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ELECTRICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWNER Bt]ILDER DtL( RAI'ION <br />I hs.t-v amrn und6 p6aht ol pdjiry th.l I m er.mpl frem lhc Conradon- Li.e tlw for thc lollorvins lten (Ss 701 I 5 <br />Rusinds and PNlsion codc) Any cily or counry $hich r.qun6 a pemir ro conslrud. alts. improve. dmolish or EPen an, <br />srtucru., I)nor ro ns issuec.. also r.quir6 lh. applicd lor slch ,.nnn ro 6le a si8n.d srarondr lhal h. or sic is licds.d p6Lianl <br />ro rhc lEolisio6 olrh. Conta.tors ti..nsd kw lchapld 9. Con'dencin! *ilh Sdion 7000 of Dilision I ofrh. Busin.s &d <br />Pioicsnrns cod.) or thar h.orsnc Gcxenpr lhs.li.m ed rne bd.h aor the alles.d cxcmflion. Anyliola onofsEtio" T0ll 5 byany <br />flpplicanrlorap€ntrnsubjdsrh.applic.nlto.civilpcnahyolnolnorclh&fi\chu..lr.ddollds($500). <br />l, 6 o*nd oflfi€ prop6ry, or ny oplo)B *nh wrt6 s $cn sk comp.@iioh. tr ill do ih. \ork dd tlE sltucl@ 6 6! <br />i"rd(H or olldld lor sL (Sd.7044, Busirs ud Prcfsions Co3.: Tt. Codraclors Lic.N t$v do6 nol ap?l) lo e ownq of <br />rhc pmrEny who bdil& o' inrr6v6 rha€n. ed {ho dE such Nri hnns€lf or h@laor rhsulh his or nd oM .mployc. <br />proliden riar such inprovcnots @ rcl illdd.d orofl.rcd rorsk.ll howa6. fi€ hrildins or inprovffir is eld qilhio o.c )@ <br />ofcompldio.. rhe oM6 Build6 will hav. llE hrb olrrovins rhd h or sh. did rct boiE or iqtroit lh. PlDpdq tur lhc ptrpos of <br />L s o$ nd of rh€ prcDsly. m cxclusivcly co'n.a.ri4 snl licdrs.d .ont.clou to co.rrud rhc Fojai (Se 7044. Acind <br />.nd Pmkion Code Th. Contrcrors Licasc Law do6 nol apply to d ov.r of liop.ny qho builds or inpror6 lhndn. <br />and who .odnds for such pIojc<s wilh a Co'i6cto(sl li.os<l plsmr ro rhc Conlmclois L'ctue llw) <br />I m.rml, uMd SErioo <br />D.lq Orre. <br />laaKEaL(oltSENsAlIoN <br />DECIAEAUqN <br />I h@by arm u.dn p6aly oap6ju., otrc ollhc fouowins d(ldatio6: <br />I h"v. r.d sill naintain s Cqlific.l. oIcongl to S.lf-lNuc for *ork4 .o'rpoetion, a Fovid.{ aor bt Sdlion 3700 offiG <br />t bor Codq for rhc p6fomec. o f th. wort fot s,fiich lh. pqon b asucd. <br />I lDvc and wilt mainlain workd cohp.Nation iBu6n c. 6 r.quted by Scl ion 1700 of lh. Lrbo. Codc. fot thc Ffon@.c of <br />rhc sork aor whicn rhis lmnit is isued. My &npdsarn)n nBurancc ca s a.d a ,licy nutoh{t d.: <br />.Ic.niryrhari.tbcpdfom.c.ofth€\rcrkfortrhNhthispcrdiriljsu.d.lsh.llnolenployanypdso.i.a.Ynrmnd <br />$ s ro h..orhc srbjd ro tic Lvor k6J comp€Mlion ldws oa(aliaomi.. ,nd a$e lhar il I should b..one subjd to lhe <br />iorlm compm.rionprcvsionsolS€dion I700 ofrhc lrhir Codc I shall,lodnsilh complyvithlhospm\hions <br />\VARNING: Failur. ro ssure \orkes composrion cov(asc is onlawtul. and shall suhjcrr an onpl.td ro ai,niml Pdahi6 dd <br />.ivil fins rp to one hund.d lhousand dollas ($l <br />tlo, ;;te <br />6 P"v ded i'r rhc <br />1\^ <br />I h6€by aflim undeQaalr, o lpBjury lhtrl I dn licosd unds prolisio. of Cha/6 9 (comm€ncins wilh S..lion 7000) of Oivision l <br />oa rhc lrusins ed Pmf*ions Cod., &d my li.ds. is in iull lorcc ad cIt<r. <br />L,cosccrEs.' C'\O <br />^- ",g,,1>11fu," <br />(1 <br />nl^t/\ ld a <br />AEfII(:AILDEIIAAA!]A! <br />I lEet', aflim u s p..al'y of tojury onc oalh. aollowin8 d(la6tions: <br />Denrlirion PsmiB.Asb6los Norin. <br />R.quned Lellq ol Nolificaio. <br />cotr(t I alrero comply wilh aU Cny&d Cour, <br />rc[rsohrn6 ol$is City u{Cou -[;1WbalDle nrcnrion.d rtropslyfor insDd <br />IApplicnnl or q.nl SiBnatrr. <br />Site-Work <br />Underground <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Life Safety /Low Voltage <br />Fire Alarm / Dampers <br />Communications Cable <br />Buildinq <br />Under SIab / Floor <br />Bondinq / Groundinq / UFER <br />Transformers <br />Torqueing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Rouqh <br />Ceilings (T-Bar Rouqh) <br />Ivleler Release <br />Rouqh <br />Service It4eter <br />FINAL z/tz/oa ,.lb-qt ,, <br />Notes, Remarks, Etc caluagiloN.LENulclq[lcy <br />I h@by aiiflr mdd F ally of pdjury lha lhde s a co.$tuclion ktdin8 .86cy for !h. pdfomd.. of rn work for shich lhis Fnn b <br />issu.d (Sc.109?, Civ. C.). <br />Gndo sNamc <br />- <br />fT