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ELECTRICAL.INSPECTOR RECORD APPROVALS ID/SIG.COMMENTS Oe6'Buildd DcclBti@ I hcrby lanm undq p.nllty ofFjury $ar I m.rdpl tm tt. C@mclo6 Licos lle for $c followin8 rcEon(!c.rolLJ Sqina! dd Prcfc$ion Codc): Aiy Ciry o Couity which cqun6 a pcmn to conriroct, alrcr, imprcvc, dmolirh or r.p6t uy sttuctuE. Drior ro ib j$uDcc, also r.qui6 !h. +pticet for iud p@it ro 61. . sig.d lr.tndr $at h. o. sh. is licms.d puEuxr ro 0r FovilioN of $. conracbas Lianscd Llw (chaptr 9, comhdcins wirh s.crion 7000 ol Divtion I or thc Busine ed Prof6sions Codr) or $.r hc * sh. ii.xmpr lhftfrm ed th. b6is fd rh. all.g.n.rcmptid Any violrrio oaSction ?O3l J by ry lppli@t for.p.mir 3ubj&E rfic applic r ro a civil po.lry of nd lMr $e fiv. huodrcd dolla (1500) _1. 6 own.r of $. Fop.ny. d my cmrloyG *iln w.8s a th.n sol. @6p.ns.tion. will do d. work md th. itrlc((c i! not in!6d.d or oflmd f6 srl. ( Se 70rra. BBin6 sd Prcf6idr Cod.: Th. Co.tudt Li.as. L.* .lod nd .pply lo $ Ms ol $c prop.ny shobuil& or improv6 fi.mn, ad who do6 such wort hiru.lfor h6dadlhbugh hi! or h4 own qmploy.B. Fovid.d $at such imprcvchcnE &c not i.6d.d or offdcd lo. s.l. Ii hov.vcr. th. buildinS s inprovadt n soB vilhin on. yE of compldi@. ttc Owr.rBuild.rwill h!v. th. burdc, of proving tn.lh. or!h..ol build or improvr aor ih. purpc. ofs!1.) _1, 6 o*n.r of lh. p!oF.ny, m .:clsiv.ly @nr&titr8 enh lic.ns.d conkrou ro consrtud rh. proj..r ( Se 704r, B6ins ud Profâ‚¬$ion Cod.r Thc Contr&tor's Lik.!. L.w do.s nol .rply lo u own* of propdy who builds or ioprovs lh6@. , dd who conEacb lor such prcjccts witl 5 cot@to(, liensd pu6u&r to rh. conractofs Lic.hrc L.w ) I m er.mfl undcrs.crion ,B &PC for rhir r.d6n !.qBAEBS-CO!IE lSAIOllqEClABdr&! I hd.by if6m undd pcirlty ol pcrjury on. of rhc follovin! &.I&.tions: _l havc dd will mainhin ! C.nifierrc of Cons.nl ro S.l nsur. ior wortcE cmp6sati6,6 providcd id by S@rion 3700 offic Lsbor Cod., fm tn. pdfo.rMe of ih. wolt aor vhich thc pnn b isru.d _l hav. ud will mainlain workcB' @mpasalion iNurocc, s ftqun.d hy S.dion 3?00 of rhc L.bor Cod., for thc pcdffiec. oi rh. wort for *hich this p.mn i! issud My wo*.6 coapcni.rio insu6.. cdia &d policy nunbd e ffiffiffi,J"il;for onc hundicd dollm {I100) ot mmp.nsatior provirions of SdiM l7O0 ofrhc L.6or Cod.,l sh.ll, D,& > R-oL *n'*\a Failur.lo s.c ur. wor&.E ' comp.nsation co rubjcct d .mploycr to eininal paaltiG md cieil fin6 up to o. hundrcd rhoGdd dollm {l I OO,oOO),ii additi@ ro $c @n ol comFnrador, damag6 a prolidcd for 0E S.ction 1076 of thc Labor Codc, intcrdl dd atomcrt fccs. LICENSED CON'I'RACTORS DICLARA'I.ION I hcEby afllm undcrp.nahy ofprjury lh..l m lic.nscd und.rprovision ofChaprn 9 (@n thcBusinqs dd Pror6iG Cod.. ud hy licaic ir i. rullfo!c. aid crat virh Scction ?000) ofDivilion3 of I h.r.by amm und6 p.ialry of p.rjury lh.t thd. i5 a @ntrrqctid l6di.B s86.y ld thc pafm&c. of ih. wtrk fo *hich rhir p@it i! nludd(scc log7,Civ C.). APPLTCANT'S DECLARITION Dmolition Pcmits-Asbstoi Notiti tim Fc&nl Rcguldio. (TnL 40. Pfi 6) _ R.quircd Llnd ofNodllcltio -1*,,rhal ih. f.d..al Egularions rcgdding ab*l6 rcmovd s. nol applicabl. ro rhis poj6t $ar I hsvc Esd $is appli@tid .nd to.omply wnh llr City and County ordiidcA dd staL L.ws Ellling lobuildins is City ad County ro.ntd upon th. ab6v. hcnrioncd propcrly fo inrp.dion Site-Work Underground Pole Bases Light Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Voltage Fire Alarm / Dampers Communicatrons Cable Building Under Slab / Floor Bonding / Grounding / UFER Transformers Torquing Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rough) Ceilings (Hard & Soffit Rough Ceilings (T-Bar Rough) Meter Release EAIJIKE v Rough rED U I & Service Meter SAI vlC 8-43, 290, i tEâ‚¬,667 FINAL Notes, Remarks, Etc DATE Dar O*ncr