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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS Ownd-Buildd D.cl@ti@ <br />I h6.by aftm ud.r paalty oaF.jury thar I m.x.mp fom th. ContEloB' Licasc Law lor thc fouowii8 E66 Ga.?031 5 BBin6 <br />dd Prcf6ion Cod.) Any City or County which rcquirB a pdmit to cmLucl, slldi inprov., d.holish or rcPat dy slrucru., pflo to iE <br />issu cc, also r.quiG thc 6ppli@1 for such pnnir ro filc a si8ncd slarfidr thar hc d shc is licoscd plrudt ro th. provisiW of th. <br />Cont adoar Licnscd L.w (Ch6pl6 9, ComDcncins wi$ SeIion 7000 ofDivisio.I ofd. B6in6s dd Prcf6iqs Co&) or rh{ hr o <br />sh. h .xmpt lhftfrm ad 6. bais fn th. all.8.d .rdption Any violarim ofs.clie 7031.5 by uy ap?li6t fG. !.mn iubjec lh. <br />applisr b a civil p.n5liy of not mor. tn fiv. hundr.d doll4 (1500) <br />_I, a omd ol lhc Fop.rry, or ny cmployd qilh vas6 s thct solc @mpa$rion, will do lhc wo,k ud ltc sLuclw is not inrad.d <br />or olIcd fs $1. ( Sd ?Oaa, BBi!6 od Prof*i@ Cod. Ttc ConFa.rd s Licds. Law doG nor apply lo e omcr ol$. prcp.ri, <br />who builde or improvs lhffin, ud who doe such wtrk hi@lf or hddf tr firdgh his or ho own nployG. prcvidcd rhal such <br />inprcvdmE ac,ot irrodcd d olIacd for3.lc Il, ho*cvo, rhc buildi.g d inplovdc is eld *i$in o. y@ of compldrm, $. <br />Oma-Buildd will havc thc burdn of povinS d8l h€ or shc nor build d ihp@w ld thc puDGc of salc) <br />_1, a ow.d of th. propdriy, m .rclsivcly cmlreling witn licar.d cmtracrm Io .dihd lh. Foj.d ( S.c. 7044, BBines ud <br />ProfsiM Cod. Thc Contr@ror's Lic.ns. L.w dc no! apply to m own6 ofproFny who buil& { imFov6 th6@n , ed qho <br />@nl.els for such proj4ts vith a CqE&!o(, lieNcd puEer ro thc ConL.rtor's Lic.n5. Law ) <br />I m cxnpr undcr S..ti6n ,B &PC i6 rht,cson <br />WORKERS COMPENSATION DECLARATION <br />I hocb, aIfim uidd p.nalty ofpcrjury on. ofrhc follo*ins dccldlions: <br />_lhav. d will msinrain gCdifiol.of Coh@l io Sclfl.slrc for wor!4'c@Frs.1i6. a prcvid.d fn by S@tion l?00 offi. <br />Llbor Codc, fo. $c p$fmdcc of dE wdk lq *hich rt. Fmn h isucd <br />_l havc dd wiu mainBin vdt€6 cohFnsrtion insuMcc, a r.qut d by Scclion 3700 of th. kb.r Cod., for th. pqfomec. oa thr <br />work ftr which 6is pamil is isucd My wort6' cmposarion insumc. cMid d policy numbd m <br />PolicyNuhb.r Expi6 <br />*ffi,yr,y <br />b. conplct d if lhc pdmit G for On. hun&.d dolld It I00) or l.ss) <br />pcrfomacc oa thc vori fc {hich this pcmn k iss!.d, I <br />laEoaC.lil@i4 Dd ag@ $.t <br />ui Labor Codc, I rhall. ionh <br />, dma86 s provid.! lor <br />inrcr6t darh.ysf.6. <br />LICENSED CONTRACTORS Df, CLARATION <br />I hc!.b! amm uddp.nally ofpcrjury lhar I m lic.ns.d undiprovi.ioi ofCh.pt.r 9 {fi. Busines dd Prof6sions c.nsc t in rullforcc udcfLcr <br />ofp.rjury $aI rh@ is a.onlhcri <br />097,Civ C) <br />AIIIICAILIDECIAA{IION <br />D.frolition P.mil!-AsbBlG Nolifiqtion F.d.El R.lulati@s (Titl. 40, Pan 6) <br />_ R.quir.d L.rlEoaNo tcado. <br />_l ccnily rhar th. f.d.rd E8ularions r8adinS ab6l6 <br />-r-.rry,tn, t t u"",.ua,to uept' <br />6!dinec6 &d srdc tass Eldms ro <br />abov. ndtion.d prop.rty for intp.clion <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 />Building <br />Under Slab / Floor <br />Bonding / Grounding / UFER <br />Transformers <br />Torquing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Rough <br />Ceilings (T-Bar Rough) <br />Rough E'\TIl\EIJ <br />Service Meter <br />FINAL r r:ll I (UIJ <br />Notes, Remarks, Etc SAMC &43, 290, 558, a67 <br />Meter Release <br />f------T------