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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OMd-Builds D.clelion
<br />I hcr.by amm undd p.n,ny oa pajury th'r I e adF a(m th. ConrBro6 Li@i. La* lor Uc followin8 r6on (rcc 7o3 t 5 BBins
<br />dd Profdsio. CodO Any City or County {hich aquir4 a pddn !o conmci ahd, imprcv., ddoliih d rcp.n d, lrtudw. Fd ro ir!
<br />issuecc, .lso rcquiG thc appliot fd Nch p.mn ro filc a si9crl slatddt $at hc d sh. t lico3.d pluu r to 6c prcvisions of tn.
<br />CoEactor's Licas.d tlw (Chapto 9, CMfrddf,8 with Satim 7000 of Divisio. 3 of !h. Bs,ns dd Profdios Cod.) or rhdt hc tr
<br />sh. i! .ropt thmfrom dd ll1. bsn fc rh. all.B.i q.mprio Any violatio of Sccfie 7031 5 by ey aprlicmr for . p.mn subje.! rh.
<br />applic&r ro . civil p.o.lry of rol morc thM 6v. hu.dr.d dolldi (1500)
<br />_1, a o*n.r of thc Fopqty, tr my mploy€ *i(h *ag6 a thcir solc cmpasdia., will do d. worl d thc structu. is nor inrid.d
<br />or oftard aor sal. ( Se.70,1.4. BBi.6 ud ProfBrio. Cod.: Tl. C6nE ct6'c Licdsc L.q do.5 nd rpply ro s ohcr ot fi. pbp.ny
<br />who huild! or inprcv6 thcr@, ad who dG such work hirucll or h6df d lhrough hn or hd oqn mploycs, providcd lnar iuch
<br />improvcmcnE e nol inrcnd.d or offdcd rm ssl. lf, how.wr, rh. building or rhprovmdr ii sold wi6in on. yd of @dpl€ro, rh.
<br />Oqd-Buildcr will hav. $. blrdd of prcvi,g th.t hc d shc nor build o! improv. for $. pu4e ofsalc)
<br />_1, 6 own.r ofd. p@p.rty. m.xcl6iv.ly contudng ri6 lictucd @oE&t610 conslrdct tn. proj.d ( se 70..4, B6in6 dd
<br />P.ofdsion Cod.: Th. CMtr&lo i Lica!. La* {b6 .o1 +ply ro M ownd of p.opqty ylD buil<ls G imFoc $!r@ . dd who
<br />contr&ts fd such prcjccB wnh . Cohr&lo(t lies€d puBuat to fi. Coftctor's Li.as. riw )
<br />I M cxchptundcrs.clion .B &PC fdthis r.Gon
<br />WOR,.EiS COMPENSAIION DECLARATION
<br />I hd.by al6m Edfi paalty of psjury onc ofth. followinS d.cl&ario.s
<br />_l hav. url will m.inlrjn ! Ccnifierc of Cd3.nl 10 Sclf-lnsur. aor wtrk6' comrchradon, e prcvidcd for by Scciion ITOO oa rh.
<br />L{bor Cod., ad tn. paf(,l@cc ol th. wq} fG whi.h th. pmir k i$ucd
<br />I hrv. ed *ill mainrain *dIcG! cmpcm.rim iBurmcc, d rcquircd by Sation 37oO oa rh. Labtr Cod., for thc Frfomdc. of dE
<br />work ld *nich this p.mir h isucd My wort4 conpcmalion insur&e csicr ed policy numbr m
<br />(This s.cr,o..ed nor b. cdplct.d if ln. Fmn i5lor Onc hundrcd dollds lltoo) m 16,
<br />_l c.nify that in rh. pafomd.c of drc uork ftr which this rmn i! issuc4l shallnot.mploy My p6sd ih tuy otund so 6 o
<br />b.cMc subjet to rhc work6 compdsarioo lsE of califomi4 sd asE rhar if l ihould b.cofrc rubjccr ro rhc so cu
<br />comp.calion trovirions ol Scctio I700 of lhc tlbor Cod., I shall, lonhwid conply wid lh6. lnoisions
<br />IIARNTNG FailuE lo !&ur wok.u' comF.erio covcras. is urhwful, Md rhall subjet M mploycr lo oihind F.!tri6 od civit
<br />6n6 op to onc hund..d $oaud dolle (l I00,00o),in .dditid ro rh. cct of@p.nsarior. damas6 s prcvid.d fo. lnc Sction 30?6 of
<br />lhc Labd Codq intcrd dd anomcyt fcs
<br />LICENSED CONTRACTORS DECLARATTON
<br />I hmby amm uda pco.lty ofpdjuy rhal I m li@s.d uidcr proyirion of Ch+ld I Gomm..ciog wilh S*rion ToOo) of Divhion 3 of
<br />thr Buh6 ed Pmf6i* Codc ed my lic.ff. h ir lull fore dd ctfer
<br />f-/d ./a d
<br />CONSTRUCTION LFNDNG AGINCY
<br />I h6by affim ud.r p.nalry of Fjury {lal $ac k . of,strudi@ lcndir8 aghcy td th. p.rfmm.. of dc ydk fr which lhi, p.mt is
<br />isu.d (s* 3097, Civ C)
<br />Z
<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 />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 />Meter Release EXPIR ED
<br />Rough FEB II I 2nt9
<br />Service Meter
<br />FINAL
<br />Notes, Remarks, Etc.APPI.ICANT'S DECI-IIRATION
<br />D.mlidm Prmits-A*6r6 Notificrdd Fc.ldl R.guldjG (Iidc aq Pm 6)
<br />_ R.quircd L.ltd of Norific{id
<br />_I c.niry lhll $. f.!ad G8ulatioos Eg&din8 ebdr6 rooval e ior .p?tisbl. to thir Foj@t
<br />_ I conry dat I hay. c6d this rpplic.tid md rbrc lhd ln. abovc infom.rio is c6.cr I lgre io cdply widi aI City ad Cou y
<br />Mdindcd ed Sra& L5w! rclaling lo building cstrucdm, &d hftby aulhoia EpG@r.ljv6 of lhie Cny od Courty lo otr lpor lh.
<br />.bow n.nlion.d Drcp.ny for inrpcctiM purpos6.
<br />Appr,6,or.86,{84 ,,,, 5-,,<,r/o 6
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