agplicabl. ro lhi! pojdl