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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.Omd-Build.! D.clsalion <br />I hc!.by alfim und.r pc.ahy ofpaju', th.t I n.xnp( aom rhc ConteloE L'.asc lrw fordc followin8 r.son (@ 70ll5 Esird <br />and Pof6rion Codc) Any City or Cou.ly which rcqoirB . p.mil ro .o.sttud. alr.r, idprov., d.molish or rcp.n dy 'lr!.tw. Fior to iB <br />issudcc, also rcquir4 $! appli.ant fq such pcmn ro 61. a sign.d sLt m.nt thar hc or sh. is licarcd pursuut to th. prcvisions of rhe <br />Conirerof3 LicaEd Laq (Chaprcr 9, Cohdddns wnh Scction 7000 ofDivision I oatfic Buin6 dd Prof6sios Cod.) or dal h. d <br />slr is cxmp{ thftlron od lh. bsis aor <br />'h. <br />all.B.d .r.mplion Ahy violaiion of s..rion 701 I 5 by any applimr aor . p.mit'ubj6t5 lh. <br />applicdt to acivilpcnalq oliot morc lh& fiv. huodrcd dollds (1500) <br />_1, s oqncr ofrhc prcptlty, or my dployc *ith *ag6 a th.t sol. comEnsalion, qill do th. wort ed rhc structu. is nor inrdd.d <br />or off.r.d for sal. ( S.c 7044, Bsin6 od Prolcssions Cod. Thc Conr&tols Lic6s. La* dcs not apply b an own.r of rhc propcny <br />who builds o, imprcve $.r.on. andwho do6 such work hiruclf or h6clf or $rou8h his or h., own cmploy.cs, provid.d rhal such <br />improvcm.nB e nol int.ndcd or offd.d lor salc Ii ho*cvq, lh. buildins or impror.m.nr i, sold Grnin on. ycd of compl.rd. rhr <br />Own.FBuild.r will havc fic burdcn ofprovi.s ttar hc or shc not buildor improv. for th. purposc orsal.) <br />_1, a oqnd of d. popcrty, m cxclusiv.ly contradin8 wirh li...scd conbncroE to conshcl rh. proj.d ( S.c 7044, B6in63 ud <br />Prof6sion Cod.: Th. Corkcrorl Lic.n* liw do6 nor apply ro u own.. oipropqq who builds d imp.ov6lhtuo , an'l vho <br />contracB for such prcj.cE vnh. Cont etor{,liccnsd pusuur ro thc Conracror'. Lic.n!. La* ) <br />I m .x.mF rnd.r S.dion _,8 &PC fd this rcaon <br />WORKERS COMPf, NSATION DECLARATION <br />I h.rcby al6m und* p.nalry of pcrju.y onc oflh. followins dccldadonsl <br />_l hav. &d will mainrain a C.rtifietc of Cons.nl to Sclf-lnsur. for work6' comp.nsation, E povidcd for by S.dion l?OO otth. <br />Labor Cod., for th. pclfmmc. of fic work ior which th. p.mil is irlucd <br />_lhavc d *ill mainroin workcB @mpsNaliotr i.surec., 6 rcAun.d by Scction 3 700 of ih. Labor Codc, fo. rh. pcrfomac. of rh. <br />uork ro! which tht pmil is issucd My *ortcG' comp.Nalion insure@ tri.r ed policy nunbcr dc <br />nor b. conplct.d il lhc pcmn n fo. On. hun&.d dolla lllO0) or 16) <br />rh. pcrfomdc. of th. qork for wbich rhis tmn <br />dr. vdtcE ' cofrpcnssrion liws of Califomil, ud <br />comp..rarion provis'ons ois.c on r?00 ofrh. L.b.rCod.,l shlll, ionhwnh comply <br />WARNING: Failurcto s.c urc workc6' comp.nsai ion covcrasc is unl to crininal pcnaltid and civil <br />find up ro onc hundrd $oB&d doll6 (llO0,O00),in ddilim to lhc cos s provid.d fo. dc Sccrioh 10?6 oa <br />ln. Labor Cod., inr.Btsdrbmry! f.6. <br />LICENSED CONTRACTORS DECLARATION <br />I h.rcby aftm und.rpcnrlry of p.rjury lhar I @ Iicascd udrprovtio ofCh!9t.r 9{ <br />dr. Busin6s ed Prof6lioB Cod.,.nd my licens k ii fulliorcc and.n cl <br />)-'LL+- oL <br />I h@by .ftm mdq r.nalty ofplrjrry thar rhdc ir a coNrruction la <br />issucd(Sd l097,Civ C.) <br />;!cn.y for 6c pcrfomanc. of rhc wdk for which $is Fmit ir <br />A}PI ICA]Y'ItS DECLARATTON <br />Dcmolinon P.mils-Asbabs Notificalior F.d.ral R.gu l.rions (Till.40, Pan 6) <br />_ Rcquircd L.!dof Notifietion <br />lhi! City and Counry lo .nlcr upon thc <br />abov. h.nliocd prop.ny aot iNp.ction <br />224 o1 <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 />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Rough EXPIRED <br />Ceilings (T-Bar Rough) <br />Meter Release FEit : I l0ll <br />Rough <br />Service Meter <br />FINAL <br />COMMENTS <br />Site-Work <br />Notes, Remarks, Etc. <br />Lcnd.r's Addrgs