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ELECTRICAL.INSPECTOR RECORD
<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 />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueing
<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 Rouqh)
<br />lt4eler Release
<br />Rough
<br />Service lvleter l"
<br />-2M14FINALb/1./2."o vl)
<br />-:7
<br />vNotes, Remarks, Etc. /'/
<br />OWNER AUILI'i]R DT-I,CAIiATION
<br />I rEEby dfrm und.r p.nalrt ol !.rJury dar I mr.rcmpr fum rh. CodraroG Lt.n& tj* ,or lh. follo*ing raei lS(.7011.5
<br />Busincss ,r Pn,Icsion Cdc): Any Cirt, or County *hich rcquncs , Fmn b conshcr. altci i'nprov., d.frnth or Rprr y
<br />srru.ruE, pdor k, ns i.suric.. so kqriEs rl* amlier lor such p.n,i ro fiL a sig..d rar.flrd rhd h. o. dE is lic.,sal rs r
<br />ro $c p.ovisionr orrh. Conteto.'r l-t.nscd lj* (Chrprcr 9. Comtncncin8 enh Sccrion ?m0 d rrivision I ol lhc Busimss and
<br />PmfesioN CqL) or rhlr tE or nE t r\.fl{,r rh*nonr ad rrE b6ix ior r dh3ed.*nlnlion. Aoy violdion ot S(rion ?01L5 byany
<br />ipplicrml'rdpcmirsubj.crs(h.3ppliclm16xcivilp.no(yoln.rmr.rh{nfiv.hundEddolh6($tuJ).
<br />-r.
<br />a orncr.llhc proFny, or y c'nploFc! *nh Baecs is rhct $t compc.s{n'n, qilldo th.,o* 6rd rh. (M@ [t dr
<br />lrdrlal or ofl.rcd for el isa 7(x4. BusiD.$ od PEf.siotr\ Cor.r TIE Co{rdois LiFne ll* dfts nd rpply ro D o}N, o,
<br />rht lk)p.ny *lx, huiu! or ntpmts rh.Rrxr a wlx, do.s ffh x,rt hioNrlf or lss.lf or rhptgl hn or lFr oer.nDlottci.
<br />proidcd $ar such nnF.rsmnts m mr idc en oroflcod lor s]c If, ho]cEi fic hildry m i,pnrcE tsldwi'hinoBrtr
<br />olcorpbix\ [E Owrcr Buil,]6 vill luvc rlE boi.l.n ol Fovir8 tlu tE o. she di.l tror t'uill] o, itrpn,E [E pBpoiy nr rE purlo$ of
<br />_1. I own r oI Lh. pmp.n r, d.xcfusn cl), ronr!{ing *ih liccrErl .otucro to.on{rud rh. pbJ.d (S(. ?O14, Buses
<br />and PDlixlixiCod.:'the Corkrcktr s Li..ose Law do.s nor apDlyb a ownei ofproptnysho builds or inpov.s rh.M..
<br />Md who .onu.rs ttr su.h pft,i..k *nh a co khns) k.N.d p!^ud r. rh. Gfudoar Lacm lj*)
<br />-l
<br />aDcknlPt und.r Sec
<br />D.l.
<br />-
<br />om.r
<br />-
<br />loBf,lll:CAliulNlAllq!
<br />D}:CIAf,AIION
<br />I hcrcby aflirm ondd p.nalty Df psjur! om oI tbc follovin8 dccLdioB:
<br />-l
<br />havc etd w,ll nEinl.in ! Ccn itual. ol Clt'Mnr ro S.MnsuF fc rnkqs &n{ENarDn. ar Favid.d for by Sorklr 1700 of rh.
<br />bh.i Cod., foi rh. l'.rfonltr. of rh. *orl lbr whi.h rhc Foir k i$ucd
<br />-l
<br />luv.udwill tru ar wo*.m' comn.nsirhn iNur.ke. as Equt d by S.dion 3700 of rlE tjbor Cod.. for rh. ,dfomrE. or
<br />rlt qoik for *t,ich rlns ltr. is i:*{ My rorkh con{usrion iNum. crmr ad rclicy .ufrbs dc:
<br />Polic, Numb.r: Erpircs:
<br />I c.nify rhai r rlr t{rfo'iuncc ofdE wo,k for ulkh rlns o.in i. issucal,I shdlmi ci\rby any pcrsn in any nErrcr
<br />s usro bc.onE rubjd ro rhc workcn c.Np.Narion l.wroIC{liforni!. and 93rcc thdr rrl sh.uld tEcom subjccl ro tlr
<br />s ofs..ndn 37C{ ot lh.Irbor Cotl.,I rrsll fonn*irhdmdy*nh rspmvisi,E..
<br />UCETIDO.CONT8dCTOf,
<br />DDC!484M!
<br />I h.Eb, fr rnrtci !.n!lryofpajurythd I an [ens.rl undd povaionofChirr.r I(.onrmDciq wnh S..rion 7000) ofOiqsion ]
<br />o, lh. lrusin.s and Pmlcsiohs Cod., and my lE.ns ir in aull foe qJn.rf.cl.
<br />Lic.Dr. ClJs:_Li&ns. Numb.r:
<br />CONIIBIEII!}NIENI}IN!.ACENCfIhcftby,fltnuidcipttulr,olp.rjuryrharrhrcn,conntocrhL.din8a8.r,forrh.p.rlomE.Irh.strkro.qhicilhnp6mnis
<br />i.su.J (S.c. 3097, Civ C.).
<br />4!EL!Cl{LpES!4!l!r0!
<br />I hdryanimrundlr p.nally.lpcduryon oIth! lollowine d,lddio.s:
<br />Dcfr)lition Pern a Arh. ios Ndificarion Fcdcrul Rc8uhbnsGnk40, Pd6)
<br />-Rcqured
<br />Lrt.r ol Mr lcation
<br />-l
<br />c.nil, rbd tnc Ld.ral rcgulari,,ns (grding a\6cnns rcrmral 6. nor rppltabl. to lhn proj.d.
<br />_l ccnily rhd I luve ,cad tnis apllicaiiotr &.d Nrr rlHr rhc rhle inlomr ion G .omr I a8r6 ro oq,ly wirh all City rtul Coudy
<br />ordiro..cs and Skrc bws rcldinr nr hnilding coutu.riG ad hcreb, suihori4 tpreMtiv.s .a rhis city tud c.unty lo c.is uFrn ilE
<br />$oE ,Enrion d pop.ny for in*p.crion purpos.
<br />IIIIIIIII
<br />Bev. 08 07-2015
<br />WARNING: Failur. ro €cuc roA.r'comp.nsarion tuEto8. jr u.l.*Iul. ,l shall subj.cr .n.mploy.r ro ainjnal FeliJ md
<br />civil lin.s up h on.l'u.drcd rlnr$nd dollar (S|oo.UJO), in additnr ro rlE coi o l .on'p.,rs rion. drN!.s d provid.d tor rb.
<br />Scction 3076 ol rhc ljtsr C(de. inrcrc$ and .uormy\ Iei
<br />CoDtEdor
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<br />Lire Safety /Low Voltage
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