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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS OwncFDuild.r D.clation <br />I h.rcby affim und.r pcnalt, olprjury rnr l a.xcmpt fom th. Confucrm' Lic.B. Law aor th. aollowin8 Ea6 (iE.70l I 5 B6ind <br />and Profssion tuc) Any City d Counry vhich Equir6 ! Fhn to cdsrruct, .ha. imtrcvc, dmoliih d rcplir ey strucruE, Fid !o ir. <br />isuMe. also rcquiB rh. appli@r fn such pcmi ro filc a 3ig.cd stat mot rh.t h! or rh. i3 licoi.d puBuot to tic prcviio ofrh. <br />Conb_acto,'r Licor.d L.w (Ch:Fd 9, CmBmcin8 wnh Sanion 7000 of Division I of lhc Buines ed Profsri@ Cod.) or th{ Ic d <br />sh. is .xopt !h.r.frm ud thc b6is fo rh. .ll.8.d rxnplion Any viol io of S.clion 703I J by uy .pplicsl ior . plmit subjccb th. <br />lpplic&r ro 3 civil p.iahy of .ot mq. thM ,lvc huidrcd dolls (1J00). <br />_1, d owncr of rh. p.opsty, or my cmploy.6 widr wag6 d rhcir rolc comp..s.tion. will do rh. wo* ud fi. shcru. is nor inrc.dcd <br />6r odd.d for s.r. ( sd ?044, Burins ed Prof6sions Cod. Tnc Cortraclor's Lictr. kp dG rol a9ply lo u owncr oflh. prop.dy <br />who buil.te or improvd lh.@n, ud who do6 such work hi6.lf or h6.lf or ttrough hii or h.r own.mploy.d, provid.d dd such <br />improvcmcnE e. not inrodcd or olfacd fodak I( howcv.i thc buildins or improvdor is sold within oc yceofcompl.uM, rh! <br />Owr.FBuild€. will h3v. thc burdcn ot provins thal hc or sh. nol build o. improvc fo. thc purp6c of salc) <br />_1,6 o*no ofri. p$Fny, e *cl6iv.l, conEacring,th liccnscd cont.cro4 to conrlJlcl dc Foj.cr ( Src,704.1, Bsih6 dd <br />Prof€rion Cod.: Th. Conb&torr LiccN. L.* d@ no( 6pply to oa of propdy who build5 o improvG th6@ , ed who <br />conracts for such proj4ti with a confelo(, Iictrcd puisu ! ro rhc contradors Lic@. I-3w ) <br />IAB6EBIC9MEEISAIIAd,!ECIAEAI!9N <br />I h.r.by.ffi m u.d.r p.nclty of pdjury o.. oaih. followiig d.dm ois <br />_lhav.edwiumainrain.C.ninst.oacons.nltoS.lf-lnsulcforworkRcofrp.nsalion,6provid.dforbyS.ction1700ollhq <br />Labor Codc, for lhc p.rfmac. of dr *dk for vhich drc pcftn is issucd. <br />_l h.v. dd will m nt in wak6 @mptu.lion iEu6.., 4 r.quircd by Sction r?00 of rh. Lnbo! Codq for thc ptrlomue of th. <br />wort for phi.h tht pmil i6 issucd My work6' comp..sarion ins!@.a.miq ud rolicy.!mbs d. <br />Policy NMbn I Expi6l <br />-ffi*ffi"ffiffi;for On. hun&cd doUm {llo0) o.16s) <br />compc.s.tion provisions of S6li6 oilhc Lalor Cod., I shall, fonhwnh <br />-o <br />\{ARNtr{G: FailuE to sc.uE work.m' comp.rstio covqrag. <br />fin6 uploon. hud!.d ttoaud doll6 (t100,000),in addilionlo <br />lnc Labor Cod.. im.r6t &d .nohry! f.6. <br />dma86 s provid.d aor th. S?cdo.10?6 ol <br />LICE\SED CONTRACTORS DECLARATIOI{ <br />I h.rcb, affim undd pdahy ofpcnwy thar I M licoscd undd provhion ofchapt .9 <br />thcBusinds ud Prof6sidi Cod., ed ny liccnsc is in full fo@ dd cffccl. <br />I h@by .fiim und.r p.nalry ofpsjury 'n 6@ is rconslrucli& l.ndins ls.ncy fo. thc <br />i$wd (Se. 309?. Civ. C.) <br />ofthc wdk ior which this p.mt ir <br />AttucArrfD[clanar]aN <br />Dcnoliion PmitlAsb.stos Notiiicaion F.d.BI Rcgulari@s (Tirl.,l0, Pan 6) <br />_ R.qliEd L.nd ol Notifidion <br />-lrr{'fy <br />thd fic f.d.r.l Eguldroni rcgEdh8 sbarG <br />ll elnry rtd Ih.v.Erdrhit rpplidion &d $r.dd tocomply ynh all Crly ed Colnt, <br />ordinuc6 ud Srai. L.wi rcl.rin8 ro buildine <br />cbov. motion.d prop.ny fd itupcdioi purpos6 <br />lhh City ed County lo otcr upon thc <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 />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 E;(PIRED <br />Rough FE B I ZUI I <br />Service Meter sA^rc 8.a3 ,qn a4, <br />FINAL <br />_l d cxcmpt undd Scction _,8. & P.C. fs lhh rc6on <br />Darc _Osnn _Communications Cable <br />Air Conditioners <br />Noles, Remarks, Etc.