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APPROVALS DATE tD/stG.COMMENTS <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 / Dam pers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bonding / Groundinq / UFER <br />Transformers <br />Torqueing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough)1\(< <br />Ceilings (Hard & Soffit Rouoh ) <br />Ceilings (T-Bar Rouoh)t l(*(1 ./,Ld.4/iq <br />Meter Release I <br />Rough <br />Service [Vleter <br />FINAL (q /.41liltt) <br />Notes, Remarks, Etc <br />OI!NER BUILDER DET,CANNTDN <br />I h.rcby affmn undB paalty of p€rjury lhal I dn cxcnDt fiu lhc Conra.tors License La$ lor lhc follosin8 r.Mn {5(.703 Lt <br />Busin6s sd Profsion Codc): Any Ciry or Counry {hich Gquir6 a pmnil to coNru.l. rltd. inprov., dcmolish or Epat dy <br />slru€lue Fior ro ils is@c.. also r.qui6 lh€ applicd for such pemn ro nk a sign d slarmol lfi.l h. or sh€ is ltd.d p6udt <br />ro (h. Foli.ioB ofth. Contracroar l-ic.nFd Law (Ch.F6 s, Comn.ncins sirh S..lion 7000 ofDiv6ion .l oath. B6in.s md <br />hoi€sionsCodc)orrhalh€orsn is.xcdpr lh6.iio'n od lhe h66 ror th. .llesdt .xmprion. Arylioltrtionofseclion?011.5by6y <br />applicsr for . ptrnn subjds rnc .pplica loacivilpc.ahyoinornDr€lhofivchundrcddolles($500) <br />-1, <br />d o* ns oflh. p.op.ny, or m, .niployG wirh $ar6 6 lh.ir sl. comFnsrion. will do lh. \ort ad th. n,u.l6e i h <br />imdddl orofid.d aor el€ (Sa 704,1. Busif,s md PmfsioB Cod.: lheConrracn i l,icosc IiN do6 nd apply b rn ownd of <br />thcpNp6ty who hrilds o, imPpv6lhoan. dd *to do6 such wn hins.llor h.6elaor rhmu8h hi3 orha own mploy6. <br />provid.d th such i,npmvmots N not inls'dd or ofisEl lor sk It ho*so, $c buildins 6r imprcvddr i. $ld sihin on. y@ <br />oacompdion. fi. ()trn6 Buildd sill hsrc tn hrd6 ofprorins rhd h. or sh. dd trot boiU o, nnFov.lhl Fopdy aor lh. porFsof <br />_1,6oms oarhc pmll€ny, rh c&lusively.omGcring wirh l,censal .o.talloE b coBlruci lhc pmjd isec 70,14. BEind <br />at P,rlision Cod€: thc Conrracroi! Licas€ L.rv '106 not applylo ao\nq orpropd, *ho builds or nnprores lhs@n. <br />&d *,ho.onrackturu.!Fojdisenh.conta.ro(s)li...sdpuffianrlorh.conlruct.asLicosl.ss) <br />-l <br />e cxempt undr Scdion-. B. & P.C. torthL r@n <br />Drre O*n.rl <br />rtoru<f, ns' col\tPENis[rloNp&gaaarlg! <br />I hdeby amnn undd pdalry oaD6ju.y on olfi. follo*in8 dcldalioml <br />I hav. od sill matrrain a Cdia,.aE orcolMt ro Sclf-ltuur. lor solkcE comp.nsolion. s providcd for by S6tion :1700 o ath. <br />Labor Codc for fi. pGfonnm€ oltfic worl tor {hich lic pq,nit G isued. <br />-l <br />haveandNill hAi aiiwork.B.o'nFnsarioni6u6n..asr.!uir.dbtS€.iion1700ofthcL,abo!Code.forlhepdlomd..oa <br />f{n $hich rhisp.nnit L\ isskai My r ier aipolicynumbs c: <br />7r! <br />Ic.nify th.t in th. psaomMc ollhc vork aor uhichlhis p.mil is issu.d.I shnll nor alploy uy p6st in eym nd <br />e e io bcoe subj<r ro th. world .omp.Mio. Lws of caliaomia Md osr lhsl if I should beomc subjc.t to th. <br />*od{6'comp6srionpruvisioBofSe]lionlT0oofrh.LahorCodc.lslEll.aonhwilhcooplyrnh0D$trov6ios. <br />WARNINCT failurc lo Kuc work6 conposalio! cov@s. is uilavful. dd shtll subFl e onployB to oiminal pdahiG dd <br />cnil lins up to on. hmdred lhousnd doll.6 (llLxj,000)irion to rhc co$ oa compcMiiotr d-n096 6 provid€d tor lh. <br />lt r <br />!f(.!Jl!l( <br />I hq€by aflim und6 poahy ol psjury lhal I m liccns.d und6 rrovision oachaplE 9 (conmacin8 wnh Salion 7000) of Divisio. l <br />oa thc BBi.Bed PmfsioB?.1b ){so3C' <br />,;l{r,{€ <br />CO!$AICITONIENDIIG EdcI <br />I hdiy alrm udd p.nahy ol pcllry lh,l ths. is a .oBtru.lion laditrs asdcy for Oc pohlr@.. of rh. work for trtich lhie p6hn t <br />isu.d {sd.1097. civ c ). <br />AIIIICANLIICIABAIIO! <br />I @ afm uods pdahy olpejury on. of Oc folb*ing dclrarioN: <br />Demoliiion Psmirs-Asb6ros Nolificdion F€ddal Rcsulalions (Till.40. Pan6) <br />R.qut.d t.ll6 of Notiftalion <br />-l <br />cgrify thal rh. tcddal !€eularions rcsardinS db6r6 rdoral d. nor .ppli(lbl€ io this prcj.d <br />-l <br />cditthd I h.!. redrhis applicarion dd sral. rhd th€ ab.vc inlornaion is con<i I agla ro complr *iln a[ Cilyand Counly <br />ordinrnc6 and Staie L.\vs relatinB k)d hc'cbyaurh.rn. rcpr*.tari!6 olthis Cilyatrd Counlylo ore uponlh. <br />a6o\e nrernnrcd propcny lor <br />Appli.inl or.\getrl Signal ^,"/l/rolt <br />ELECTRICAL.INSPECTOR RECORD <br />(odc. Md nrylicose is in lulll'orcc d eff€cl <br />o"., /1 <br />L.ndc, !Addrs. <br />- <br />I <br />--T_----- <br />I <br />tt