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ELEGTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE IDiSIG.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 / 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 E\rrrrrErar tl f EIJ
<br />Rough ETRNI ,n!0
<br />Service Meter
<br />FINAL 5AMC B-43, 2!0, 556, 667
<br />Ownd-Buildd Dccletio.
<br />I hcEby:f6m u.dcr p€,dty oap.rju.y rh l dcx@pt fom rtc Contr.ctoa Licc,sc L.v for6! aorlo*in8Bd (s4.703!.J Burin.$
<br />ud PiotBion Cod.) A., City or Cou.ry vhich EquirB r pcmir lo c6Lucl, ihd, impbvc, d.moBh or rcp.t sy slructurc. ,rid |o iE
<br />i$o&c., alro Eqone lh? lppli{t ftr sucn p.mit to fit asig.cdit.tmot thar hr or sh. is lic6,.d puEuel to th. Fovisios of thc
<br />Conl,&rdt Licd3cd Lrv (Ch6ptcr 9, Cmnfidns *ith S*tion 7000 of Divirion 3 of thc B6i.6s ed Proa6rions Codc) or thar hr tr
<br />lhc is q.mpl th.rcarm dd lll. bais ld th. .llcg.d .x.hprion Any violarion ol Slcton 701 I 5 by dy applicd for a p.mn subjeB t.
<br />lppli@r io ucivil pmdlty ofnol m(. lhd fivc hundr.d dolld (1t00).
<br />_1, a ow.a of th. prcpdry, or my .mploy.6 with w.g* 6 lh.ir solc compqsaion, will do lh. wort dd rhc st$clurc is nor iDtqd.n
<br />or ofi.Ed ftr salc ( Scc 7oaa. Busi!6s ed Profesions Cod. Thc Cohcro, s Licasa L.w d* nor 6pply to u wn€. of th? propcny
<br />wno buil& or improvcs thdc6, ed who do* srch *ork hiruclf or hdclf or lhrough his or h.. @r .mploycd, provid.n $1 tuch
<br />improvmcnls &c nol inlddcd o, ofcrcd for sdlc It how.v.r, th. buildins o. improv.mot is sold wi$in on. yc of compl.uon, $.
<br />Owna-Build.r will h.v. th. blrdcn of provinS thal h. oruhc nol build or implov. ad lhc purpcc ot s.lc)
<br />_I, a ownd of lhc prop.ny, mqcluivcly @ntutin8pnh lic.nscd 6nr.croE to conshd rh. prcj@( ( Sa. 1044, Bsincssed
<br />Prof6sion Code Thc Cont&loat Liccnsc Lav de nol apply lo M ow,cr of prop.rry who builds d iEpovd fiq@n , d who
<br />.oiitd! fo. srch prcFcr5 wiih a Cdr&ro(, li6s.d puEuar ro rhc Contraqtor'r Li@nsq Law )
<br />_l e ?x.mpt lndr S.ctio.
<br />-B
<br />& P.C. fo $i5 r.aon
<br />!9B6EAffqMII!!ANO!-DIC
<br />I hocby affim undcr pcMlty olpcdury on. ofrhc followins dcclmtions
<br />_lhav. d will m.iorai!. Ccnilic{? oaconscnl Io Scll-lnruft lnwtrt6 conpds.tion.6 providcd ld by S*tion 3700 ofrhc
<br />kbq Codc, tor thc psfomae of lhc *ort for vhich ln. pcmit is isrurd.
<br />_I havc ed will miiraii eork.R @mpcsarion iNure.c, a r.qutcd by Sccion 1700 of d. Labor Codc, for lh. Frfmecc ol $d
<br />wdt for *hich thh p.mi t issu.d My world' corD.Ellion in!uru.. ceid ed rlicy numb.r arc
<br />Polic, Nueb.. : Elpi6
<br />t'thtz,ftr rt.n
<br />".-*,,6,.., ,"
<br />.ot bc @oplclcd il$. psmn is ftr Onc hun&cd doll6 1ll00l d 16)
<br />lh. p6fomM@ ofd. wor[ for *hich rlris p.ftir t i3su.d.I shr]l
<br />tic porlca ' codp.niaiion las of Califomi\ ed a8!@ rhar if I
<br />comp.ns.ti@ provision, of Sation of$. Llbd Cod., I shall. ionhwnh
<br />-o
<br />WARNINC Failu.c to s.curc*ort.6 compcnsiion covcra3c ij ro diDinal ,.nahi6 ud.ivil
<br />finB up to onc hun&.d 1ho6&d dolld (1100,000),in.dditio. to
<br />thc Libor Codc. intcrd dd alomeyt f.B.
<br />provid.d for dc Scclim 3076 of
<br />LICENSED CONTRACTORS DECLARATION
<br />I hdcby afljm uid, paahy olpdjury drsl I M licds.d und.r provision of Chapkr 9 (
<br />thc Busrn6s ud Prof6sions Codc, ed my lic6s.is i. full aora xd lff.ct.
<br />o
<br />I h.r.by,ifim und.r p...lt, oap.rjury that rh6c is a connruction lcndi ofihc wdt f( *hich thiipcmirit
<br />isucd (S.c 1097, Civ. C)
<br />AETI]CAIII]IDECL4BAI]O!
<br />Dcnolnion Pcoirs Alb.itos Norilication Fcd.ral R.sulalions (Tiilc,i0, Pan 6)
<br />_ Rcqut.d Lcttr olNolifi calion
<br />abo!. m.ition.d prcpaly for i.ep..rion purpGe o
<br />Notes, Remarks, Etc.
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