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ELECTRICAL.I N SPECTO R RECORD <br />Ro h <br />Service Meter <br />FINAL <br />Remarks, Etc. <br />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 SIab / Floor <br />Bonding / Grounding I 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 <br />a/r19/o>4f%'/ <br />/I a <br />t//\- <br />q@l 2L DfJ*+<,9 <br />Ouaa-Buikla Doclmtio <br />I hq.hy 16r ulds poelry of pqjuy thc I u mpt Sr tts Contrrrton' Liw I:w 6r thc bllowing uhr (s.7031.5 BurirF$ <br />ud Profcsior Cor,c): Aly City u Couty which rcquis a pcnit o outnrcq dta, inprcvg dolirh or rtprh uy !tn(frr!, ptior ro ft! <br />issuancg also rcquircs ltc applicet for $c.h pmit to filc I si8lcd stlt e6t that hc or shr is liccarcd pursuut o rho pmviriou of thc <br />Contsactor'! Li€E d kw (Chapta 9, CoaEcrciog vi& Sction 7000 of Divisior 3 of thc Buire ud Proftssiou Co<te) or thet hc c <br />shc is dcEpt thsc&om udthc buis 6rtbc rllcgcd aoptior:{[yviolatbu of Soctiou703l.5 by uyrpplicut &rrpmit mbjeu tha <br />rpplicet to r civil poalty ofEot Eorc thla ivc hudrcd doUars (3500). <br />_I, a omq of thc !rcpdty, or oy coplole vith wag6 a th ir dc oupasatioa, will & tho m* ud tho rtnrare ir mt inodcd <br />orof@d fors& ( Se.?044, Buiru udProfssior Co&: ThcCmtrr.to'sLic@hw do6DtrpplyioeowEofth.popqty <br />who buildr 6 iEproE lhmo, rod who dc suc,h srt hiE&lf G hcclfortbrcughLir or ha om @pblB, gwidcd that ruch <br />improv@aB [c mt iiladrd or ofr@d for sl,a It howaa, tbc Nlding or inpovmt is rcld withia onc ]acr of coEplaioD, thc <br />Omcr-Buildq will havc thc burdo of provirg thlt h. or rbc Dot htild u inprovc br thc purporc of s&). <br />_I, u ow of thc prcpcrty, u crclurivcly oatracilS with liccotcd coltr.toB to oatruct th. Fojet ( Se. 70,14, Buias ed <br />Prcfsion Co&; ltc Coarndor's Lic@ IJw do6 rot apply to e owE of Fopsty wDo bBilds or iEproE tbEo! , Ed wto <br />I conracts for such projccts with a Contractor(s) liccoscd punruatrt to the Contractor's Liccosc Law.). <br />I <br />| <br />-f <br />aE qx,eopt uod€r Scctiou 8. & P.C for this r,easotr. <br />r- <br />I o"",*lc-2-O 6 o","46r, ymo z R. le /eSCa <br />I <br />I WORKERS COMPEI{SATION pECLARATION <br />I I hcrcby affirn rrndcr peoaltyofpcrjrry onc of thc followiag dcclaratioos: <br />I bvc ad will maiutain r CEtifigtc of Cou@t to ScU-Ire fn wrtE!' oEpcllltioa, sr prcvidod frr by Sctiol 3700 of th. <br />hbor Codc, br th3 pafomracc of tbc work for which thc pmi! is ilsucd. <br />I havc rod will uitaia workcs' conpcasaion iwc, a requircd by Setion 3700 of thc hbor Codc 6r thc pcrbmcc ofttc <br />m* forwhi<tthis pmit ir imorl MymrLc' oopa;rtion iurmcc crria adpdicymba m: <br />l-qrrie+. <br />PolicyNuba: Expts: _ <br />Crhirietioa dtor)- <br />I catify tt.t iE thc pcrbmrocc of thc wort 6r which thir pmit is isuo4 I shlll Dot @pby ray pcrroa in ray nrDg ro u to <br />bcre nbjct o thc wrlqs ' oopcurtior lawr of Crlifon[ ud agrco that if I sbould bcorc rubjc.S to 6r vmstas' <br />onpcoruioa provisios of Sccrion 3700 of thc hbor Codg I .Lrll, forthvith ooply with tho* provirbu.. <br />o".*ic-2'- o 6 mu^,t €,e'vne," 8.Lle)aS Ca <br />WARNING: FEilur to scorc worlss' conpcor*ioa covagc ir uLwfirl, rod rhdl subjccr I GoploF b ciniul pcultic ad civil <br />fiG up to oe hDdrcd thoueddoll8 (S100,000),inadditiontothc o* of cooposatioa, ,t.-.gs !rprcvidcd brtho Scrbn3O6 of <br />tLc Lrbor CodC iltcct aod rumcy'r fe. <br />LICENSED CONI?ACNORS DECIIIRATION <br />I h6cbyrfrm uldElraelty ofpcjwyttat I ulicased udaprevirbaof ChaptE 9 (coEeing witb Sccio 7000) of Divirion3 of <br />thsBuins&dEo&ssior Codc, edoytic@ir infilll fore rdcffcct <br />Li@c Cla:_Lic@NuDba_ <br />Datc: CoDtractor: <br />CONSTRUCTION LENDING AGENCY <br />of pcrjury that thcrc is a construction lcnding agcocy for the pcrforoancc of thc work for which this pcrmit is <br />[.cuder's ^ ) -t-- <br />APPLICANT'S DECI.ARATION <br />Dcoolitioa Pcmis-Asbcstor NotiEoarbn Fc&nl Reuhtiu Clltlc 40, Put 6) <br />_ Rlquircd L.tta ofNotificatioa <br />I cc,li&tbrt tbc edalrqubtioE rqrrdir8 rsbcmsrevd rrcrct ryplieblcto thi! pmjct. <br />_I cati! that Ilevcrcad thir rpp[catiol ud ttdort'.tthr lborc i!6rlti6 ir orrcre Irgreto cooplyvith dl CityEd Coulty <br />odiM &d Stltc Ls rclatiry to hildiry oEtruc&q rod tst.by aut[orizo rtpsatatie of &ir City rld Couoty to ans upo! rto <br />rbovc Bcdiolcd pcopaty for iaspcaba purposcs. <br />Applicant or agcot <br />Pmittcrec(pric): <br />-lnspection <br />, <br />3097,Civ. C.).