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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS <br />Site-Work <br />Underground <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Life Salety /Low Voltaqe <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bonding / Grounding / UFER <br />Translormers <br />Torqueinq <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 Rouqh) <br />Ivleler Release <br />Rough <br />FINAL ?,.bila L)4 /o/ <br />Note S, RemarKS, EtC <br />EI t <br />t lo <br />OWNER BUILDER DELCARATION <br />I h..cby .mrn x.d( Il.nal'y of Frjury rhnr I d cr.mpr fiom rh. Coor,Ecro* Ltcns. Llw n, $c firlowi.e r.!$o ( sk 70l l 5 <br />Busi.c$ Md Prolcssion Codc) A.y Cily or Counr, whi.h rcquiBs 3 lf,.mil lo con(rcl. rhd. inprorc, d&mlirh or qliifuny <br />strucrurc- rior to irs hsuancc. alrc rcquircs thc amlicsnr for such Frmit ro 6lc a si8red srarcrcnr rhar tf or e ir licenrd puruanr <br />ro rh. povisionr of trt Co.h.lols Li..nsd t2* (Chap'cr 9, Comc i6S *nh selion 70(x) of Division 3 oflhc Busincss.nd <br />Pofc$ions Codc) o.lhrl he or shc is cxcmpl lh.rctom and lhc $asis nn lhc lllc-qed c,ciprion. Any violarionofS..rion 70.11.5 by any <br />ffidffi;ffi#il;ffiffi;*****., <br />rlrc pmFny wrF huilds or in{ro6 rfieNn. ad uh, dcs ssh mrt him\cllor hcrcifor rhmlgh hk d h.r ow.cmployes. <br />tmvid.d rhar such inD Emnt m nor inr.ndcd offcrrl ft/ $h.Il howcE. rhc toilding or impmwm is mld lirhin onc )eq <br />oi cos{ftrhn. thc Owocr BuiHer will har thc t ud.! ol pmvin-q rhar hc or she dil rer hxi! or irwok nF Imrdy for lh. l'{qss or <br />L as ownforlhc pftJpcny. lrncrclusivclycontncrina wirh I ic.n\L!l .o nt..bn to can(rucr lh. pojccr (Sa. 7014.Iru!trcs <br />and Pnrfcssbn Codcr Thc Conlrnlois Liccnsc Llu des nol {nly lo !n o*ncr or px,rEny qh{, builds or i,nptuvd <br />'h.r.on.r d wh. co ktr.l\nn \u.h Jtr(rj..( qirlraconr&ttrl\)l Nsuanr h rh. cotrr{.tor <br />6 <br />DIiELA.BAITIIX <br />I lrrcbt dftnnundd pc alry.lporjuryotuofrhcfi'Uowir!dccl rrn Nl <br />lhr\r a willtuinrainrC.nifi..rcorCons.nrbS.lflrt\xrdfitrsorkcJ.ompctrstrion.as pmvidcd for I'y Ssrnrn lTmolrhc <br />ffir;;r <br />tor rhc p€rformne otrhc wort for which rhc p€rmi <br />will nDi rinworkc^ compcnsation inru..n.c, ds rclut.d by S(t ion 3?m of lhc Llbor Codc. for rh. Ffolr1@e of <br />ion insuMs oEir ald plicy numbcr elh rhis!.iinir is issucd Mysorkcs <br />I ccnifyrhd in rhcrcrhrnrnc.ofrhc solk lor $hichrhis pcrmii is irsucd.l shrll nor cmploy 0ny lln.tr in lnt mrnmr <br />{, os r{, bccotrE subjcd ro rhe worlcr' co'npcnslrion lNr ol Cllifornir. lnd o8rce rhlr il I \txrlld bcmft subjcd t) rltr <br />$ork^ comFnsarion trovhions olSErion l?OO ot rhc l:fin Codc.l shrll. fonh*irh d,mplr sirh rlr,r pmvisio.s. <br />WARNINC l-':riturc h, {curc workc^'.onpcnsoriotr corcm!. is unlnstul. nnd \hrll \uhjccl m cmnlorcr nr qidina! p.tu rk\ and <br />civil fincs nr ro om hundrcd lhousand <br />::aI#;;ZE <br />DEII.AMITAN <br />I h.mby aflnn uMcr Fnalry oa p.rjury rhar I m li€tu d unti.r provision or Chaplq 9 (comncin8 with S4tion T <br />OO0) of Divhion 3 <br />of rhc Burinc$ and Aofessio.s Codc, .rd ny liccnk n in tull ,ore lnd eflel <br />COISIBUqIIONIENI'INC.ECENCI <br />I heEl,y affiro lnder pcnalry of ncrjur, rhlr rkrc n a o.srrucrion lcndins aseq tor rhe n rfumm ur rh. wo.k ror Bhth rhis IEmn ir <br />ksucd (Sec.1097, Civ. C.) <br />kndcis Addrcss: <br />- <br />ATILICANLDECI/SAIION <br />I lxehy lllm hdcr pcnllly ofpcrju,y om ofrhc follo*ins dcclaralions <br />Dcmlilion Pcrmils.Astf, slos Norifi calion F.ncral Rqulotions (Tilb r0. Pan6) <br />-Rcq!tcd <br />Ldrer oa Norifrdion <br />ffi:,:::,'"::^-::"..ftlinin..\ rnd Srxi. L' <br />lcdcrol eSullrions rcBrding aslEslor Nmval r. nor,prlkablc to lhn pru)(l <br />rhc!h,vc i'nnn rri{,n i\.or.cr lrerc <br />lhovc nrnriomd pmpcn, for in <br />Appli(,nr or AE.nr skmkrre <br />CR i ec-K <br />Lly silh aU Cilyand c'ornry <br />ry or'd Connryro c.rcr ut[n rh. <br />I <br />Pole Bases <br />Service lvleter <br />z,zals <br />tt