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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS almd-Bnild- D.ch.rim
<br />I h@by affim undd pcially of p.rPry lnar I m cx.mpt fom thc ConiEclm' Lic.ns. Lsw fo. thc iolloving t6on (s6.701 l. t Busin*s
<br />&d Prca6i6 Cod.): Any Cily or Counly which Equirs a p.mn io construct, ak6, improyc, d.molirh or rcp{i ey sl'lclurc. Fiq to it
<br />isuec., alro rcquir6 th. appli@r for sucn Fmit to fiI. a sign.d nat mat 1t6t hc d shc is li.dscd puBuel lo tnc Fovisims of th.
<br />Cdtr&tor's Lta$d t!* (Chaptcr 9, Commdcing {i$ S@tion ?0oo of Divbi@ I ol tn. Bcins ed Prci6siot Cod.) or rh6l h. o
<br />sh. is .xmpl th.r.frcm ud rh. b6k ftr rhc .llcsd .r.mplion Any violatid of Sdnon ?01 I 5 by d, appli@l for . Fmn subj.c6 in.
<br />applidr to . civil p.naliy ot nol mrc the 6v. hundrcd dollm (t500)
<br />I,d owD6 ol $c popdiy, or ry mployG sirh *.96 a dcir solc c@p.nlarioh, will do lhc aoit Md lnc sruclu. i3 not inlad.d
<br />or oll.'!d atr s.l. ( 54 ?044, B6in6 dd Prcf6sions Co<tc Tn. ConlI&rort Lictu. Lav d@.or apply loe ovncr of rhc propdy
<br />who brild! o, improvB th.l@, sd who dG luh *dt hifrs.lr or h6da or ddgh hir or hcr @n dployds. providcd tnlr soch
<br />inprovcmdB e. aot i.rddcd o, oiLr.d fd ral. I( hw.vd,lnc buildi.gor irprovcm.rl is $ld wirhin onc y.d of compl.ro., ln.
<br />O*nd-Build.r will havc thc burdd ofproviq $.r h. or shc not build or improv. lor th. purposc ofsalc).
<br />L a ow.d of dE prcptny, m dclGiv.ly conFdine wi$ licdrcd coF&lc to cmrruci 6c projcct ( S.c ,oaa, B$in6s dd
<br />Prcfei@ Codc Th. Contrac{or's Li@.s. L.w d..s not apply to d oed oapropary who buil& d inFo!6 tha@n , ed who
<br />co.rrts for slch pojaB wnh a C6tr&to(, li@scd punusr ro (hc ConE.cror t Lic.nsc Law )
<br />Policy Nunb.r Erpic
<br />(Thi3 sotion f,dd not b. mpl.ld if fi. pmn ii fc O.. hlndr.d dolla ll 100) d 16)
<br />I c.diiy rhat in th! psaomdc. oad. rorl forvhich this F.mit is issucd, I shall rcr cmploy dy FEon in aoy monncr so 6 to
<br />bEec subjcct to $. wo.k6 'compdsalion laws ofcaliaomiN. ud asE€ thar ifI should b€com. bjcdtorh.wo (6'
<br />conp.nsaron prcvirions olS*ion 3700olihc Lalor Codc.l shall,lonhwnn comply wirt rh6c povhions
<br />' z--.^J-ro/of
<br />WARNING Foilurc to sdurc workcE' @np.nsalion cov6ag. is unlawful, sd shall subj.cl6 mploydlodiminal paahi6 ed civil
<br />fins up lo onc hundrEd lhoBdd .10116 (l100,000),in lddidon to lh. cl ol cmp.ns.rion, damagE s provid.d ftr lhc S.dion 1076 of
<br />tnc Lalor Codc, inl.6t ed ar@cy's ac6
<br />LICENSED.CONIBACIO.SiDECId.EAIIO!
<br />I hcrcby allim undcr pc.atry of p.rlury 6.1 I m ltdscd undcr p.ovision of Cha$d 9 (comncncins wnt Sccrio. 7000) of Division I of
<br />thc Busin6s ud Pmfcsions Codc, ud my lic.nsc h in aull tm. and.fccl
<br />COIIIIBTCUAXIIIDITC.ACBCI
<br />I h.rcb, a,Im und6 paalty of p.rjury rhal $@ is . @slructior ladiry .socy f6 lhc pdfmee of th. *rk fd whi.h tii Fmit i!
<br />i$u.d (Se.3097, Civ C).
<br />AIEIICANIIiDECIABAIIAN
<br />D@dnion PmneAsbdl6 Nolifi€adon F.d.ral RcSrlalioB Gnl. 40, Pd 6)
<br />R.quircd L.tur olNorifi etion
<br />-/._d-z. /,/o /
<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 />Meter Release
<br />Rough
<br />Service Meter EtrAnli ,0:q
<br />Notes, Remarks, Etc.SAMCS-4X,290.556, 567
<br />_l m .xmpl undd S.cdon _,8. & PC. ad lhis Eaon
<br />roErEat-co!4rEliauo!_Dfct^aaEotr
<br />I haby .fiim und.r paslly ofp.riury on. of th. followinS d.clffilionr
<br />_l navr ed will mainhin r C6tific.1. ol CNmt b S.lHrow ftr wmtcB' mpasaris, s provi<lcd for by S.clio. J70o oflhc
<br />Llbor Cod., rd $c p.rfro@ of tn. sdt fo whid lnc p.mn b i$u.d
<br />_l hav. d Mll hdrLin wqt6' @mposalion irouMe, s rcquncd by S@lion 3?00 of $c Lsbor Cod.. aor th. p.rfomde ot th.
<br />wort ad which ihis p.mit is i5rucd My work6 mhp.nslim iBume ffiid &d Flicy numb€r E
<br />Liccnscclas Li.dsc Nuhbq
<br />_l eniry th.r ln. a.dq.l E8llalions Esddins 6b6t6 rmov.l d tol appli@blc ro lnis prcjcr
<br />_ I ccln8 tfid I hNc rcad this lppliqdM od s@ thd ln..bor. i.fm.tion i3 @i. l.gre to cmply {ifi all City Md C.uiy
<br />ordindc6 &d Sl.t Llws rliring lo building dslrucrie, sd heby Nthodzc E?Gdt livB of rhis City sd Cou.ry ro c.tcr upo,r rh.
<br />abovc tunlio,cd prcp.ny for inspcction purposB
<br />FINAL
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