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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS Om.rBuild.r D.cl&ation <br />I hcrcby affim uidr rcnahy ofpdjury rha! I e.xchpr fom thc ContBctoE Licms.l,aw ior$c iollowi.gEson (ra 7o3l 5 Buins <br />and Prcf.$ion Codc) Any City or Counry vtich rcquirA a p.mit to consrruc( !hd, imprcv.. ddolish or rcpat my $ruduE' Drior !o it! <br />issudc., .lso Equis rhc appliqnt for such Fmn ro 6lc . ii8ncd sutmat rlEr hc d sh. is licdtcd pu6uet lo rhc provisims ot dc <br />Conrac|or's Lrcmscd L6* (Chrptfi 9, Cffin.ncios wirh S.ction 7000 ofDivision 3 oarfic Busins dd Profgsios Cod.) or disr hc m <br />shc is .xcnpt 6.r.frcn ad rh. bdn fd rhc .Ucscd cx.mplion Any violalion of Setion ?01 I 5 by ay applimr for . p.mir subjeE rh. <br />orplicel loacivil pcmlty ofnd h@ th fivc hundrd douq (1500). <br />_1. a ownd oflh. !.op.ny, s hy dploy@s wnh wag6 a th.ir sol ! .omp.^s.rio., will.lo rh. work Md (hc st ucre ie nol inldd.d <br />or off@d f6 ol. ( Sa ,044, Busind ud Prcfcrion! Cod. Th. Cdri.loi's Liccnsc Law dG nol r!pl, lo & own.r of thr prop.n, <br />who builds o. imp.ov6 lh.@n, Md who dq ruch work hinsclfor h6clf dlhrcugh hi! or ha own cmployc.s, provid.d !h!l such <br />inprov.m.rs e not i.ladcd or ofl6.d fu s!l. Ii how.vd,lh. buildine or iop,ovhat i! sold wiihi. onc yar of coEpt.uo, $c <br />Owns-Suild.r willhavc thc burdd ofprovins thd h. or sh. no( build or imp.ov.16dc purposc ofs.l.) <br />_1, d ownerof$c prop.rty, m.xclusivcly @nF&tiDB witfi lic.ns.d conracrod to construd lh. prcj4r ( Scc. 7044, Bsiiq! ed <br />Prcf6sion Code Thc Conrraclols Lrco* Lnw dG nor apply ro d owid oapropdry who builds q inprovB rh.mn . sd who <br />co.r&r for such p'oj.dr wnh a conrr&ro(, liEns.d puslbt to rhcconhctor'r Lic.ns Law ) <br />_l m .xmpr und.r Sato. <br />WORKERS COMPENSATION Df, CLAR,\TION <br />I h.r.b, alfim undcr p..alr, ofp.rjury or. ofrh. iollovinsddl&arion,: <br />_l h.v. ed eill m.indn. Cdifiar ofCo.s..r ro S.lfln.urc for eo.km' €onp.nBrion, 6 providcd id by Sadon t?OO oflhr <br />Labor Cod., f6 Oc pcrfm&cc of 6. *ort for vhich lhc Fmit is isu.d. <br />_l havc dd willmainhi. *qt..s @mp.niarion iEurucc, s Equir.d by Sc.tion l?00 olth. Labor Cod., for rhc pcrfomMc. of rhc <br />work lor whicn rhi! p6mit t i$ucd My wortcR cohp.rsatio insulan.. ffid md policy numbq d. <br />b. compl.cd ifth. panir h ror Onc hundr.ddolles 1ll00lor16, <br />p.rfomecc of thc wort ftr which rhis p.mn k i$ucd. r ,hail n <br />law! ofCal'tomia. ed o8lcc lhar ifl <br />oflhc Labor Cod.,I shall, fonhwnh <br />Failur to sEuE workd' cohp.nsarion covdag. is <br />fii4 up to on. llid.cd ttoGed doll6 (t I00,000),in addirion ro <br />th. Labor Cod., int.ron ed.nm.yt fq <br />LICENSf, D CONTRACTORS DECLARATION <br />I hdcby alilm uidq pcialty ol pojury rl1.l I m licc6.d undq provision of Chapln 9 ( <br />$. Bu5in.s5 dd Proldions Codc, &d my licdsc is in full forcc ud.liccr <br />of pdjury fid lhft ii r consrtudion p.rfmuc. oarhc *dk ftrwhi.h rhis p.mn it <br />hru.d (S.c.109r, Civ. C) <br />A}PLICANT'S DECLARATION <br />Dcmolilion Pmils-Asbcn6 Norificolio F.d.BI R.gul.!ion! (Tidc 40, Pdr 6) <br />R.qut.d L.tlcr of Norifidion <br />I asr.r tocmply wnn all Ci9 Md County <br />abov. m.nrion.d prop.ny ftr insp.cti <br />v6 oithis City ad Coury ro cnrd upoi 0r. <br />Site-Work <br />Underground <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 />Torquing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Rough <br />Ceilings (T-Bar Rough) <br />lvleter Release trXPIRED <br />Rough EFR - I 2019 <br />Service Meter <br />FINAL SAMUo.J+.)'49v'vv'|'-. <br />Pole Bases <br />Transformers <br />Notes, Remarks, Etc.