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ELECTRICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG,Omr'Buildr Dalraioi <br />I hq.by affim undn Fnahy of F.j!ry lh.r I @.rdfl lom ln. Conha.toa' Licasc lrp ior rh. rollowins r.Non Ga 7031 5 Bu.in4 <br />and Prof6si6 Co&): Any City or County which Equt6 r p.mit lo ensflct, alt r, imPlovc, dholish or rrpdr dy s(r!.uE p{ior to itr <br />issuecc, also Equir6 rhc +pli@r tor ruch p.mir ro filc ! si8n.d stalmcnl lhar hc or shc h li@ns.d puuuut 1o th? provisions ol $c <br />Conm.loii Lic.n6cd La* (Chr$6 9, Comn.ncinS vi$ Sc.tion ?000 ofDilision I ofthc Busings dd Pofdsions Cod4 or$.r hc or <br />sh. t cx.mpl $cr.frcn ed ttc bais 16 $c allcg.d cxcmptio Any vioktion of S.ctior 7O3l.5 by ey applicut for a Fmil tubj.cB lh. <br />applical lo acivil paalty oanol nqc lha fiv. hund,cd dollB (5500) <br />_1, s owncr of lh. plop.rty, d my cmploycd wilh wag6 o lh.ir iol. @mposztion, will do th. work and thc su!.tu. ir rct inadcd <br />or oficrcd as sal. ( S.c 70a4, BusinBs sd ProadionB Cod.: Th. Cmtuiort Licd3. L.* dB nd .pply to m Nia ollic prop.ny <br />who builds or improve lhs@. udvh. dc su.h work hiru.laor h6dan$rou8h hii or h.r @n cfrplorB. p.oyid.d th{ toch <br />improvcm.nG a. not inl.n.Ld or offRd for salc.If, how.v.r, thc b!ildi.8 or improv.mot h sold wnhin onc ycd of@mplcnm, lh. <br />Oen.FBuilda *ilr hN. th. burda orprovihs th.r h. o' ih. nor build r imprcvc ld fic puposc olsalc) <br />_l, d owntr ofrh. prcFny, m lxclusiv.ly conb&ting sith lic.nscd contracroE to co$lrucr lh. proj*t ( Sc 70a4, Bcin6 dd <br />Proadsio. Cod. Th. Conrador! Lieo5. kw dd ior apply ro & ownq ofpropdry who buil& or impovdlhaEn , dd sho <br />@ntr&is fd luch poj4ls *ith a contlelo(, li@ns.d puBuet to rh. cmhd.''s Li@r. L.w ) <br />_l m cxcmpt undd S.clion <br />-4. <br />& P C ftr rhis rcen <br />UABXEAS-CAMIEXIAIIAN.DECLAIAIION <br />I ha.by alfn ud.i pm!]ry of p..jury onc of rh. follovinS dccluarioN: <br />_l havc ud vilt maintlin aC.rtifiBl. ofc,nscmro Sclalnsr forwok6 @p.nsitim. s prcidcd for by Scction 3?00 of$c <br />L.bo, Cod., for $. p.rfmMe ofrhc {o* ld phich thc p.mir is issucd <br />_t havcddwill nlintain *dk.6 compoB.rioa insudcc, q rcqutdd by S.clion 3700 oi rhc l.3bo Codc, for th? pafmuc. of t. <br />*ort ior which lhis p.mil ii i5su.d. My wtrI6 cmp*.tion inrur4c. coio Md policy iumbo dc: <br />Policy Numbd: : E4iG <br />(I\E $.!on n4d nor b. compl.cd (rh. rmir 6 fo, oi. huidc! <br />-rf.nifv <br />thar,i rh? p.raomrc. or rh. qorl ror Ihrch rhB p.m, <br />b!6m. subjcq ro rhc rorl6 ' cmpdr.lrm lrB of C.lifmi\ e <br />compdsarion provi5i@s ol 3700 of$c L.bq Codc, I sh.ll, <br />o <br />WARNINGT Failurc to s.cur. workcEt compcnsation e mployo ro dihinal pcnshig Dd civil <br />fi.6 !p ro d. hundrcd lho6dd doll6 (l I00,000),in rdditio ro <br />rhc L.bo. Cod., iorcBr ed ,tomcy'i 4.6. <br />. dd.ae 6 prcvidcd for $c Sdio 1076 of <br />LICENSED CONTIT.ACTORS DECLARATION <br />I hdcby alfim und.r p.nalty of psj ury thal I m li6s.d u.dd prcvision of Cbaptd 9 <br />thc BusinBs ud Prof6sioE Cod., od ny lic.ns. is in full forc. and.ff.ct <br />'(> <br />I h.r.by af6m urdd lcnalty ofp.rlury thar rh@ is a consEuclior lodif,! <br />i$u.d (Sa. 309r, Civ C.). <br />ofrh. wqk ld rhich rhir p.mn is <br />APPLICANT'S DECI--][RATION <br />D.molilio. Pmib-Arbcle Noifi.alim F.ddal RcguhddE (Tnl. 40, Prn 6) <br />_ Rcqutcd l,td of Notilic.rio <br />-'y*"$c fcdcral rc8ulslions r.gading 6bsro. <br />I havc ald rhis lppliqid ud sat I asrcc lo @mply wnh all Ciry ed County <br />ordinuc6 sd Sst. t ws rcl.ti.e !o buildin8 v6 ofrhis Ciry sd Counry lo cntcr upon lh. <br />sbovc n.nliorcd prop.ny fd insp..tion <br />oD_D <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 & Sofflt Rough <br />Ceilings (T-Bar Rough) <br />Meter Release EXpil Itrr) <br />Rough FEBOI ME <br />Service Meter <br />FINAL 'vr iroo. oo/ <br />COMMENTS <br />Notes, Remarks, Etc. <br />Dar.: Ownd: