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ELECTRICAL.INSPECTOR RECORD <br />APPROVALS DATE tD/stG.COMMENTS <br />Underqround <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 />Buildinq <br />Under Slab / Floor <br />Bondinq / Groundinq / UFER /oz?-/Z .Ve 2t <br />Translormers <br />S ".5 ?antrl .*!4r--Torqueing to--zjr.l8 4c-27 <br />'Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rouqh) <br />Ceilinqs (Hard & Solfit Rouqh <br />Ceilinqs (T-Bar Rouqh) <br />Meter Release <br />Rough lb -r t-tB 7c 4\ <br />/o +?-16 4e *i,z <br />t)Notes Remarks, Etc <br />FINAL <br />OWNER BUILDER DELCARATION <br />I hcrcby siltm undcr t,cMlty of pcrjury rhlr I um cicmnr 6oi rh. Conrlcrua Liccns. tjw ror rhc lbllowing relson (SN.?oll 5 <br />trusincs Mn Profc$n n CGr.)r Ant Ciry oi Couity whi.h rLl]rins a ,.rmn lo consldcl, !lt.r. ihprovc, dcmli\h t{ rcn.t y <br />{fl.ruru, l,rii ro irs issuur.c. rko rcquncs lhc E plicani for sucn lrrnil ro fih r \isdd {aremm rhd h. or shc is licensd Purua <br />ro ric ro ions ofrhc Conrfucror's Lk.n$d ljw (Chflcr 9, comcNins wilh Scclion ?O0O oI Divnion I ofrh. Burincss and <br />PtuLr\iois Cddc) .r rhlr h.orshc iscxchp rhcrcfromlnd lhcbrsis ror lhc ullcgcd cxcmfli.n Atryviolnt,otrofScclion?031.5$yBny <br />,pplicrnr lor rrc.nrn subjccN thc ifplic0nt lo !civilpcnultyofnot nn,crhan nvc hundrcddollars (550o). <br />-1. <br />as oercr ol rh. lml](ny. r, m, d rrl.rrcs wnh w+cl ,i rh anc compcnsnriotr. siU do rhc wo.i ad ft. nMm is fr <br />inrcdcrl .r oficrtd {or {L lsd.7u14, ausiN$ and Pr.ltssions Codc: l hc Conrraci, s Li.eose Lr$ do$ nor amly lo an owncr of <br />lhc pmtcny who buikGor improlcs rhcE)n, aJd uho dds \!ch k)rk himsclf or hcrscll.r rhmuah his or hs o*n cnfloyccs. <br />Irovnkd rhlr xuch iDpmvcmnlse Bn iorcndcd orollcrcd for salc ll. howcvtr. rht hoildinS or improveEnr i\\old sirhinonc red <br />.rrodplcri,rn. rh. Owmr auihcr *ill h0r rtE brrdcn of provin8 lhll lE or she dkl mr t{ild or i,{mw tr pmFn, n,lh. purlx,r ol <br />-4, rs ow cr .r rhc rmpcny, ,m cx.lusivc ly conrmding wilh licctr*d .onlracrrs ro .on{dcr rlt proid (scd 7t!l4. su$ncs <br />atrd PisrL\sbn Cod.: Tnc Conlracrors Liccnsc l-aw docs nor apply b an ownfi orptupcnywho huilds or imrmlcs rhci.ot. <br />!.d who .onrkc for such pmj.cF w h a Contmd(( n lactrrd nu6@r b rhc Conra.tn \ l-kcns bw ) <br />l,rcrc.Dr urdc. S..rn I & P.C. turlhi\ rcrvnl <br />]voatrE8s3;!)llfENsarloN <br />DECIANAIITN <br />I hcrchy alnmundcr lcorhrorFrjtryonc orrhc r(rk,win8 d..latdri.rs: <br />Ihrvcn, $illnui rirICcnii.ricolCotr*trrt'sctrln\ur.lnrrorkcs conrtcnsrrion. r\ pnrided I{, hysccrb.lTLx)ofrhc <br />titxtr c(xh, ntrrhcrdlnntun.c Dlrh. work iorshi.[ rlE Ennil is isucd <br />I hNc aM sillnrdinlnir sorkcri.otr,p.i\nri,n, i',\rrrnrc. r\ ruqrncd b!Sccri( :r7(xrofrhc Lnhor (idc.lnrrh. Frr.n'ur...l <br />rhc work nn whichthis Dcnnir is is\ucd My worke^ onr|*nsrri{r i!1s$ni.cranic, Dd Flicy Nuh.r rc <br />-l <br />ccdilirhrl nrlhe pcrionmnccorrhe sor* fttr shi.hrhh pcrmir is istrcd.l sholl nor cmrloyunrI.6on in nnymnncr <br />sr t, t{..N \ubjdr b rh. wo.*cm snlrnsliotr liws ofc.lilornia. .nd aErcc rhr ifI sh.uld h..om subF_r h ltE <br />workcr' co'hFnsar n,n !rcvirions ol S.d ion 3rm ol thc l-!t{r Codc. , shau- fonh*irh .omply w irh 'hs tovni{'ns. <br />WARNINC l'0ilur. h rcurc {orkc co t sari{ ..r$ngc i\ !trI,wtu|. md shrll \u6fccl m cmrlortr b rinin,l lf,orllts lnd <br />civil tur\ ut ro orc hundrcd rholeid dollts l$100,(xD). in idirir sr ol conrcnsarion. drrogc\ n\ ptuvidcd li,r thc <br />2-o ti&, C{xL. inrcrN rid at.nry \ la.r <br />'tS <br />DECI,ASd.IIQN <br />I h.obysfln xhdfp.nxltyofp.rjurylhal I m lian${ undq lovhion of Chaflcr 9 (d,nftncing *ilhSc ion7OO0JofDiviri.il <br />ol lh. Busincs ond Pmlcssions Codc. ad m, ltensc is in tull n,& nd .nc.r. <br />f-a-r2l <br />q)IEIII]CUI}NIEIDINCIIiIN.CI <br />I h.rb, afinr ufldcr pcnuh, oa pcrjory rhd rhcrc h a .on{fl.lirn lcndin8 08cEy rot Ih€ pcrlomncc or rh. w.rk for rhich lht Ismn is <br />hsucd (sN l(l)7.C,v. C ) <br />A&UCANI.IIEII,A.BTIION <br />Itrrctrynliinnutrdcrpcn{llyolpcrjuryoncoirh€n,ll.singdccl rrn,ns: <br />Dcmlhn,n PcrmnrAsb.{os Norilicurion ltdcrul Rqulilions (Tirlc.lo, Pan6r <br />Rcqrrcd txnft of Nolifi cation <br />-l <br />ccniiyrhd lttr\c rc lhis pplicrrn,n kl i\conccr I a8r loonDly wirh rllCirymd Counry <br />rcrircscnrarivcs ofrhh Ciry and counry ro cnrn ult)n r.rdmarccsnnd Store L.ws rcl ins nr bui <br />rh,\c mni nrcd [opcny ror irN!(li <br />,\ppliun or'\rt l Sir trl ^,. E.'\''g <br />Site-Work <br />Service lt/eter <br />lf,ndcr\ Namc <br />ttr.nd.''\ AJJrc\.. _ <br />I ccdiiylh.t thc ldcrrlr.sular otr!frgxrdidg r\lr{os trurlrrc trol d|tlic$lc I' rhi{ pnrt cr <br />I <br />--------r------ <br />= <br />I