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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE IDiSIG.O*n(-Bdldcr Ddlr.rim
<br />I hcrcby ailim undcr po.lry oapdjuiy lh.r I o qcmpt lom th. Co.trh Lic.n* L{w for th. following E6on (sa.70ll 5 B6in.$
<br />dd Prof*ion Cod.) An, City s CMty which EquiB . p.mn lo €Mstru.r, alt6. improv., d€molhh or rcpair dy rlruclur., Fior to i6
<br />issum.., also Equir6 rh. appliur for lEn pcmir ro fiI. a sign.d slrffit th.l hc d sh. i! lico!.d p6rDr ro dic FovisioN of rh.
<br />Co.relolr Lic.iscd L.w (Ch.pt r 9, CmacinE {iO Sation ,000 of Division I of ttc BuinN ed PrctNions Cod.) or thar nc d
<br />shc h €xcmpr dlmiid ed lhc bat ld lhc allcecd q.mBion Any violatio of Scciion 703 I 5 by my appli.dl fo a Fmi subj*rs lhc
<br />appliml to a civil pdalty of not hdc thb fiec hu.drcd dollrs (tr500)
<br />_1, a omd of th. Fopcrty. or my mployG qid' waa6 s th.n sob cmp.nsalion, will do lh. work sd thc arucr@ is oor inhd.d
<br />or ofid.d fc salc ( S.c 70,14, Bair6 &d Pofdim C!dc, Thr C@E!clor'3 Lic4. t2e dG od +ply io d oM.r of Uc prop.rty
<br />wno builds tr imFovg rh.'!o, od vho dG slch wort hirelf or h6clf q $rNsh his or hd Nn cmploy6. providd drd such
<br />i6provm..l. e nor inrcnd.d or offad fd 3a1.. If, how.vr. $c building q improvm.,r i. rold wilhin or. y.a of.omplalon, lllc
<br />O*nd-Buildcr will hav. ilc hdd of prolin8 rhat h. or shc not build or imprcv. for ln. puposc of sal.).
<br />_1, a o*ncr oathc proFrty, u.xclusiv.ly conturihg *i.h li..nscd contEctoB lo mslrud rh. projccl ( S(.7044, Bcinds ed
<br />Proa$ion Cod.: Thc Colrdd s Lims l-3s do6 nor apply ro m wnd oapropdty who builds c inprov6 rhqcon , Md who
<br />cmkcb lor such p,ojels vilh a C!irr&ro(, li6k! puE@t 10 fic Contr&lort Lien* Lav )
<br />_l m cxcrpt uo&rS*tio B &PC rd$isEaon
<br />WOAI(EAS COMPENSATION Df, CT,ARAfl ON
<br />I hcrcb, afim undd p.nrlty of pdjury onc of th. aollowin8 delmtions
<br />_lhavc d Nill nainlain aCcrlificat ofcdsdllo SclHnsuE for *orkcrs' corpc.saton, a povidcd forby Sccrion 3700 ofth.
<br />L6bor Codc, for tn. p.rfmse of lhc wort for wlicn thc Fmn is ku.d.
<br />_l hay. dd*iU oaiollin sot6 c@p.Barion iBufucq a Equicd by Sccao. 1700 of $. t lor Cod., for 0t. F fmac. of rhc
<br />wo'k ld *hicr, rhh pdf,ir is isu.d My edk6 @mp.nsdon insu@e csnn ed polic, numbd d.
<br />Poli.y Numb.r ExpiG
<br />#ffi,;
<br />b. corlplcr.d if d'c p6nn ir for Onc hu(t d dolle {J 100} o, ls,
<br />pdfomrcc of fi. wort fd which thi pqnn ir issu.4 I sh.ll
<br />wdtc6 ' cohp.nsaton las of Glilomi4 ud agEc lhat if I
<br />.onpcnsation provtions olS.crion l orthc Labor Codc, I rhrll. Lnhwnh
<br />WARNING Failurc to s*urc wdk6' @mp€nsatim cov.r.ac is mploy.r to aininal po.l
<br />fin6 up to o. hundrcd lhoEud doll6 ($ I OO,ooO),in addnion io
<br />lhc Lab. codc, inrfd dd arom.yt rc6
<br />d,ma86 a provid.d fo. thc Scdion 10?6 of
<br />I h@by !,fim undcr Fnally ofpojur, lhal I d licas.d und.r provisio of Chapro 9 (
<br />thc Buins ed ProfsioB Codc, ud ry lic.ns.is in full lorcc ud circcl
<br />I hc.cby affim und.r p.nalty of pdju,y th.t lh6. is . mslllction l.ndif,8 ra@c, for tn.
<br />isrucd (S.c. 1097. Civ C).
<br />oalnc *dk fdvhich rhis Fmil it
<br />APPI-I('ANI'S DECI,AR.\ IO}
<br />Dcnolitid Pem,ls'Asb6l6 Nolifi @rid FcdcEl R.8llations
<br />_ Rcquircd L.n.rofNotit.a on
<br />abovc n.nrimcd propay for inspetion Q-//-0.6
<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 />EXPIF IED
<br />Rough
<br />Service Meter FF'B I .xll9
<br />FINAL
<br />COMMENTS
<br />Notes, Remarks, Etc.
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