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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS Oma-Build.r D.clrtrion <br />I hcrcby affim undc, paalty olprjury th.l I m.x.frpt lom $. ContBctors Li. s. kq for thc following E6on (i.c.703I 5 Bain6 <br />od Prcfc$ion Cod.) Any City or Couniy which Equire a p.mn b conshcr, .1t6. improv., dmolth or rcpsn ey mcrue pnor ro 'l!iss!Mc.,.lso llq{iB thc applic&r fd ruch Fmn io fiI. d sisn€d !ral6.nr $dr h.or shc is limscd pusudl b {rc Foviiic ofth. <br />Cdtr&td! Lictucd t v (Ch.Fd 9, C.moodis snh Sadon 7000 ofDivision I orrhc BBi.6 !d Pror6ioni Cod.) or dtar hc s <br />sh. is .xcmpt rhq.fM ed thc bais 16 $c allcecd cxchFion Any violation ol S.ction 7011 5 by ey appliot fd a pqnit subj.cLr ln. <br />applicer ro 6civilpdalty of.d hoE fie fiv. hund,.d dolldi (1500) <br />_1, s own.r oi lhc Fop.rir, d ry coployc6 Nith wagB a rh.t solc compc6ation, *ill do $c *ork and thc attuciuc is not inrodcd <br />or off*d tq .al. ( S.c ?044, Buiin4 sd Prcf4ion! Cod.: Thc ConGclor's Licorc Law dB nol apply lo !n ovnq of thc p.op..ry <br />whoboild! o.improvd dmn, d who doo such wor, himlclf or h6dl o trcu8h his or hd ovn .mployccs. prori<i.d lni! such <br />improv.hcnE e not inlad.d o. offrcd lor s.l. It hoq.vcr. Ihc buildins or ihprcvmcnt is sold vilhin o.c yd of compl.oo, th. <br />OwncFBuildcr willh,vc thc burd.n ofprovinS tha hc orsh. nol build or improvc ls thc lurposc ofsalc) <br />_1, d ovno of $c p6Fny, @ .rclGivcly @ntr&rins viln licdscd contr&lod to @nsrtucr th. prcjd ( Se. 7044, BsinB &d <br />ProfBsion Codc Ihc Coir&rtr! Liens. L{w der not Aply ro d owncr ofp.op.ny who buildr or ihprovB $acoi , ed who <br />coituB ao,suci p'oj.cts wirh a cdturo(, li@scd p{6u r ro ri. Conh4toar LiccG Law ) <br />_l m .x.mpt !nd.r Sanior .B & Pc. for this rc6on <br />YOB6DBiCOI4IENSAII{IN-U.ECIABdIJ9A <br />I h.r.by affim und.r p.nalty of psjury orc of lhc follNins d.clr.tioc: <br />_I hav. ad willmainr.in !Ccnifietofco.r..lro Sllf-IsuE forwqt6 cmp.nsatim,6 provid.d for by S*tion l70O of$. <br />Labor codc, for $c PcrfmMcc of $. wo'k lor which $c p.mn t i$ucd <br />_l havc sd will mainBin wdkcs compasation imurdc., a r.quir.dbyS.c on r?00 ofth. L.borCodc, for rh. p.rfomacc ofth. <br />wort for which fiis p.mil k hsu.d My worl.6 cmpdation insuru.e 6i.r d policy numb.rar. <br />Policy Nunbcr ' Exptcs, <br />#,ffi b. cmdcLd iirh. p{hil i6 for On. hun&.d doll4 (1100) m 166) <br />L <br />dolles (ll 00,000),in additi comp.n$rion, dama8d 6 providcd for lh. S <br />I h.Eby afUm und.r poalty ol !nj!') ihar I o licdscd u.dd prcvtio of Ch.pk, 9 { <br />$. Bsin6s dd Prcf6ions Codc, ed my lieosc t in rull fo@ 6d cff4r <br />pcrjury fiallha. is a const lcrio lodinS for lh. pqiman@ oi thc w6l for <br />, civ C) <br />APPI ICA]VTtS DECLAXATION <br />D.molidon Pcmirs-Asbctor Notificatim F?d.r.l R.gul4ios (Tiil. 40. Pan 6) <br />R.qutld Lcrd ofNo lic*ioi <br />_l c.9fr,da' 6. rcdoal rcsular'onr r.s&dins db6tc <br />i4attty t!1d t n*c n.d thir appl'dd ud rErG rh{to comply wnh 5I Cny dd <br />ordinuc6 d Srat. Laws rclalinE lobuildins <br />8bov. n.n.ioncd propdy for isp..tio plrpd6 <br />Site-Work <br />Underground <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 />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 />Rough EXPIRI D <br />Service Meter <br />FINAL r-hts0t'!n!i!iiiJ <br />Notes, Remarks, Etc. <br />Pole Bases <br />Sub-Panels <br />Meter Release <br />Drb: Ov.r <br />Lcndcrs Ad.lrc$