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APPROVALS DATE COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Salety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Bonding / Groundinq / UFER illr lt y'z {iltaz*.,t2.,''
<br />Transformers
<br />Torqueing
<br />'ttu-otri-Sub-Panels 4Luh t I 6a--
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilinos (Hard & Soffit Rouqh
<br />Ceili ngs (T-Bar Rough)
<br />Meter Release xl(0lt&f44AnX lKv't/ \,L
<br />Rou gh qlt0lt*Ovr*l6t-,
<br />Service lvleter ;lili* 1
<br />nzvta'A4-Itn
<br />FINAL cl r, )k anorD.'lf.--7.2
<br />Notes , Remarks, Etc
<br />OWNI]R BUILOEi OOLCARATloN
<br />I hercby aiirm unier pcn,lry of pc'jury rhlr I o c(empr lrom rhe ConrEcr.F l,icensc tr* fitr rhr f(nk,wntg mv'n (S$70!l5
<br />Businrs r Pror.ssbn CGlr)r Any Ciry or coutrry shi.h r.quircs i l,.rnir b .onnrud. alt.r. inpro"c. dcnrlnh or rcnan rny'
<br />strucrurc. pritr ro its n{aRr. all, rcqun slh..pplknm rorstr.h pciinil ro lilca ri8trcd slarcmnl rhar hcor shc n li.ci{d Pu^urnr
<br />tu rhc toli\ions ol thr C.ilrdcioas l-i.c s.d trw (Chaprcr g, Conmcncin! wirh Sccrion 7fi)0 ol Divhiotr 3 oflhc Busi"c$ and
<br />Pmfcssbn(C.dc)orrhdrhcorshchcxcnrlthcrcftonandrhctrrsisforrhcrllc8cdcxcflDrion.AnyviollrionofSarionl0.ll5hrrny
<br />+pliclir ior aF nir strt'jcch rhd llplicsnr ro !cirilpcn,l(yoinor mncrhan li!. hundtuddollds (S5tD).
<br />-1.
<br />us oqncrol'thcrn,rEny. ormrcnDlolNs wilhw0scs0\ rhcn btcompcnsariur. *illdo lbc worl &d rh. stdEc n nor
<br />inrcnd.rl .r offcred (r ek (Sr 7044, aoaiftss and Pmacaiions Cor,q Tfic C.nh.r.is Lt.ns. ttrs dfts nor o')ply ro on ownq ol
<br />lic pmpcny who builCs or inrl,mEs rhc@n. at qho dc such sd( hnnscllor hcrclfor lhmu8h hh or hc! owncmploycc\.
<br />piovidcd rh3r {ch imporHxnk m rer inrcndcd or oncrcd ,or $L lt ho*cwr, rnc boilding or imlreknnr t s,U *irhin Dnc jM
<br />oaco Dlertun. thc OUE Buildcr vill halc lhe hdrdcn ofprovin8 thir hc o! shc did nor hoitl or irtrK,h rhc pmpcny r(r rl[ pu4xsor
<br />-1.
<br />n\ owmr oi r hc pmpcny, 0m cictusivcly .onrracr inA wirh liccn{d conh.lon ro consrrucl lhc proj(l (SE 7{x.r. Bu\incs
<br />u0d Ptuli*\irnC.dc: Thc Conrrnck sLiccnsc l-tr* does nor ryIlytr onoqnfiofpiopc ywhohuild\.rimlrcvcsthcrcon.
<br />rnd who rcma* nn such pmlccrs with ! G,nlr.*)n t latn{d puruad r, thc Conrtrdofs Liccnr LIw)
<br />-l
<br />tun cx.mp( undcr scr
<br />!!IBtrE&5I;!J!IIENIAIION
<br />DICIJNAI]OX
<br />I hcrchy allnm uid.r l)cMhyofldluryonc ofrh. tulL,wing dcclnrnnnrs
<br />I hrvc nnd will nun .in , C.niltnrc of Cotrstrr ro Scli:l nsurc lor workcs $nrFnsal ior, rs prcrrdcd tu hy Sccl ion .l?00 ol rhc
<br />Uh.r Cdl.. L' rhc psfofletuc of rh. N.rk for whi.h r h. p.nnn i\ irsodJ
<br />I hrrc anJ $illnEinrlin sorkerr conucnsarion iNuran.c. rs rcqutcd hySccrn,n.lT(Dofrhr l-abd Codc. rorrhclslr{n Ncoi
<br />rhc work nn which rhis p.nniri\ i\{Rl Myworkcrs (nnpcnvrior insur d.. crtri.r dIx,li.ynu rb.r u.i
<br />I ccrliry lhar in lhe pcrlornuncc o{ rhc *ork (tr shi.h lhi\ l}.lnir h is\ucJ. I \hrll ior .nfk,y aiy t ^on
<br />rn rtry n'anncr
<br />$ * ro b.$nrc suhFcr h rhc *olkcs conlPcnqrion law\ orcalinmi.,0nd lgrc rhar if I lhould bccom subjs' ro rhc
<br />Rorkcs .o lPjn\ar ion pmvhions of SNtion llm .i r h. ht r C.dc. I shrll. lonhwir h comply wirh thoc Jrrovkions.
<br />IV RNIN{; riih'r n) +.ur. ql covcrrgc i\ unhsful. rnd \hill snhjccl nn cnl|noycr lo si'nin,l n nalrics nd
<br />.ivrl fitr.\ u! i(, nrc htrndrcd rhousrnd dnllds dau*8.\ ss I'r.rid lar rhc
<br />?bsLt
<br />I hcrcby liln r undcr penullyol I).rju.y rhar I !ni undc, pmvision orChxprcr 9l.ommn.inC wnh serion 7000) olDivi\ion.1
<br />of rlr Busircs..d Pmfi s io.s Codc. atrd nrylNNc is ir lull (n.c frklcitc.r
<br />91os ,6
<br />I hcNby ofiirDU.dcr p.nlhyolpciurylh0l $crc is ! conslrudio. lcndinS .sem, for lhc pelformmc drih. {ork ro. whichlhir Pcrmit is
<br />hsxcd rS.. 1097. Civ C.l.
<br />AIILICANLI]EII.ABA.II!]N
<br />I lElby unim under penalry oipcrjury oic ofrhc followiiE dcclarurions:
<br />Dcmlirion Pcrmih'AstEnos Norificlrioo Fdcrll Rcsuhr io.s (Tnt 40. Pan6)
<br />-Rcquftn
<br />tlrrc! of Nolifi corion
<br />s Egadin8 rsbc(os r.trb\ arc mr lpflical,lc lo rht pn)recr
<br />i{,nrBl{rr.rh r rhe rbv. n,lnrn riini i\rotrc.r lrgrrr o conDlywith rll Cityand Counry
<br />rhk Ciryand Counly ro cnrcr upon rhc
<br />,,," lfosf tA
<br />flrl lrrchyauik,izcrcpr.s. rarivc\of
<br />rf
<br />ELECTRICAL.INSPECTOR RECORD
<br />ID/SIG.
<br />Under Slab / Floor
<br />I
<br />1,*,n,
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