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APPROVALS DATE ID/SIG.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 />Torqueing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Rouqh <br />Ceilings (T-Bar Rouqh) <br />Meter Release <br />Rough <br />Service Meter <br />?trvr-FINAL .1.-a) <br />Notes, Remarks, Etc \}\T | \--.. <br />OWNER BUII,DER DELCARATION <br />I hd.by amm undo po6iy of pdjury ih{ ! m .r.mpr arom rh. (onlr.clo6 Liccns. LaN for lhc folloG.s ..sn (Sd 70.1 I 5 <br />B$in6s .nd Proa6sion Cod.) Any Ciry o. Counry Nhich rcqriB a psnn ro cofudrucr, rlt6, inprovc &nolish or ra.t ey <br />srrucrm, pno. lo ns isueq aL. rcqun6 rh. rorlic&r for such p6ftn b nl. r si8n d si4ffir thol tc or $c is licdscd p@dl <br />to rhc Fovisio6 of rh. Conu&roa! Lic.n$d Law (Chlplcr 9. Commcnclnr *irh S<lion 7000 of Divbion I oflh€ A6in6 ed <br />holNions Cod.) or rhat h. or sh. i! .x@pl thdcfrcm ed th. bais lor Oc alLedl .rmption Any viohtion oasc(ion 701 I .5 by uy <br />applicafl for a Frn subjfls th. rppli.dt rD a ciril p..alr, of.or nDr. thm fivc lundrcd dollas I lt00). <br />l, 6 owM otlh. p.op.ny. or nry .mplo)6 wilh wa!6 6 lh.ir $lc conFeridn, will & lh. *..t Md $c srrEim b nol <br />Dtad.d or oll(cd for el. {56 7or4, BBinB dd Ptul<ioc Codc In. Contraclois t-ic@ Lrw do6 nol lpply lo M osni ol <br />Ihc ptDpdy who blil.h or iDpmv6ln@r ud wno &6 sch r!* himclf or hqs.lror rh.olsh hi. or hd os mploy.6. <br />,rcvid.d that such ihFnvdob e mr i ad.d or olI.ral for sL l I hoq6 6. rh. toildiag or impro\ c1Bl i! eB lnhin on. Ja <br />otcotrrpkion.lh. Crxn6 BuiEs sll hav.ltE ttrrdo olprorins lhd h€ o. sh. did @t t ild or inFo€ lh. Fopcty for th. pu,pos oa <br />_ l, a osr6 otrh. Fopdry. d cr.lusir.ly codiad ins *irh li.aMn .o6tmlo6 lo conslrud lh. proj..l (S( 7044, BBmGi <br />and EDf.ssion Cod.r Th. Conlrictois Licms. LaE do6 m! aDplylo u os!( orprcp.ny $ho builds or inpb\.s thdan. <br />and who .onld.ls for such Foj.11s wnh a ( odDcro(3) licotsld pu6@d b thc Conlraclois Licdse lj!). <br />WOR,<ERS' COIIIPENSATION <br />U:QAAAIIA! <br />I hd.hy 6mrn undd p.n.ltyofp€luryon. oflhe fouo$in3 d(laratioE: <br />-l <br />hav. a'd Bill mamrain . C.nin.alc ofcoas! to S.ll lBurc ior work.6 conrp.ns.lion, G Fovidcd lor by Salion I700 oalhc <br />Labor Codi aor th. pdfomec. oflhc Nrk lor vhich lh. pGnril is isu.d <br />-lhav.andwillmai.inwork.ccomFsaiioniBura.c..6r.qun.dbySdionl?00o|thcLaboiCodi.ao.rhclcfomdc.ofp.mn i. issu.d. My worksr cohp.roalion i6uruc. cono and F,licy.uftbd d. <br />do 6 . tt5: <br />-l <br />ccnilyihal in thc pslo.lBncc oflh. sork tor \hichlhis Frmir t issu.d. I shall nor mplo, any p.mn in any muncr <br />$ 6ro bc<o6. sobjd Io th. workd' comp.Nl ion lawsofcdiaomia. and as!ft lh.l irI sh,uld bc.on 3ubjd' to 'h.{od6' cohpdsdon l,srisioB of S.clion l?00 ofrh. t bor ( od.. I shall. fonh{ilh conply wilh lho* prcvilioB . <br />WARNINC: Fa'lurc to ss. work6 conpccamn cor@sc s u.lasfu. dd sn.llsubj.rl dnployE to qininal p6ahi6 dd <br />c,vil fines up lo onc hundr.d lhousd d{nlds l, in a.Union b th. cosr oi ion, dmas6 a proidt! <br />Smri,)n 1076 ofrhc lf,hr (ixl. in <br />ffirA <br />I <br />I hqcbr amfln und6 p€nalry olp.rjurr I undd FnvLiob of Ctapta 9 (comMcins wilh S61ion 7000) ol Divi <br />ol Ihc Lrusin6s md Frol6i0N Cod.. dmy <br />I hd.by .mm undr pcn0hy of p€riurr lhal <br />bsu.d (s{ :1097, civ ( ) <br />n! aloct ldr rhc pefofran.. of the work for Nhich lhs p.rnn Ls <br />AIIIICANLDESIAAIIO! <br />, hqtbr.frDn undd pdahy ol pdjury on. oflh. follorvins d(loalioB: <br />D.nohion Pmirs-&b6ro. Norili.arion F.doal R.grlarioN (Inl. 40. P,n6) <br />R.gun d t?rnolNodfE lion <br />I c6li& thd lh. a.d6al rc8ulalioN rcsadiu ab6los rmoval de nol arplicabl. lo lhts lrojed <br />amliclxon dd (arcrhar rhc ahorc ' <br />nnatin is.ondr I aBrero corrp! Nnh:llCnrand Couhry <br />aurhoriz. r.prddrali!6 ollhis Citydd Cou.ryro ors uFd fi. <br />""-u**,\.,1r/ <br />r) hurldn! rotrsrrudnnr, r'd 144 <br />ELECTRICAL.INSPECTOR RECORD <br />Aa <br />,l x .\rrtn un .r Scdtrr . ll & P ( lnr rh s 'dn{l <br />l).t. ()str€r <br />'"'"€{irt <br />_l