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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE tD/stG.COMMENTS
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Satety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding / Groundinq / UFER
<br />Transformers
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Bouqh)
<br />It/leter Release
<br />/r\/uE/lRouqhn-l{lA -r 4_/
<br />Service lVeter 1)
<br />FINAL tlqln i vlttiQt J"2,n)
<br />Notes, Remarks, Etc.v\
<br />-!
<br />OWNER BUILDER DEI,CARATION
<br />I hftchy,ind undcr !.nalry of pcrjury rh,r I am cremfl fn, rhc Conrra.k,r'I-i...\c tj* ror rhc rolk,wing rmso (Scc 70315
<br />Busincss rtrd Prorcssnrn CGlc) Any Cily .r Coumy *hi.h r.qui(s r Fihi! ro ..n{dcr. rlrcr. imtrore. dcmli$ or q'an any
<br />structurc. prior fu ik nsuincc. also rcqutcsrhc appli.a.r ror such Fhnir ro filcasismd (itcmnl rhol hcorshc is licc.\cd pr6!a
<br />b rh. F,vhions of rh. Conrrncfttr s l-iLtnsed tr* (Chlplcr 9. Comrcncn,g with Sccri{)n 70(n of Divisnn I ol lhc Busirr.s drd
<br />Pmacsions cod.) or lhd lE o. shc n crchfr lh.&ln,m dnd rh. b]rh frr lhc rllc8cd crcmption AnyviohrnnroiScclionT0ll5l'yony
<br />lfrlicanr lor a lxnnit bjcch lhe aDrlic.nl lo rcivilpcmltyolnor nnnc rhln fivc hundrcd dollmls5(xl)
<br />l. as ow d orrhc F,Jxdy. or my.Nplottri wirh wagci,s rhcn *,b .dnr&6snr iotr. willdr th. wr and rlrslErure h mr
<br />inreftl.il oroftrcd lor $k (Sa.7(I44. Busines lnd ftofcsio.s Codcr 1h. Conr,aciols t,iccnr Ii* docs nor apFly h in o*ncr or
<br />lhcpmFny wtx) blilds or in{,mrcs [rmn. oRl who docs iuch *d( hnnsclfor hcMlror rhmqh hh or h$ own cnrnloyces,
<br />lrolid.d rhur such imrrok'*.h m tror inrcndcd oroobrcd for st lt hoev.r. rhc hUiui'B o, irpmtcrnnr is v,H airhi'r.n. ]qtr
<br />ofsmplcrk'n. Oc Owner Buiucr willhrw rlr burdcn oapDving rhar he or sh. dil mr hdild or improk rhc polfny for ri. puqr)s ot
<br />-1.
<br />$ ouncr or rh. Fbl[d!, rm cx.lDrivc l! .onrh.riig wirh li.cnscd .ont .t s ru cotr{d.r tl.r roj.rt (Stc ?()'l,l. Businc$
<br />rnJ l\Drissir Codc ThcConrraclol\LiccnscL0$docstrorrpplytomowmtofnropcnywhol,uildsorimpRrv.rrhcrco.
<br />n.d who .onr * rd su.h pr+chwirh, CbNm.k,nr) kcn\cd tunu,r ro rh. C'ontacrn sLicenscbw).
<br />H & P(' ri*rhi\ r.xu,,/1,Ll4a/e?l8 o""* 2(/-'r'r\.
<br />I h.'chy rlltrm undrr tcmlrlol t^-rttrr!nnc olrh.lnllo$ing Jo.lrrrri{n,s
<br />-lhlvcondwillnuinrainuCcnifictrrcolConrcnll,,Scltlmurclo!sorkcr'..mtx-nqrnrn.acpmlidcdnrbyscctiotr3rmolthcLabo Codc, forlhcrcfonMnccollhc wolk tuwhic[ rhcl,.rnnr h *ucd.
<br />Ihrtandsillnrat rin workcrr'..trrtcnsrti(nr in\urarcc. as rc{luircdhtS(rion.17(Xlofrhclih.rCodc,iorlh.Itrrionunccol
<br />rhc rork ftn Nhich rhi\ pcrnir is isusl My $or*cn conD.lsxrion in\rrm( csicr dd Bnicy tru mbd u.
<br />I ccniiy rhrl in rnc pcrionnancc.rrhc w.rk ror which rhh p.irni is Gsucd, I shrllnor cmrl,,y ri, |'crn,n ir.try n'inmr
<br />v, r\ k, bccom srhjNrro rhc sortlri .onr8n\di(nr law\ of Crl'fonir, ridalkc rhd n I dn)uld hc.onE sunFd lo thc
<br />qo*r^ conp.n\rrion px^ i\ ns of S&r bn l?0{} of rhc l-rhtr C(xlc, I sh"U. r(tr rhwirh c. lltly s irh rls* tovi\ions
<br />IVARNING: Failurc r, *urc wurkcs .o rFnsdion .ovcn'g. i\ unldwtul, illd shall sublct 0n cmfloycr ro siminalIlcrolrks and
<br />cNil tnrcs nn ro .m hufldrcd rhou\a d dollr( (Slm,fln). in ddirion ro th. .o oi comlrensoron. damgcs as proviJcd ttr rhc
<br />'")))'" t/il)i or..,,_.,
<br />I hcrcby dnD uftlcr |xn lry of Frju.y thd I am li.ctrd io. ol Chrflcr 9lc.nnxri',8 Nirh Sc.rion 7(x)()) ofDiv(i,nr:l
<br />ol rlc A!\inc$ md Pnnts\i(,n\ Cod.. dd ry lirci{ i\ ii full larcc nRl cllc.r
<br />LicnscClass:-
<br />Coni.octo.
<br />CONIiIBUEIIQNIENIIXIi.ASENII
<br />I hcEhy amrm undcr pcnllryofpcrjuryrhd rherc h a condtucrion kndinS 4cn.y ror rhc p.rlnmfte orlhr wort lor whi.h lhis Fnnil is
<br />hnEd (S...3097. Civ C.)
<br />aftuc NLDfcL nAlloN
<br />I ltrby rltnn undfi pcnrxy ol t rjury orc of rhc lollowin8 dc.lardr ids]
<br />Dcmolirbn Pcr.,irs Ashc{o\ Notiflcrtn,n FddcBlRc8uhrnrr l'l irh.l0. Pid6)
<br />R.qutclt l j(cr of Norill.iri,ni
<br />-l
<br />cdiiyrh rhc lcdcral rcCllltions q.rdirB 0shcslosrcni,vararc nor opllicahlc ro rhn pojccr
<br />rtx,vc nrnri{n,ci pmpcny lff in\rE-rion pDrF^cs
<br />\rrlnxnr 'r ^!ont
<br />si!Dnru
<br />r"..ir"" no*" lp;nrr,i(
<br />a)r,** ",," ' ileLs- f7',rra, ,n)
<br />knd.r-.^LiJrs
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