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E CTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Li ght Standards
<br />Spas, Pool , Fountains
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof To p Equipment
<br />Facto Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rouqh
<br />Ceilin gs (T-Bar Rough)
<br />Meter Release /t/'l
<br />I
<br />Rough
<br />Service lvleter r,I /-- \
<br />FINAL v &tlsilm -4FVr 2/hbtr )
<br />Notes, Remarks Etc.
<br />OWNER BUILDOR DELCARATION
<br />I hc.by amm undd p.nally ol pdjury lhar I m .rmri norr rh. Conlr.cloR' Li..ns. k* aor rh. followinB rffin {S( 701 I 5
<br />B6in6s dd Proldion Cod.): Any Ciy or Counly Nhicn rcqune a p6mn lo consrrucr. alrq. improve dsmlish o qan my
<br />s'tu.te., prior ro ir! issudc.. aLo ,equt6 rh. applicdr lor such Fmit ro file a sisn.d sraldol rlBl he or stu b li..ns.d purx@l
<br />b lh.,rovisions ofrhc Conta.tori Licnlcd Lsw (Chorier I, Com.ncinS wnh Sdion 70(S ofDivisio.I otth. Buin6s Md
<br />Pmf€siofls Cod.) or rhar h. or sh. b .rmfl rhGc6o6 ud thc bast tor rhc sll.sqi cxoplio.. Any violalion of Sdion 70.1 I 5 by 6.y
<br />applicdl lor a Fmil subjdls thc applicMl to a cil il p.n.hy oa nor oo.. rho fiv. hundr.d doU& ($500).
<br />l, 6 .wnc of rh. popdry, or ny enployG wilh {as6 s rhcn sok comp€nsarion, *ill d. thc rvoi( dd th. srrucr@ is Nr
<br />iotodql or olTd.d for sale (Sa.7044. Bsin6 md Proa6sio6 Codc Th. Conlnctor's Lic@ Law doc ,or rpply ro m ow.d oa
<br />lh.pmpcly *no 6ril& or inl!ro!6thsoa and who &6such qo hinE.lfor hGllorth,oush his orho oq.n c6ploy6.
<br />provdcd rh.r such inlprovddrs & nol hrodcd or ofiE.d aor sL. Il howdd, rhe hrildins or impmw is $ld {irhin onc }a
<br />ofcompkrion. th.OMn Buildd willlEv.lhc hrk orp.oviry thd hc or sh. dil nor build or inprov. $. popdy for th€ pupoE or
<br />l. a o*nd of th. pn)!dy, m.rclosiv.ly conra.rinB vith licmcn contracroBro Nnsrru.t th. projet (5(.7044, B6D6
<br />and Pn,isbn Codc: Tt. ConrBcloas Licms L.w doe nor,pply ro d 0\$6 ofpiopdy *ho builds or inpro!61hd6..
<br />md who conrtus ror such rrcjds wnh a Contrado(s) licos€d puuu.r lo thcConr.acrois l-iceNc liw).
<br />l
<br />t-
<br />PECI4AAIIA!
<br />I hftby alfim un.ld p.nrlty ofFlu.y on. onh. foUowirs dcledioBl
<br />I hav. ori will fiaintain a C.nificr. oaco.gr ro SdHNu. lor ert.B 6nrp.nqri6n, 6 Fovid.d ror by Sdrion 1700 of rh.
<br />t bor Codc, aor fic pofoill@c of tc *!.L lor *hich thc p€ it is Lsu.d.
<br />_l hav. and will mai ain sorl.( comFcation i6uan e, a cquircd 6, sdr io6 1700 oarh. tibor Code, lor th. pdaol:l@c of
<br />lh. vork for tr'hict lhis Fmil i3 isd. My workdr minpd3liion i6r6c. @id &d poli.y numbd &.:
<br />I cdit rh.t in rh. pdforman.. ofrhe wolk lor shich this p€onn is issued.I shall nor @ploy any pcen in any mdnft
<br />e 6 lo b€con subjd to th. q ort6l omp€Nrio. lass oicalifomir. md a{ra $d il I should b.{oni. subla:l lo lh.
<br />s orkeJ comlEetion provisions oascl ion l?00 ofrhe L,bor Code I s\,11. lodh$nh co,nply *irh thoE pmvisioN..
<br />WARNINC fiailurc ro Bxrc qor[.6 compdsar n .ov€rag€ is unlawfll. ud shall subjdr d onpbys to di]ninrl pdrhi6 &d
<br />civil fin.s up to on hun&cd thoHnd doll6 {1100,000). in lddnon b lhe c.s oaconp.Nrion. d,nale a provid.d ror rhc
<br />Serion 1076 oflb. tiboi cod€, inr.r.st ed diorney ! f6
<br />z_
<br />DICI,AAAIION
<br />I hmby amm undd Foahy of Fjxry lhat I ar lic.nsat undr Fovbionoachalld9l.onnna.ing wnh sdion 70110) olDivision l
<br />of lhc Busi!6s md PoaaioN Cod., ai my lic@ n i. tull lorcc d .l'<t.
<br />Liccc CUs:-Lic.B. Nudb6
<br />Drl.: Co ncrorl
<br />cqNtr&lcra!-LENlac.ac$cr
<br />I hd.by .mm undd Fnally of psjury lhai lhs. ie a otr(tuciion lmdi.E a8mcy for lh. pgfof,mcc ol th. pork for which lhis p6nit G
<br />isucd (Sd.1097. Civ C ).
<br />A}IIICANLDECI.AIAUA!
<br />I hq:by aIIEn und6 Fmlly ol Fjury onc of lh. following d(lanlioN:
<br />D.molilio. P.mirs-AsbdG Norifi.ariod Fc{nal R.suLrions (l ille 40. Pan6)
<br />-R.quiftd
<br />L.ttE of Ndi6calbn
<br />-l
<br />.diry rha $c tu ral rgubtions rcga.dins Bbelos rooval d. nol arplicoblc ro lhis projdr.
<br />-l
<br />crlify lhnl I b.rc r6d thi! .pplicori.n ad star. thlt 0t. .bov. infomalio, i! @rar I agE lo omlly wirh all Cily Dd Co!m,
<br />orJineceed Sr.r. hwsFlfldEr. bd 'ldii! .oanr(liotrr4tk'.b aurnoru.'.r'6ordN6otrncC ) ed counryrn drd Jp.n llE
<br />'b"r. Mr,oncd Drcldl, Jor ,6oe!,/"t,.mso / ' ]
<br />*,,*"",^" ,i"^.,*.:iff [:#i4_ o,", . l]-21't?
<br />pmrren.n.(pnnox. CrurA.\-n7 Qu,ti
<br />*
<br />- -
<br />Pole Bases
<br />Signs (monument)
<br />Under Slab / Floor
<br />B & P.C. io.lhs r.aon.( tlu' (o-c-
<br />I-eideisAdd6s:
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