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ELECTRICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.OWNIiII BT]ILDER DEL(ARATION <br />I fis€by amrm r.de p.nalr, ol p.rlurr rhd I @ cx.mpl tom Ihc ContrcroE' Lic.h* ljN lor thc follovins rc&n (S(.7011.t <br />Bsio6s ad &of€ssiofl Codc): Any Cily or Comr, whi.h r.qun6 i lEmir ro odtud. ahn improle dmolilh or r.par My <br />shcrrc. Fio. to irs ilsudce aL6 r.qun6 $c arplical to. such psnil to 6lc a sisncd stalmnt rhar h. or shc b lic€nscd pu6u.4l <br />o rhc !.ovisio.s ofths Conractoa! Lic.nsd Lsw (Chaptd 9. Conmlncin8 wilh Seiion 7000 oaDilisio. I olthe BusinBs md <br />PmfNions Code) o. rh8t hc or she ii .x.mF th6.lion tud Ihc basis lor the all.s€d cimption Any violdlion of Sdion 70ll t by a.:, <br />applicanl io! r p.mn su6jdls th. rpplica.tro.cililp.nlllyofnot niorc thai 6ve hundr.d doll&s($500). <br />L G o"id of lh. Fopenj. or my mplo,6 wirh $Es6 d lhei. elc compoetion. vill do rlE No.k dd lhc sru.r@ E mr <br />int6d.d or olld.n for saL (Se ?M4, EGiIB nd Po aeio6 Code Th. cont..lols Lic@ tls &6 .ol .pply t6 & o{ffi oa <br />rh.ropdly who hil& o, i'nprov6 rh@r &d ulb do6 slch sd( himclf or h.elf or lhfush hG or h6 o*o mpl.)r6. <br />provid€d lhal such irprNmls e mr inidxLd d ofd.d tur sl. ,f, ho*N, rh. hilJin8 or inpn)r.lmr n eU *ithin on. Ja <br />oi coflI|lioL fi. oNnd Build( will hrv. thc hr<!n ofp.ovins lha hc or sh. d'd d boild or inp.ov. lh. propdy for rh. plrpoi or <br />l. a ownd oarhe ln)pdy, ar .r.lGiv.ly co .aclins wnh liccn*d conrBdots to codrrucl rhc rrojccl (Se. 70.14, B6m6 <br />tud PlnisiinCod€:lhcconra.ror'rl.i.cnscLawdoeno'applyro oRnn ol propd, who builds or inprovs lfitr@n. <br />lnd who contrds for sxch Fojsls$nt a C.nhcto{s) li.r.*d puBuanr llJ thcconlr.clors Li.G.Ir*) <br />I m€rcm,{ u .r Sdion ,B.&PC forthilr@n <br />troB(EalcollrExtaro!p.cctaSarlt! <br />I h6eby amnn undd psahyolpgjrryone ofth. folloei.s deldarid.s: <br />-l <br />harc od willrminr6i. a Cdrific.t.olCoNmt io s.lal6ur. for porksl onrp erion,6,r6vid.dio.bySerion1700oIrhc <br />L.bor Code for rh. ,6aor:Mc. ollh. wort fo. which lhc pdrn is isuci <br />-l <br />havc and *ill mainlain vo,k6r conp.Nalion iNudc.. d r.quir.d b, sdiio. 1700 oalh. Lobor Cod.. for th. Faol:mcc of <br />lhc *ork fo, which this p6mil is issu.d. My wort6 comFnerio. iNllm.. 6id dd polic, .unbs ac: <br />I cdiayrhr! in rhe Faomd.. ollht *ork lor shich rhis !E mn is $su€d.I sh.ll nol oploy any pr$n in dy nma <br />e 6 lo ko'ne subi.cl to thc vorl6' com!.Gario. laws oacaliaomi.. md a{e $ar if I shorld baom. subid to rh. <br />*ort6 comp€Ntiotr provisions ofS{tioa lT00otlhe Labor Cod..l sldl.fonh*ilh compl} wilh thoF pruvisioN.. <br />WARNINC: Failu.lo s@ sork6 <omFErioi covqasc is unlautul. dd shall subj<t d dployd ro 6ni@l pou[i6 dd <br />cilil li.es !p ro o.c hundrcd rhousdd dou6 (5100.000). in addirion ro rhc cosr ol competudion. dma86 a provid.n aor lh. <br />Sc.rio.3076 ofrh. Labor Code inrs6l md afiohey\ f6 <br />o.tet /2-/ 9- / .?X ---2- <br />Ll.Fr!sm <br />D!gdAAIIA! <br />I h*by .jIrD ond6 paalry ofpdjory rha I m liccnsr @do Fovision ot ChaFd I tmnda.ins * nh Sdb6 7000) of Divhion ! <br />ol lhc BBins ed Prol6sioE Cod.. ald iy licmc is in tull lorc. ad.fId. <br />g'? g ?L <br />colultlcltor!.rElDllc.acElcY <br />I h@by arnn und6 paahy of pqjury lh.t lha. i. r ointudion hnding aBmcy aor ln. pstoflm.e oarh. Mrl for which dris Foil ie <br />i$o.d (Se.1097. Civ. C.) <br />AIII.ICANLDICIdAAIIA! <br />I hdd,y af@ unds r,6ahy oa pdjury onc ol thc followins d{ lsalions: <br />rxnolirion Pmrils'Asb6ros Nolifi$lion F.d@l Rqllarions (I irlc 40. Pan6) <br />R.\1,tr'cd I dr.' olNorifi !dk,, <br />l.L1lilr11ft rlrr l(ddrl'qLL nnN rL!tuJiris aslrnosi.nnrlJc nrr{rd'.xl,lrt' rlrisf',)j..r <br />-l <br />cdiry rhal I h8re rqd rhis applicalion ud sarc rhar fic aborc infonn,liotr is codd I a8re ro conply Nirh all Cny d Counry <br />ordinuc6 od Slate L!*s rclalias lo buildin8 cotrsrtucliotr & h6.5y axrhoriz r.prMtaliv6 oflhis Cny dd Couory ro ord upon the <br />abo\e mdrioned prop.n) for inspEdio <br />orr,n", * o**, rn-.* A lrrt <br />Site-Work <br />Underground <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Life Safety /Low Voltage <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bonding / Grounding / UFER <br />Transformers <br />To rquerng <br />ll-S-ltt Y WtWlill <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Rouqh <br />€eilings (T-Bar Rough) <br />Meter Release <br />A <br />Ro ugh [t-5-lt,btWil <br />Service lr4eler \{ <br />FINAL t2-+--lt:Y k.ULtt) <br />Notes, Remarks, Etc.V L <br />COMMENTS <br />Licn cl$' <br />' <br />/ z' Licc@ Nunbd: <br />Sub-Panels