|
ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE tD/stG.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 / Groundin / UFER
<br />Transformers
<br />Torqurn
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Sofflt Rou h
<br />(T-Bar Rough)Ceilin
<br />Meter Release
<br />h
<br />Service Meter
<br />FINAL
<br />OMa'Bdld.r Dc.ldllion
<br />I h!6b, affim uids patlr, ofFjury $!l I m.xdp{ aom Ih. CdtracloE Licas. hw fd rh. followinS @or G*.70,L5BBin6
<br />d Prctsion Cod!) Aiy City o Coury which EquiG . pcmn to consEu4 alt r, iBprov., d.,Elish or r.p.ir uy slrldur, p.im ro il!
<br />i$!ec!, also rcqnt6 tt. rppliur for rud pmn lo fil. a siSncd sl dcnr thlr h. or rh. h liccnscd p$qt to dE Fovisioni of th.
<br />Cdrador's Licascd &w (Ch.pr6 9, Comm.,dn8 with Sation 7000 of Divirion 3 of $. BBinB &d Prct4sionr Co&) or drl hc tr
<br />sh. is d@pl thd.frm sd rh! b$ii a6 tl'c .llcg.d cxcmflion Any ,iolarid of Scclion 703 I 5 by &y applicDt fo . pdnn rqbj.cb $c
<br />rppli@r to.cieilFnalry ofnor mo.c thu fivc hun&cd dolla (1500).
<br />_1, 6 ow.cr of lhc prcpary, or ny mployss with w.Ers E ihcir rol. conp.nrarion, *ill do 6. work ed lnc slrucluc is nor inrcndcd
<br />d ofrEcd ror salc ( S.c 7Or.{. B6in6 dd P.of6sions Codc Tn. Cont@tor's Liccn!. L.q do6 not apply ro .r o*n.r of rhc propldy
<br />who builds or
<br />'nFov6lhcrco,
<br />ed who dG 5uch work hiGclf or h6.lf or through his or hfi oM mploy!6, providcd $.t iuch
<br />improv.m.n6 a. nor intcnd.d or off@d for s8l. Il ho*cv.r, rhc buildinB or improv.m.nr is sold *ilhin oncyclrofconpl.rotr. $c
<br />Owor-Build.r will havc riic burdcn ol provin8 lhd h. or sh. not bnild or improv. for inc purp6. ol s.lc)
<br />_1, a own.r ofthc prcF ry, a archrivcly @nn.ding *ith lic.nr.d @nEacto6lo conslruct rfir prcj.d ( Se. 70ar, B6in6r udProf*io Cod. Ttc ConEelry'r Liens. li* dc not .pply to e os6 ot Pf@aty wno buil& q imp.ov6 rh@o. . sd wto
<br />cooretl for iuch prcjeG with a ConF&ro(s) licas.d puBuor ro rhc Coir.cior's Liccisc Lsv )
<br />_l m qmpt und6 S.dion _,8 & P C. for this r.sor.
<br />WORKERS CON'PENSATION DECLARATION
<br />I h.r.by affim undd pa.lty of p.rjury on. of rhc loll@in8 d.cldstions:
<br />_l havc ed will mdinlain . C.njficar. of Cohrcnl to Sclf,ltuurc for *ort6' €ompasarion, s pmvirtd lo, by Sdrion 37oo oflhc
<br />L,bor Cod., for ihc pdforfuc of l.l. wmk aor vhich $. p.mn is is5lcd
<br />_l hzvc o will mainlain wtrk6' @npdsalion iBuro€, 3 Equirc.l by S.ctio. 3700 of l]rc Labor Cod.. for $. p.riomdc. oi thr
<br />wort for which $i5 p6nt is iis!.d My wqt6' cmp. .rid iusuru.. cdia ed ,olicy nuhbcr dc
<br />PolicyNumb.i ExpiG:
<br />(Tht rccrion nccd nol b.@mplctd if th. p.mn is for Oic iuidrcd doll6 {t 100 ) or ls,
<br />a*,^,,.^
<br />#"*,,i:*,,"
<br />rh. pafomee of $. wdt fd which
<br />WARNNG Failurcto sccuB wtrkm' emp.n$rion & mployd ro ciniial pcnahiG -d.ivilfi.6 xp io onc hundi.d rhoudd dolla (t l00,O0O),in addirion io
<br />rhc l-3bor Codc, inrd6t ad ltlom.y ! f6
<br />damasB d provid..l for fic Scctio 1076 of
<br />LIC[NSED CONTRACTORS DECLAIIATION
<br />I h.rcby affim ud.r pady of p!:t ury rhrt I m licoscd und{ provision of ChapE I
<br />drc Businss ad Prof6sio5 Codc, Mdmy lic.nrc is in iull fore und.afccr
<br />I hcrcby af6m u.d.r p.n.lty oapajury thar rh@ is a const uclion l.ndjn8 .8.ncy for fic oflhc w.rk ior which lhk p.mn ii
<br />isu.d (S.c 109?, Civ. C)
<br />APPLiCANT'S Df, CLARiTION
<br />Dcnolition PcmilsAsbar6 Nodncadoi fcdcsl Reguhrior (Tnl. 40, Pln6)
<br />_ R.quircd Lri.. olNodfidid
<br />,bovc n.nlion.d prop.ny fd inrFcrion pu.p66.
<br />-6
<br />s City ud Counry !o 6t6
<br />Sub-Panels
<br />t XPIRET I
<br />r .g-t (U J
<br />SAMC -43.2S0 5l 6 667
<br />Notes, Remarks, Etc.
<br />oath. Labor Codc. I sh.ll. fonb*rth
<br />I
<br />-------T------
<br />t - -T------
|