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ELECTRICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.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 / F_!H <br />Bonding / G.founding /!FER //-2n-t7 [Lc 77 <br />lranslormers <br />Torqueing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduil) <br />Walls (Rouqh) <br />Ceilings (Hard & Soffit Rough <br />Ceilings (T-Bar Rough) <br />n/eter Release <br />Rough <br />service Meter -- \ll -r^ tQ DO,. t- ran 4 l'-t <br />FINAL u 7v't I /" v t>lrq 4.4 --/2 -v./, <br />Notes, Remarks, Etc. <br />o\r \ t.tR Bt r)rrRr)r.r.( \R\lloN <br />I hd.Liy rrtr,n undd p6ahy ol psjury lhat I m dmpl iion rhr Gdracrou' Lics. Lsw for lh. following r@n (5(.7011.5 <br />Businds Md Pmf6ion Cod.) Any Ciry or Coud, which t.quic a p.n n lo co[(rucl, alrd, inprove ddlolish or tp{r ey <br />$o!ldc. rrior ro irs 6ud., also r.qri6 rh. applicmt ior such pqnn lo 61. t sisn.d {.tmdl thst h. or iE i! li<d*d psuml <br />ro Ih. provisioN ol ti. Conlracrois Lic.ns.d Lr* (Chlprd 9. Com.ncin! Eith Strlio. 7000 .f Dililion I oilh. Baii.s -rnd <br />Pturrsione Cod.) or $ar h. or sh. i..xcnpl lh6.nom ed lh. b.sis lor rnc all.rql dmprion A.y viol.lion ofsdrio. T0lI5 by my <br />applic6rl for a p€nnil subjrrsrhc applic.nl lo acivilpdallyofnor mor.lhan liu€ hun&.ddollds(S5001 <br />ffi\s .n".ot't'.p.opar.or m) mplo)G tr h s aE6 s lhcir Fl. .omp.6ar ion. *ill do ltE ro,k ud lh. etudm i! mr <br />inr6d.d or ollocd for el. (Sc 7044, Busind d PmfdioN ( od.: t h. Co.rraehis Li.ds. L.w d.6 not tpPly lo atr o$rs or <br />rh. Eropdy sho hil& or inlroiElh@n. ad uho do6 sch slrk h'm*lfor h6.liot thmush his or hF o$n cnployG, <br />provirlqi ihar such inFovo66enori dddoror6.dlorsL lf. howes,lh. build'ns or injtnokmdt is$ld wilhinoE )@ <br />ofcompl.1io.. rhc O* B Ruild6 * ill hlvc rhc tirda oarrovins rhd h. or dE did mt hild or inlro\r lhc FlFry aot fi. OrFF of <br />s ou nr oflhc aop<ry. an .x.n6n clt .ontacrin8 trnh licmsdl conlBdo6 kr conrtud 'rt pmjd (Se 7044. ltsins <br />.nd PDfision ( od. Th.Contllclors l,iccn$ l.!vdoenol lpplyro anownd olptop.nlwho buildsor irprcv*rhdtun. <br />and who codBcrs lor such rojds with 0 conrado(s) licds.n pusunl lo rhc Conttcror's Licft. IjN) <br />I an.r.npr undd Sdlion ,B & P ? rorlhirr.d,,n <br />"-".. >{- lZ nr,(Lr ,,-^- <br />'uuBriisstaurnfiaroNpEctaRA]i6N <br />b l!4 <br />I h.r.hy amrn unde p..aht of Frjory onc oalhc lollotr in-! dEla.atiotrs <br />I hav. d will mrinrain a cdificatc ol CoNdt to S€lanNr. for Norl6 comp.nerio.. a Fovid.d for by Sdlion l70O o f lh. <br />l,abor Code. for th. pstomecc of rh. "nl for whi.h th. pssn is isucd <br />Iha\..nd\villman ainsorlds compc'saxon,tuurantc, ri t qund bts(lion l700oflh€ lihorCodc, nr rh. tElonnonc. o{ <br />thc $ ork for {hich lhis p€nnit i5 irsucd My sotkG' .o'npdsrion iNtr cc ceid md policy nunbd e. <br />Poli.yNumbd <br />I cdilylhar iD rhe rrlormanc. oarh. *ork for $hi.h rhk pdmii is issu.d. I shall not srkJy a.y rrson in any muM <br />$ sro b..o,n. subjet to th. port6' comp.Gation laNsorCaliromia. mdasErlml ill shouldtE o'.c subj<r to'h. <br />sorlss'conrpastionprevisionsofS.cliof,:1700oalh.tltnr('od.,lsh.ll.fonhtrithcomply\rirhihreprorisioB <br />WARNINC F ilur. ro KUc Nort6 compdsalion cov6as. is unltsful, Md shall subjNt an oplo)lr lo dinin l Frolli6 md <br />.ivil nn.s up r. on. hmdr.d lhoNnd doll6 (S100.000). in add ion r. rh. coi of comp.6aiion. dmscs as pr.vid.d for lhc <br />4-t''* <br />!.L!l lB,vlJlt <br />I nftby aflinn unds rEnalryorpoju.' rh.r I an li.d*d unikt ro\ision of(q9(com,nd.int with Sdion ?000) orl)ivEn,n l <br />.l rh€ Busines nnd Proa6sioN Codc. dd ry lico5e is in full for.. md tilNr <br />CAIiIAIJCIIA!.IENDINGAGEICI <br />I hftby amm und6 Fdry of pdjury thal rh@ b a codrucli.n lcdi.s as6cy for lh. pdfolruc. of lh. vo* lir *tth lhis pdnit i! <br />ilsu.d (Se. l0s7. Civ C ). <br />APPT,I('AN'I' DE('LARA'I'ION <br />I lEd', afiimund6 p6ahr ofFrjuy on. oarh. follo$ins d(l aiions: <br />D.mohion Pdnnekb.xtos Norificarion rcdsal Rqukrhns (Tirl.40, Pd6) <br />R.quncd tnrd oa Notifidrio. <br />- I (sr'b rhdrthc fdn !l FBu |rr iod r.lrdins Nb6rosmovda.m! arrl'c.bl. ,o rhL Pmttr <br />i(1/.d iry rhar I h'\. sd r hn 0pphc Dr md *ar. rhar rhc rbovc infom8rion t codd I asre ro onply wnh ar Cn, md comry <br />n;dmec6 Md sar. t s ! Ehl iis ro buildins colnrud ntr dd hscby aurtoi@ (p..slaliv6 of lhis Cny ed Couty lo dl6 upotr tlE <br />[..4 d'=- "",'x., <br />sdrion 1076 oa rh. Llbor ( odA imdcn ed auomey s fc <br />,,,,orr/o7 //4 <br />L <br />L <br />=