Laserfiche WebLink
ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWNIiR BI'II,DAR D'I,(-ARATIO]I <br />I hr€by amm undq p.mlry ol rErjury lhar I m cx€mpt fro,n lne Comricrors' License l-av for rhc follo*ing l.@n (Sa 70ll , <br />BBinds aftl Prol63ion Cod.): Ah, Cny or Cou y which r.qut6 a p6nn to coBrrud. .ltd. inprov.. d€nolili or Epan any <br />srruclu.. pr6r lo its issu c€. aLio r.qui6 lh. applic&t for sfth p.mil to 6l€ a si-!n.d sralmor lhal hc or sh. is lic@d p6udt <br />ro rhc provirioB 01lh. contractois Li€.nsed ti\! (chrfl{ 9, Com6m.in8 wnh S.dion ?000 of Division 3 ol $c tlusindr.ud <br />PmfNioN Cod.) or tld h. or shc ie €xmpt thd€from and the bsis lor rhc all€scd Exmption. Any violrtion oasdli.n 70ll 5 by my <br />Applicanrforapsnnsubjrlsth.appli.dtroacivilpcdltyorool'norrhdfiv.hundr.ddolles($500). <br />l. 6 o$rd ol th. FoFny. or my mdoyc wilh saB6 6 rh€ir sl. omr€elion. eill do rh. sorl dd lhc nndre is nor <br />intodcd or oft(cd for sle {Sc.70,14. Bsins dd PrcfNiom Code Thc t ontrddls Lice@ lls dod not apply lo e owncr of <br />th. Flpiy vho build! or inprov6 rh@n. and *ho do6 such {ork hitu.lf or hs.laor lhmuBh his or h€r oM €liploy*. <br />pmvid.d $d such i,nFavcMts a!nor i mded orofi.r.J forsL. !( ho**d.lh€ hildins or inpmrdrfll is eld wihh onc r@ <br />ofcompkiotr dc OMd Buildd will hav. thc htrd6 of povine lhrr h. or sh. d'd mr hild or idFov. rh. Frpdry ior th. porror of <br />_L6.Md olrnc pFrrnr, @ .rcluiv.ly contadins Ni$ licor.<l .onl raclo 6 lo coGlrucl lhe prej(l {S(. 7044, aumat <br />md PDlsbncod.: Th. Contra.rois Licd. La* doB nor applyro o$nd ofprop€ny Nho builds or improvd thd.on, <br />a.d {ho conlscrs ror such projdrs{nh a ConrEcto(s) licos.! puBudr ro rh. Conlftcto.s Li.ds. Ijw) <br />_l dncxchF und& Sdio <br />!oa6[at:l:a!ltE!rar]a! <br />DEC! AAl](,! <br />I hcrcbr.mnn und6 p.Blty of pqjury oflc of lhc lollowin8 deloolions: <br />_I hav. &rd *ill maimain r Cdificar. oacoM{ ro Sclf-lsurc for uo,k.u compdstion, N prcvidcd !t'! by Sdrion l70o or thc <br />Labor Co.t , hr lh. pqlomdcc onhc *orl for nti.h rh. pcoit t bsu.d <br />t havc and sill mitrrain wo*€ra comp.nsolion insurancc. 6 .eqtrt d by Sd ion 3700 ol lh. libor Code. for th. palommcc oi <br />lhc work aor which tnis Fmil is isucd. My workgi conpsation iNurancc cams ad policy .udb< 4c:S+.te C.'-qers-t,n /alur+r.e F*-'d <br />.+fula lalqtnhrs^ t? <br />I.dify rhar in rh. paaomanc.oa'h. *ort lor *hi.h rhis p.mn is &tr.d. I shaU not dnploy.,! p6son io atry oonq <br />$ s to beonn sbjsr to thc worlsJ composarrcn la\sofCalifomia. sd as@ rhd ill should baom. srbjel lo th. <br />art6' co'np.rerion pmriiiod of S.clion 1700 ot rhe l-ah)r Codc, I shall. aonhwirh comrl, $ nh rh.* prorisioE.. <br />WARNING: fdilur.lo sre sorkm' comr€nsalion co\@s. is unlzwtul. ud shau subjdr d @ploy$ ro oinbt] F,altie ed <br />cnil fincs up io onc hundred thous d dollaB (!l in.ddnion lo the cosr of conpt@ridi. damg6 d provided lor thc <br />seriotr ltrT6ofrlE tiborCode i.rdd d <br />)r /zL/6 k.^ Y(-- <br />I hecby afim und6 p.na]ty olpdjury lhol I d licss.d udd p.ov6io. ol Cna$o 9 (.omnocin! *ilh Sdion 7000) or Division l <br />of lh. lrusin* dd PmlsioB Cod€. .nd ,ry licN is h full aorc exj .rat. ,/, <br />c46 s"1?6 <br />4t lz a S.e ','v.lle,r Ssls. -Ce"l^ /n" <br />J <br />(jaNflauqllaN]I;Nlllctcflcl <br />I h6.by lfnrd und6 Faalty olpdju.y tbal lhd. i! . co.lttu rio. Lndin! aBdcy aor lt pdlomoc€ oflhc wort for shichlh6 lddt b <br />issu€d (56. 1097, Cit. C ). <br />AIIU(AALD}:CI.AAAIION <br />I he*yafimu 6 paalty ofpnju.y onc ofth. aollowios del&ations: <br />Ds"olirion Pmits-Asb.slos Noli,icarion Fcdsal RcBulariors.lTirlc 40. Pd6) <br />-R.quir€d <br />lslaof Norifi carion <br />I cdtlylhal rhc ltdrftlrr!trl.tons rq!:trdn{ rdbr,s r$nrrirc !r 4,!ll(al,lc tr rhisJ,rojRl <br />I.6tifylhar I hrvc rcrd rhi, appllcdio. a.d sdclhd rh. ahove inaomation is conecl. I aste to cohply B ith .ll Ciry &d Colmy <br />ordi.ec6 ed slal. ti*s El,ling to buildi.g coBlrudion. md hftby aulno.ize rcp(6dfaliv6 o I this Cny md Courry ro 6rd upon rh. <br />) r hcf .-p <br />fe.( ln c. <br />Appllont o. Asql Sign urc./ . a <br />P.mhe n.me {prinn: L'-Sl,'tu <br />^l l.-f SJ <br />Site-Work <br />Unde rground <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 l1 I t0 -f?u A^ra,^/r'>,) <br />Transformers I\ <br />Torqueing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Rouoh <br />Ceilings (T-Bar Rough) <br />Meter Release <br />Rough <br />Service [\,4eter <br />FINAL i t(lcl ',lt',rtC.,.n8 '2) <br />Notes, Remarks, Etc T (\