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ELECTRICAL-INSPECTOR RECORD
<br />tD/stG.COMMENTS OWNER BUILDA.ll DELCARATION
<br />I ncrcby !firnr undcr Fmlry ol Frjury Uur I m crcmpr iioh rh. G,nlEcron l-k.nsc hs lor $c followiry rcasn (Ss?oll5
<br />B.sircs lnd Pn,fe$ion Cdlrr: A.y ciry or G,un'y ehi.h Equircs a ,crn to con(Nd. nllcr. imprcvc. {Lnelirh or rc!{t dny
<br />{ru.ruE, tri, io irs h{rft.. Nlso r.qun \ rh. ,t'/i.0d for ru.h lfrnil lo filc a siSncd sraremflr lhlr hc o, sh. k liotrrd puisuonr
<br />ro rh. povnions oi rh. Conl6ctols Licc.rd L{w {Ch.prcr s. Commnci.s wirh sc.rion ?(D0 or oivnion 3 oflhc Busnr$ ood
<br />Pmfcssions Codc) or rhat,E or (hc is.xcmpr rh$caon nnd rh. b€si\ ror rh. lllceel .xcnplion. Any violalionotSdhn ?0.ll.t by lny
<br />,pt'li.dnr rd , I.nnir sublc.hthc 0lrli.ant lo 0civilricnslryornot mrclnan fivc hundrcddollacl$50o)
<br />L rs osnd ol rh.,tutrriy. or ry c rtlorccs wirh El8cs i. rhcir alc .nmpctruri,n,. slllJo lnc sorl and rlE smrurc i{ mr
<br />i ctrdL{ orollcrcd lor sle (Sa.7tll4.0u\incss {nd Pmlc$ions Codc:'l hc A,nticktr r l-i..nsc Lrw docs n.lamly ro an o$ncror'
<br />rhc pnrpcnr ehr hilds .r nnpr.\rs lhctu{, dwhodocr\mh*rrkhnnscllorlErscliorlhmughhkorhero*ncmpn)yc.\.
<br />rovidcd rh suci imnmrcnEnr u mr i cM.rl or oilircd ,or sok lf. hosclcr. rhc l,lildlr! or imrorcnrm is dd rvilhi', onc Jt
<br />of confLtioh. rhc Own r Buildcr sill hr( rtE hurdcn .f lr ,rir8 llnd hc or nrc did mr $!ik or i&ri'vc ihc pmp.ny ror lhc lrll!$s of
<br />l..souncrlrprcFny-0mqclusivclyrodracrirs$irhliccn*dc.ntrrc(B(,coitudrh.r.j.cr(scc7o'1,{.l,unncs
<br />and Pnnla\ i- (-i'dc: 'I hc Contrror's l-i.cn\c tjw doc\ norrfnlyro rn.s cr ol lropcny$h. huilds or i'npn,vc\ rh.rcon.
<br />rnd q,ho .nnk cts for su.h projccls*irha G.rradonn licctr*d purunnr t, rhc Contra.rr's Li.cnsc Liw).
<br />lr drc rt utrdd Sc.rior .ll & P.C.l'orrhk r$$n
<br />Drre ()an€r
<br />uaaK[&:]!!)!lfti!s^Ito!
<br />AECI.ANAI&N
<br />I hctuhynlfi nutrd.rpcDrllrolNriMyoncolth{lnllosilr8dc.l arions
<br />lhJvc sillnrinrainaCcnirf,arc.fC.tr\.trrhSclf.lnsuicforworkcc conrlrcn\dn8. as n()vidl{hrbtSt.rdnl7firolrhc
<br />lf,li, Cqlc. i{tr rhc pcrfoflrrMc ofrh. w.lk ntrshich rlE pcnnir i\ i\sud
<br />I hrvr rkl wrllmrintrin soikcrl conrpctr\arion iNnmncc. as requircd by Sn-rion.l?0llofrhc libor Codc. for th. Pcrfoonrc of
<br />rhc Eork for *hi.h lhh pcflnil is iswd My*ortc conwnsalion in\urrn.r cari.r rid F,lhy numh.r m:
<br />.._. MrdNg* rr l,'rtllttY
<br />I r lzotqq o-70 I't
<br />I e.dily Ihrr in rhc pcrioflnANc.lrhc $ork Lr $hich rhn p.irnlr is i\\drd. I \l[ll nur cnll)]oy rny lEnotr irr.try ntnm!
<br />v,ast,hcconrc\ul'jfttt,rhcwo*r.J.o'nlcnsnri().1.w\orcrlrroiin,.rndrsrccrhrrillshoul(lhc.om\uhjccrhrrr
<br />workc! ( co6pc s ri(,n ptuvi\bN or Sc'r Mr ]700 ol rhc Lrhtr Codc- I nnll. n,n h$irh (nnnly wir I ihos. fmrsions..
<br />IVARNINC frilur. r, {.urc tr1trkc.s .. r!.rsdnn.ovcmg. i\ utrlrwlul. nl rhrll subj.cr u chpk'}tr k)
<br />riril lnrrs up t) orc h ndrcd rlhu\nn,l dfllin (Sl().1XX)). ii nddiri.n r. rhc co{ or.onr
<br />S..ri,r.1076 ofrhc lrhtr (inl.. iflor.\ ind
<br />tzuL(
<br />pElLa8ano! -
<br />I hm$ynffirnundcr p.nalry of lcr$ry rhd I !o licned lnder pmvkion ofchaplfi 9(co'nmncina virh Serid 7{xl0) orDivkion.l
<br />or dc susin.sed Pmfcsions Codc. and nrylicctrs is in full forcc und cff.cr
<br />, *** "*,*,, I*F*eciqc-ot14Zb
<br />" 4 to.rX
<br />CONiI&JEIIONI.I'NI)INJi.A{jENEI
<br />I hcrchy oifirmunder lcnalryolp..Juryrfitrr rhcrc is u con(dcrkn bnJine n8cNy fot thc l)crtunrrmc.flhc *orL for whi.h rhi{ !.Jnrir is
<br />is\ucd (Sc. 1097. Civ C ).
<br />Ir t,1'. ,lJ,.$
<br />-lccnifyrhor
<br />rhc fed*al rglI,lions E!{ding,sb.{.i r.E.vd u. nor E rliifilc to lhh I'nj.rl.
<br />)11 ccniry rhd I hrvc read rhh nll,lksrio 0 srflc lhar rhc .tnvc inlomrion t cone! I .gic to onply enh i cily ind Colnry
<br />ordidnes ud srdre Lrws nlarin8 ro &itinB.onnruLlion. ad lERbyNlnoria dprccnhrivcs ofrhk Ciryn.d Counlylo cnter upon rhc
<br />. x\c nrnrnnulr,lcn) liI i,,\t{
<br />Mft{.1 V4
<br />r-," {.lp.t{
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Founlains
<br />Sions (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Building
<br />Under Slab / Floor
<br />Bondinq / Groundino / UFER
<br />Transformers
<br />Torqueing
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rough)
<br />lvleter Release
<br />Rough 1/L.///(=\ $/
<br />Service IVleler
<br />FINAL 4/tTlfi 5\"fi
<br />Notes, Remarks, Etc
<br />APPROVALS DATE
<br />Communications Cable
<br />Sub-Panels
<br />knd.r'c Nsnr
<br />-
<br />AIfI.ICAILDEILAXIII!}N
<br />I IER{,y ,mrm undcr p:nnlty ol Frjury onc ol lhc fdlo*inB delral ions
<br />Dcnolirion P.rnir$A\bc{d Norific!'nr Fcdcrcl Rc8ul0riotrs (Tirlc 40- Prn6)
<br />Rcquircd rrllcr of Norifi calbn
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