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ELECTRICAL{NSPECTOR RECORD <br />APPROVALS DATE COMMENTS <br />Und rou nd <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Si ns (monument) <br />Life /Low Voltage <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bonding / Groundin / UFER <br />Transformers <br />Torquing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Fa Wired Unit <br />Walls (Conduit) <br />Walls (Ro h) <br />Ceilings (Hard & Soffit Rough <br />Ceilings (T-Bar Rou h) <br />Meter Release <br />Rough 0 c19I <br />Service Meter <br />FINAL <br />Notes, Remarks, Etc <br />Ownd.Blild.r Dal@rio <br />I hr!.by !flim !n.Lr Fnahy of pcrjrry $d I m cx.md fom $. conrhcroE' Lichi. Llw aor thc followinr ...s (sa,7o3 | .5 Bqinss <br />ud Prcf6ion Cod.)r Ary City or Couf,ty whicn Eqlire a p.ftit to cm3ruct, alr.r, improv.. d@lirh d rcpoir dy structuE. pdd ro iL3 <br />issu{c., .lso Equar6 h. appli@r lor suct p.mi ro filc . sign.d staln.nt lhat hc or sh. ir lientcd puRuor !o rhc prcvirions ot dc <br />Cdll3dols Lic6s.d liw (ChaFd 9, Commocins uith Sc.don ?000 ofDivision I ofrhc Busin6s d lrcf6ioi5 CodO or rh:t h. o. <br />sh. t.xmpt thftfrm od 6c b8is fd fic allcscd amptio Any aiolarion ol Sc.tion ?Ot l.5 b, my rppticdt for a Fmit 5ubjccn lhc <br />applitul ro r .iril p...lty of nor rcrc lhd fiv. hun&.d dollG (t500) <br />_I,6 oMcr officprcpdv, d ny.mploy..! wirh wag6 d cir $lc mp.nsslion, will do rha work dd rn. srnctqc i! nor inladcd <br />or offo.d ftr salc ( Se 7044. Buin6 md Proferion! Cod.: Th. Conn&lor'r Lictra L.w d6 nd +ply io u om6 of thq pop.ny <br />who buildi or improvB thdcd. &d who do6 tlct work himrlfor h6clf q through his or h.r @n @ptoyq, prcvid.d rlr twhinprcvmnls e nor inEnd.d or ondd ftr e.l. It h@ea,6. buildins d imrrcvd.nl i5 $l.t wirhin ocyeof .mplajo, th! <br />Ownn-Buil.ld eill har $c bord.n ol provirg rhal h. d rh. not build or imprcvc for th. puraac of srl.) <br />_1. a own6 ofd. prcFny, o aclaivcly connerinS wnh lic.nrcd conr.ctod !o corndd $. p.oj.d ( Scc. ?04a, Bqi.sr dd <br />Prcaddon Cod.r Thc Conrerdk Ue.r. kw d6.or apply to M oe.r olrrcpay vhobuil& 6 improvB rna.on, ed who <br />otnct5 fd such prol4r. eith a cdtr*to(, li@r.d puB@r ro th. consacror'! Liq5. Lle ) <br />_l m cr.mpt unda Sarioi _,8 & P C for dt 1600 <br />WOB(ERS COMPENSATION DECLARATION <br />I h@by .ffim undd pd.lty oa prjury on. of $c folloving d.clmtioE: <br />_l havc ad will m.inr.in r C.nifioc ol Con6.nt ro S.lf-toioE ltr wdkcrc, dpas.tion, s povidcd for by S6tion ]TOO ofth. <br />tibor Cod., fq th. pdfffia@ of $. sdt fo. whrh th. p.mili! irslcd. <br />_l hw. ed will m.iir.in wo 6 Mpdr.tion iNs e, s rcquiEd by S€tion 3700 of tG t$o, Codc, fm tr patorfu!. of rh. <br />wdk rtr wtid $i5 pmt ii is.d. My wort6 @m9.r.rid ituUfu@ ffia 6.1 policy numb.r s. <br />Policy Numhf ExDrE. <br />ffiffiffi.d#;fn On. hlnd.d doll6 1l I o0) or <br />ions of S.crio. 3 700 of $. Labtr <br />o <br />qr. ro reu,. w6k6' omp€nB.ion covdag. h .cl a cnployd to aiminal <br />fin6 up roon. huhdEd $oB d doll6 rlloo,ooo,.ih .ddil,on @ <br />thc L.bo Codc, inrcGt d.(t@.yk f.6. <br />or, d.n.36 a p.ovidcd lor 0F Sccio. 3076 of <br />I hd.by affim uda p.nalr, of !80 ury thlt I m lic.rscd uda prcvisid oi Chapr.r 9 <br />thc Busin6sed Prof6sions Codc, ad ny liccnscis ih fuil forcc ud cff.ci <br />I h@by affim und.r pardiy of pdjury dd rhd ir . @ndrucrio <br />isslcd {scc. 3097, Civ. C.). <br />of lhc wsk for *hich lhir pcmit is <br />APTLICANT'S Df CLARAIION <br />D.molition P.mits-Asbcsros Norificadon Fcdcrd Rcguldion! <br />_ R.quicd LctcrofNo licario <br />abov. h.ntion.d !,op.,ty fd inrpelion <br />rhis Ciry ed Counry ro ar.. upon fi. <br />Site-Work <br />I rolsrc.