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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE IDISIF,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 / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bonding / Grounding / UFER <br />Transformers <br />Torqueing <br />Sub-Panels <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Rouqh <br />Ceilings (T-Bar Rough) <br />Ir/eter Release <br />Rouqh <br />Service Meter <br />FINAL Nta\r$b/ q.l)z,{\oh A}44$) <br />Notes, Remarks, Etc.T <br />OWNER BUILDCR DEI,CARATION <br />I he..by arm uodq p€nalty ol Ddjury lhat I m exeDpr tonr lh. Conlr.clors' Lic.ns. bw lor $. iollosins rcMn (S( 7011.5 <br />Burin63 ed P(l6sion Codc): Any Ciry or Coudy shi.h rcqune a lonit to conslrucl. alla. imprcv., d.oolth oi qEir dr. <br />slruclue prbr lo ils is@cc, also r€qun6 lh. ,I)pli.d ro! such Fmn lo fr1. a si8..n 3tdand rhat h. or sh. is licmed pumen <br />lo lh. nlvisions of ih€ Conk.croa! Lic..*d Law (Chapltr 9. Comncncin! rirh Sarion 7000 of Dilision I olthc ABins &d <br />PtuGst'ns Cod€) or thar he or sh. is qempl lh@6oh dd rhc bsi. lor rhc dl.g.d ddnplion Any violalion olstrrio.70l1.5 by any <br />applica lor a p.mn subjma th. applicsnt lo rcivi,p.naltyof.ot mor.lhm fivc hun&€d dollds ($too). <br />I. oMs ol th. prop.ny. or my cmplo,6 uilh rvas6 as their sl..onFsrion, $ill do thc rvdrt ed lhc struclEe is rcr <br />int dcd oroffrcd ror saL(5€.7044, Bsin* dd P]oa6sio6Codc Tte(onlEcrols Licms Lrw do6 nol apply ro d own( oa <br />lnc prlpdly wlF buiib or inprovB thqor otrd who do6 such so* hiBsell or h@lr or lr@ugh hb or hd own anploy.B. <br />ptuvidcd thar such ii[rovddB e mr i.rdt l or oftdrt for el. l( la)$a6. rh. l ilding or inrarovml is eld s nhin on. ,a <br />ofcomplclion. thc O* nq Duildg sill ha!. lh. h{dq ofp,o\ins tha hc or sJt did .ot hrid or impm\. lhc popdy lor th. pttrpos ot <br />_1, BoM6oflh. Fopcly. d.rclci!.1, conra.ti.g $irh li.Nd.om6doBro @N]rucr rh€ p,ojnl (56.7014, BBrne <br />and h!ftsion Cod.: Th€Co.mc(ofs Ltd. Law do6 nor apply ro o0{.6of propdyRho builds or inprcr6 li6eo. <br />dd who conlqds foi such Fojels wnh a Conim.lo(s) licmsd pu6unllo thc cohtrdors Liccc. Lrw) <br />_l &ncx.nfl und6 Setio <br />.[oatrEaslollrrrtArr9rD!C!$AIIg! <br />I h€reby ailrm undcr pcnaly or psjury ooc of thc iollorvins ddl&arhro. <br />I hav€ ud {ill mainrain a C€n iticate of CorHt ro Sclf- lEule fo. sork.B conrpcnsalion, s Fovid€d tor by Strlio. l70O ofln <br />llbor Codc, for rh. p6fommc. of rh. sort lor shich lhc ,6nil is isu.d. <br />I ha!.andqillmrinhin $orle.r conrpetralion imurancc,6 rcqun.d by Se.lion l?00 ofrh. Lat{r Cod.. aor lh. pslonnec. of <br />rh. soi{ lor whlch rnG pmil is iseu.d. My workm comp.Nrion iNulmc€ c id Md I1 licy nunbo tr <br />s l-\r-q <br />ceaily lhal i! lhc psfo.o.ncc ofrhevo* i(n which (his pdir is issucn. I shall nor enDloy ony p€6on <br />'n <br />any ndne <br />s a lo h..on. subjet to tb. Mrld comFns.lion Iows oicalifomi.. ud asre lhal il I should tt{onr 3ubjdl lo tl'c <br />s!.t6' .onp€slio. povisioB of S€.lion lr00 of thc tibor Code I sltrll. fodhwnh .lrply wi(h rhoc povisio6.. <br />WARNIN(; F ilur. to surc aorke6' comp.ns.lion covcms. is unlawtul. and shall subj..l an dnplord to ai,ninal pduhiB ud <br />civil fincs op ro on. huidrcd lhoNsd dollm (t100,000). itr addilion to lt€ co$ olco in, ddares a prolidcrl lor the <br />s&ri.n lo7N.l,h.la, r <br />,,.,", tlflqlll <br />('ode. inrftd md rnomcy s aG. <br />I' <br />I h6cby amm und( pcrahy of Fjury tha I d li.qs.d undd Fori.ion ofchaprd 9 Gomdcing $ ilh SEIDn 7000) of Dirition l <br />ol rh. Busin6s ed Prof*io6 Code. ad my lic@ is in full torc. dd .lTd. <br />6 rcl1qlt" <br />IrlrtFg ft{+( <br />(oNsralcralrErDllc3cElcl <br />I n*b, amm undd Fnahy of prjury rhar lhft Ls a codruclion kdins attrcy for rh. p6aol]mc. of thc mrk for qhich lh6 ,6tn b <br />tsuql(sc 109?, Civ C ) <br />AIIIICAILDECI,ABAUAN <br />I nqdy altm undd p.nohy ol p.rjury on€ ol lh. follo*ins d6l&atiom: <br />D.mohion Pmns-Asb6tos Noti6catio. F.dml Rqul0lions (Tnb 40. P6l6) <br />R.qoil3d Lrto of Notilicrtiotr <br />y cdiiy rhar I havc r€ad rhis applicar io. and strlo rhar rh.is corst. I asre ro complyrvith oll Ciryand counr, <br />ordi'mD!6 rd Slrrr l.!\ s rclahn! h r.l)6at.tiv6 olrhis Ciryed County ro 6td u[bn rh. <br />abore morion€d prop.ny for <br />,,," fl furx <br />Air Conditioners Ii\ntres: <br />y, <br />-l <br />cdiry that lhc l€d@l r.suklioB r€sadins 6h6los rooval e nor applicabl. b tnis projdr <br />P€mlne nimc{prif,O: