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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 / Floor <br />Bonding / Grounding / UFER <br />Transformers <br />Torquing <br />Sub-Panels <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 />Meter Release <br />EAT lr\l-r/ <br />Rough t ,ntq <br />Service Meter ftrD <br />FINAL SAMC 8.4:, 290, 556, (67 <br />Ow.a-Build.r Ddlmlion <br />I h@by affm undd p.nllry ol r.rjury rh.t I m .,mF fm lh. C6IE.!.B Licos. L3w fo! th. followin8 lsd (5e.703 | 5 Buine <br />&d PrclBid Codc): Any City q County which rcquiE a ponil lo @nsru.l, .ltr, imPIovc, d.molish or cpst uy slruclu.. Frd ro it! <br />issudc., alro Eqqir6 rh. .ppliqnt for slcn p.mi ro fi,c a !i8r.d llmml that hc o. sfic h liccnscd puBudl lo thc Fovkim5 of !h. <br />Cohrr.dor,i Liccnsd Llv (Chafld 9, Comft6cii8 *nh Smion 7000 ofDivision I oaihc Burin6 Md Pof6siois Codc) or Lhar hc or <br />sh. t .rmpl thd.flm &d ti. bsis fo lh. .ll.scd .xcmprion Any viol.tion oa Sc.rion 70r I 5 by M, +pli@r for . pqhn subj*rs lh. <br />spplicdt rc. civilpo.lty ofrc. mor. te nvq hundrcd dolla {lJoo) <br />_1, s own.r of th€ Fop.'ty, q hy 6ploy6 silh wag6 a th.t sol. cohpcnrdion, will do lh. work sd thc structuc n not inrad.d <br />or ofi.rcd fr s.l. ( S.c.7044. Busin* ud Prof€sion! Co<b, Thc Co.rdor's Li.dr. LN dc5 nd apply to M.r of $. propcny <br />who build! or imlrovs rh€rcon, ed who des .uch wort him.lf or h6clt or $DuEh his o. hr ow. cmtloy6, p.ovidcd $al luch <br />imprcvd.iE e iol iilcndcd d offq.d for 5.1.. If, h@cvq. $c blildingor improv.mmr is 5old wirhin on. yd of cmplcr'on, rhc <br />Ownd-Buildq will ha* th. burdcn ofproving lh$ hc orlhc not bdld or imprcvc aor rh. lurpor ofsak) <br />_1, c ownd of thc prop.lty, cxcluiv.ly conmcins with lc.n$d cor,&ro6 lo cosrtud thc prcj.d ( S.. 704.4, Buin6s ud <br />Prof6ior Codc Thr Conracrols Liccnsc L.w dod not apply lo a owncr of propnty who builds or inpova th4on , Md who <br />conracB ro' slch prcj.cE unh a conrBcro'(s) liccnsd puEuer ro rhc conrracror's Lrccosc Lav ) <br />_l d crcmpt undcr s..ion _.4 &PC forrhisr?aon <br />WORI(ERS COMPENSATION DECLARATION <br />I h.r.b, amm und.r p.nally of p.!!r, o.c ofthc iouowin8 d.cl&rlions: <br />I h.v. ed will n.incin . C.nifiet of Consmt to S.lf-lruur. for solkds' @mp.nsation, a Fovidcd for by S.dion l70o oftc <br />Llbor Codc, for thc pc,fme@ of fic work for which rhc pcmi is i$o.d <br />_l ha!. ed will mainbin *dtcB' cmp.nsation iBure@, s rcqutcd by S.ction 3700 oflhc Labo. Codc, aor fic pcrfmdc. oa{h. <br />work ftrqhich rhis pmil is iss!.d. My work6' @mpcnsation insunne @i.r dd policy numbcr a& <br />ExpiG <br />n..d nor bc compl.t.d iflhr pmn is ior On. hun&.d douas Itl00l or l*) <br />th. Labor Codc, I rhall,lonhwith <br />work6' compcnsadon covc.aSc is <br />d dolla {J l0o.o00),in addiionro rhc 6r of dddasB a prcvidcd for thc Scclio 3076 oa <br />th. Lab.r Codc, i.r.r6t md dtom.yt f.4 <br />!!EEr5!p-e9NrA4c[Aas_pret^A^fll)! <br />I ho.by afllm uda r.n y of pqlury lhrt I @ li@scd uidr provisio of Chapra 9 (om <br />$c Businai ed Plof6sioN Code, Md my lica$ k in full fo.c. aid ctrd <br />ly ofp€rjury rhot thn ii a onslru.tion lodinS.g.ncy fn lh? p.ddmn.c oaihc *dt fo*hich rhis pmit ii <br />issucd(S.c 1097,Civ C) <br />APPIICA]ITIS DECLARATION <br />D.mohion P.mir5-Asbcrl6 Ndilidjon F.dq.l Rcgll.tidi (Titlc 40, Pln 6) <br />_ Rcqln.d Lctd of Notific.doi <br />lccniry d.l dc fcddal l.8uldiom Esrding <br />Itra'lly rh.r I hav. E d thii lppli.dion..d I asr.c lo.mply *irh allCity Md <br />ordinmG ud Slal. Lrws r.latin8tobuil <br />.bov. m."lion.d proD.ny am <br />Air Conditioners <br />Notes, Remarks, Etc. <br />Loda! Addra <br />f------T------