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ELECTRICAL-INSPECTOR RECOHD
<br />APPROVALS DATE COMMENTS OWNI]R BUILDDR I,,EI,CARNTION
<br />I lrrch, artrfl undcr pcnalry of pcrjury lh l m cxcmnl linm rh. Conracha Licc.s. tiw for lhc followils rcasn ($c 70:11.5
<br />Businc$ und Ptuicssirn Codc): Any Ciiy nr Couhry whi.h Equtrcs a ,crnril ro conslrucl- alrcr- impolc, {hnxnnh .r eFr M,
<br />(rucrurc. ri,r ro ns i\suanc.. ako rdtunN rh. applicrtrr ior su.hFrnil lo lilc i sismd {!lc .nr rhirh.or shc ir liccnscd punuunl
<br />io rh. pn,vi\io.\ ur rh. Contactols Lienscd tiq (Chl'lcr 9. G'nrmcncins sirh s..ridl ?(xx) .f Division .l of rhc Businc* rtrd
<br />Ptufcssn,nrCodc)orrhrlhcorrh.tcrcmflrhercfromsndrhchn\nnnrh.ilkgcdcrcnpriun.AnyliolurionolS..rbnTI):ll5hynny
<br />anfli.lnI tua pcrnrihufichrhc sppli.,.r b r.ivilpemhyul m( nrrclhrn ivc hundEd d.lhr ( 1500)
<br />I.,{ uwnfiofrh. Jroljcny. or nry cmployes lirh weEe\ !\ rh.ir v,lc .un{'.nstiion. $iUdo lnc sort a.d rhe {mrm i n'
<br />inrcn& or olTcrcd lor alc lsa 7(x-4. arsincrs and Prorcsi,nr cod.r Thc Conlldols Liccn\c li* d{xq fr t rly tr an owncr or
<br />rhepmFny whll t ildior in{,m\$ rtEm.. dd *ls des sEh Mtt ninsclf or h.rslf or rhroulh his or hc. own cnPlorccs.
<br />prolidc'l rhal such inUDwmds @ n intcrrl.d or oltu f.r eL ll tbqcvd. rhc huildir! or imPmemnt h $U rnhin oft
<br />'uor d,trFLrir. th. Own.r Buildd *ill h.w lhc t{rdcn ol pmving lhd h. o, ihe did d bnikl .r inTrew d. ,oFny for llE !u'F,{ or
<br />L as owR! ol thc ,ro!cny. amdcllsi!.lycohraclins *irh lic.n\cd.onra.loN to con(rucr lh. ,)n)jcd ise 7(x4. Bu\htit
<br />!d ln,rs\ion Codc thd c(,nra.ror's Lic.ns. tl* dm! nor apply h an owncr ., nfl,p.ny who hu ilds or impmvcs rh.r.on-
<br />md who ontmcrsfor sch pmrccls wirh ! Conrr(t"ls) lic.!\.d pu uani r. rhc aontrclois l-icctre ljw)
<br />-l
<br />! cxcnrnr undcr sc(rt,B &PC li,rrhisrca*,
<br />Dol. Oqner
<br />W(IRKERS' CO]IIPDNS T!ON
<br />D[l:tt8 ]M!
<br />I hcrchy rllirnr undcr ncNlr! of pcrJury o'r ufrhc inllowir! dNlar!lions:
<br />I hrrc orn will rmintlin a Ccniltolc of Conrcnl lo Self l murc tu sor*tL .omrcnssr ion. as nmvidcd ,ttr by Sftrb. l70l) ol lh.
<br />Lrhtr Gxh, tur rhc pcrformnd. of rh. work for whi.h lhc lcmn h kucd
<br />I hrvc rnd will mairrrin workcrr conD.n\rrnn, in\urrfrc. a\ rcquncd b) Sc.rion 3700 ot rhc lihorC.dc. Lr rhc t rltflronccol
<br />ir is is{'ql Myworkcn conlll.',\rri,)n muritr.c caricrnRl lx,li.y trun cr 3rc
<br />Cr -)-w,.
<br />O+o i . \-r4
<br />-l
<br />ccnify rhar in rhc DcrLrtuftc ofrhr work f.r sh.h rhis JEiitr( is nsuql. I shall nor c'ntloy,6y F6on in lny manmt
<br />q, a\ t, h.dn* subjd b th. so cB'.on!'cnqriotr l6ws of Calitonii- and +rc. rhnr,rl shouk h€onE subjd hrlt
<br />wortcr' .tmFnern,n pmvi(io.s of Sd ion 3rO0 ol rhc lihtr Codc. I shrll. ronh*ilh comlly n ilh rho{ po!ist,.!
<br />WARNINC: Ijrilurc t' $cur. sort.r( ..nr.nqrn .ovcruac rs uolaslll. nfrl shrll subj..r ,n cnltllo}lr lo qimiul Fruhi..nd
<br />::' u'lv" u tll{iidi
<br />.;rll:rrrr i.n. d!trugr\ J\ prrnlrJ f,n rhc
<br />DEIIJBAIION
<br />t h.eby,flirn undcr F€n.xy or rcrjury Ih0l I !m liansd under provision orChifl.r 9 (ommNinS with Sccrion 7Om) orDivision:l
<br />of rhc Businc$ Md Pn,rcasions Cod.. id my ltc.sc is in full forc o cfid
<br />\oolnaoa
<br />trAY 0 1 2010 YaAlllza
<br />g)NSIBUqIIONIIiNDINC.EAEdI;.I
<br />I hcftb, rfln undf l.ndry nf |Elury rhal lhcrc n ! connr.rion hddnrg 4ctrct for rh. PcrLirmrcc ot iltr suk nn whi.h r hi\ t'cirnir is
<br />isiu.dls( :1097 Civ Cl
<br />AfIUSANIIEgI.AEAIIO!
<br />t hci$y im und.r F alry or Frjury onc of lhc following dcclarulion\
<br />Dcmlirion P.rmils.AslEstos Norifi carion licd.El Rctuhrtunr (Tirlc 40. Pfi 6)
<br />Rcquncd Lxrl.r or Norifi c!|i'n
<br />sfl;;fcn€rr| rcsulartB Egarding a$.qros .cmul arc nnt arplicat h h rhh pn,jel.
<br />E rhis.mliclrion 0d shrc rhlr thc ah.rc intrrorn,n iqcomt. L8ra Io comrly*iih all Ciryn.d counly
<br />s\ rh ir!! ro huiktirA.'{\nn.rion..llhn Cilyrnd Counrt ro.nrn uB)n rh.
<br />'L,rc
<br />nEnri,)nM 0n)pcny ntr i',\Ecr(mturtiR.\.
<br />Appli(nnl or AHcnl Signolur.tl 4 ?.v:
<br />Ur r
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Sions (monument)
<br />Lile Salety /Low Voltaqe
<br />Fire Alarm i Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding / Groundino / UFER
<br />Transformers
<br />Torqueing
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilinqs (Hard & Soflit Rouqh
<br />Ceilings (T-Bar Rough)
<br />Itileter Release
<br />Rough ,//ile 9 \De l[Zr+82
<br />FINAL L/t ,/,a a7>trxa*Xfi
<br />Notes, Remarks, Etc.
<br />ID/SIG.
<br />r5vSub-Panels
<br />Service lvleter
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