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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.
<br />Site-Work
<br />Underground
<br />Light Slandards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Lile Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bondinq / Groundinq / UFER 7-lL-r8.J)c9*-
<br />"'7t/Translormers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilinqs (Hard & Soflit Rouoh
<br />Ceilings (T-Bar Rough)
<br />I\,4eter Release
<br />Rough
<br />Service lvleter -\FINAL 6,1.0.tc ,ug)
<br />l(
<br />OWNER AUILDER DEI,CANATION
<br />I hcNby dnnn uDdcr pctrrlty ol,'crjury lhol l 0n cxemfl ,nn lhc Conrr(o^ Liccnrc Inw ror rhc ldlosinE r.a$n (Scc 70ll5
<br />liusircs otrd Profc$bn CoJc): any Ciry or CoDtrry *hich rcqut r r lrnnir ro .onsln.l. trltci inlnovc- dcmlish or Errn any
<br />srrucrurc. prir r) irs hsurtr.c. lho rcquir.s rhc 0folicanr f su.h lcnni ro nba signcd slar.mnr rhrr hcor\he i\ li.cnscd t'ununnr
<br />ro rhc lrovhio.s ot rhe Contactn s Lic.n{d ljw (Chaprs 9- Commn.in8 $nh Sccln)n 70sr oi Divnion I ol rh. arsi".s nnd
<br />Ptuacssnn C.dc)orrhnr hcorshc iscxctrrpl rhcrcrromrnd rhc hrst fo.lhcallcscdcxcmrlion Any!n uri,'n.tS.crion70ll.5hyany
<br />apllicsnr for iNnnn subjcctslhc lprlicrnr to 0civilpcnallyofnol nrorcrhnn fiv. hx.drcd dollars($5(x))
<br />_1, ar .wncr of rh. teFdy. or nry cmplor.c\ uirh wag.( ns r h.n $b conDcnsorion. aill do lhe worl !.n rlt srarm c n
<br />iNcftlcd oroficrcd tu slc ISd.7014, Busircss ! Pmacsi.ns Cod. Thc Conn.clofs l-iccn* Lrw do$ nor ,pply h nn owncr ol
<br />rhc pmpcny wtr hrikls .r i'nF(,rcs rhc6n. ud who d@s skh won hinNclf or hcrslf or rhmugh his or hcr own cn )y.cs.
<br />nnvidcd Ihar su.n impmrEnc uc nor intc ci .r ollcr.at for elc. ll hrwdcr, rh. huiunE or imlrorcnrnt is bld sirhi', c )ur
<br />ol conDlcri,n. rhc OwNr auildcr rill havc tlE hrdcn .f FmvinS rhd h. or $c dil ton buiu o. itr{rov. the ImFny for lrr puqxN of
<br />l. $oNncr o, rhc propcny. amcxclusivclycoolraclins wilh liccnscd contrcb^ b c.nnd.r rhc pn,]l-.r (SL\. 104,1. Busi"u$
<br />trkl l\Dtc*ion Codc: Thc Conkrtr'\ Licctrs. l-dw doc\ nor dptly b rn owncr ri prol)cn, *ho bu ild\ or n pn,vcs ihcrco .
<br />! d who .onracts Ior such rrtca *irh n Conk!.ront li.cnscd pu$lsnr t,rhccotrtr.t, s Liccnsc l-r*)
<br />-l
<br />lnrcrcnrnr undcrSNli,,
<br />D.t€ Owr:
<br />wOtXFAS', C'OtlIpgMS,{rXrN
<br />DEI;IIISAIIQ!
<br />I hcrchy afrtm utrdcr rEnallyolFrjlryotu oilhc rollowin8 dclararions:
<br />-lhalcandqill'nainr.iniCcnificurcolCoNenltrSclllnsurclbrworlc^.omp.trsdn,n..s
<br />provid.d lor I'yS(rio lTlx) orrhc
<br />tibor Codc. turhcNrformnc.l'rnc wort ii,r whichrhepei'nir is i\\u.d
<br />I hrvc rid will rinrrin w6rk.ra .o'np.n\ i.n nNuiir.r. r\ rcquncd hySe.^iion.l7lx,ol rhc l,ltxtr Gdc. nnrhr lcnnnmmcof
<br />rh. work furwhih rhkFrmir ir isrxcd. Mytr.rkcis .omp.tr\rL.tr nNur{ncccrtricr and lr)li.y nunficr rc
<br />I ccnify thor i.lhc Dcrr'onM..c olrhc w.rk tu shich lIn p.rmir is is\dcd. I shrll tr.r cnldoy nn] F,t\on in.ny n'xnncr
<br />v,rbh(oftsubjNrtorhcworlos.orp.trs,ri.il.wsofcalinrnia.indnSrccrhalill\houldh.co,csrhP.rbrh.
<br />s.Ilcr\ @frpcn{,i.n pori\n'ns olSccr6n lTmof rhc Lihr Code.l sh!11, fonheilh conll)ly wirh rhoa pR,vi(tnB
<br />WA|ININ(; Fr'lurc ro $.uc sorkcF comnctrs{rn,n colcrigc is unlr$Tnl. rnd shrll \uhj..r ri ..itluycr
<br />civil fitrcs u,' lo onc hundrcd thoun d dolltrs ($l(x).(tD)- in lddirion
<br />Scdi.n.l076 orrhc l..hor(tdc- inrcrcsl and rlorrcy s lccs
<br />)/ttt5
<br />DECI,AAAI]Q!
<br />I hcrcby a,[rm un.lc, F.,lry olpcrjxry rhar I rf, liftns.d undd tovision ofChlnrs 9 (omnEn.ins wirh Scdion 7000) ofoivision 3
<br />of rhc Busimss and Pof€$ionr Cod., ,ri ny lk.nrc is in fxll tore drd clT{l
<br />o,*, -7 lt l15
<br />toNuBrcuoN.LENuuc-aclNrl
<br />I hcEby llfirnr udcr lrnalry .r pcrjuiy lhal rhcrc ii a conild.lbn lcndin8 qctrcy rbr lhc ,,crformne of rhc wort ror shich lhh FYmil h
<br />nsucd (Scc. 3(})?. Civ. C.)
<br />A.8ELT$NLD&CLAMITqN
<br />I Myaf[m hdcr pctuhyolpcrlury oft or rhc following del,Erions:
<br />Dcmolirion P$nrn!Asb.sros Notificarion Fcdcrul Resllalions (Tirle 40. Pan6)
<br />Rcquncd kllcr of Nolifrorhn
<br />l.cnilr rhar rft rcdcralrcluhrion\ rgrdart r\hcn.\ 'cnn^nldc n.r$flic$l. ro lhn pn+.'
<br />l.cnilyndlMvcrotrdrhhappliciriotrmdsrorerhatrhc.haveinformuri,rncorc.rlrg,L{kr.otrDlrwirhrllCirydndCouly
<br />.rdiM .cs nnd SIrrc Lrws mldill3 tonuildirEcotrslruction. hcrcbyaulhoriT.r.p'c\cirrrivclolrhhCn ,tr Counlyro. cr ul]otrrhc
<br />,h.rd nf, rionnl pmptnyfr insr.cr
<br />\Dplici l or,\srnl SiAn turr
<br />-
<br />/*-u"",.-",,n.r,l|\+ 4,. t -o{L !1€
<br />7/7 /t4
<br />II
<br />tDzzl
<br />COMMENTS
<br />Pole Bases
<br />Notes, Remarks, Etc.
<br />'14-/6 hotl 4.,Jt ,.,)futlrTf,ab.] 69-11-
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