|
ELECTRICAL-INSPECTOR RECORDln8
<br />JI uBl"APPROVALS ID/SIG.COMMENTS OWNER IIUII,DER DEI,CAN TION
<br />I h€rl,y aanm undcr p€nalry orp.rifiy rhd I d.xc.rpr frod rhc Cdntnck,N Li.cnic fav nr lhc n hBirB rca$o (Scc70.115
<br />auriFs anl Pn,fcsio. Codc): Atry Cny or Cox.ry *hi.fi rcquir.\ r Fnnii b onsrfl.t. ilcr. nryrorc. {hmlish ,tr ntun rny
<br />$0.rurc. p.dr. irs knrmc. il$ rcquncs rhcaprlicanr rbr skhrcn.irr, filcr \istrcd {rr.rtu rrhd h.or rhc is li.cn{d rrnu r
<br />t' rh. F-ovisioN ol dr Conrtrctu s t-iccn\.d l-aw ((-hr|rcr 9- C.nnn.rcinE Birh scctotr 7ix)Q or l)ivi\ion .i ol rhc Busi'rcs rr,d
<br />Ptu tusn'n\ C(xlc ) or rhar hcor rhc is cxcmpr rh.EfrcmaDd rhcbasi\ tor rhc allcg.dcr.mprion Aryvi{,L i,'nolS(rion7l)lI5byrtry
<br />apllicrnr l'or a pcflnn subjcck tlt {tli.,nt k r .ivil tlcnrlly of or trxtrcrhd tivc hu trdrcd dollds 1s5fi))
<br />_1.uso*ncrofrhct'n'rny.(trmy.nlpl{ryecswirhwu!c\!\rhcirn,h..nr!cns ion. willdo lhc work and lhc srddxru i\ ftn
<br />i cndcd nroficrcdr'orsalclsaTol4.Busitrcs\lndProti$ionsCod.Th.Conra.tr'\l.i..n{trwdocstrol+plylo0nosnroi
<br />rhc pn,Fdy sk) trilds.! ir{n&s rllrcn, and who d{$ srch Mrk hnn\cltor hcrrlrorrhn,uCh hi\ or hd.wn.nIloy.cs.
<br />prnvidcd rhd su.h imptuvcnr.rr m nor inr.ndal o' oflcr.rl f{n {lc lr, lr,*.rcr, Ih. tuil]i.g or ir{trov.mnr i\ $U sirhin orR }ctr
<br />ol.onfltriotr.lh. oqmr Build$ will harc llf hodo orpmving
<br />'har
<br />h..r shc did tr.| huild or nllp,on lhc tmFny lor rhc puqrs.l
<br />Lxsowtrcrofrhcfhp.dy.dnrcr.lu\ivcly.oitrcri"Srirhlic.n\.dcotrtrcrort,&n{tucrrtr.pn*cris.r7ol-{,Bu\(!\
<br />ul PnnashnCodc:ThcCotrlir(n\Li.ci\cl-rrdo.\mrap!1,k,rno$i.rolpiop.nysh,,htril(horitr,nn)rc{rhcr.o.
<br />rnd sho conl(ckftn luchtrirccr\ *irh aCofkackr(r) liccn\ed pu urnr hrhc(t,nkrcttr \ l-icctr* ll*)
<br />liir.r.n,|n u rld' Sc.rii,r .ll & l'( ktr r[n tu]{,,
<br />Drk o{nr.:
<br />ra.Bx,Ef,slloulllsaMN
<br />DE!:LJAAIION
<br />I hcrubt rlliirn utrdcr pcnnlrrofpcrjtrryon. ofrhc Iolbqir! dcclirdn,ns:
<br />-lhivcandwillnrnftinrC.nific{cofCoscnrroSclflnsxrcLrwolk.s(rnp.ns
<br />ion.as nmvidcd fo. by S(riotr :l7lD ol thc
<br />htrtr Cod., for rhc pdfoi,Mtu. of rh. wo.k for whkh rhc p.mir ii hqucd
<br />_l htrtr.nduillnminlain *orkcs compcnsdinn in\unRc. is r.quncd hySec'iofl:l7ll(,ofrhc ltrhorCodc. i,rhc pcrrorroncc or
<br />rnc sorktu shich rhh,Ennil is i$ucd Myworkcn .unlrnst n nNtrrnccclnicr Nnl poli.y nunrh.r uc
<br />l.rnifyrhrr i'rrhc pcrfon ncr{,rrhd work li,r wiich rhis pcnnir i\ i\n'd,I n lltror r rfloyrn, pc^or nr ifynt rkr
<br />g, rst, hlsrh- suhicct lo rhc $orkcr c.nrpctrranoD h*s ulCrlintrii,'. nliEr(rhnr il I dn{tl(l h(.nE suhlcr rorlI
<br />trorkr'\.ompcnsrrionl]n)vni.nsofSc.ri,'..lTirOolrhcljntrGrlc.l(hulln)n[*ith.omllywirIrlr,{fa,vi\n,n\
<br />WARNINO: Flihre k, $curc worke^' .omp€nqrion covcrrsc i\ lnluvful. ,nd \hnll subjc.r 0r .mpl.'tr lo.rininil ,)ctrllri.s.nl
<br />civil 6ncs up to onc hundr.d lhousnd doU r (Sloo.lxx}). in addnion lo thc cosl ofconwnsalion. daM8es us ptuvihr fo,lhc
<br />sdriinr -1076 olrhc ljhrr Codc. inrcrcsr and,n.m!\ rcc\.
<br />Doler - Applionl:
<br />r rcrrrsrr. crll,lrnN:ron
<br />I}ECIdAA]ION
<br />I hetby amrnlnder p.nalry ol Friury thrl I am liccnrd undcr pn'vkbn ofCh,prd 9 (c.mmncnrB wilh Ssthn 7(100) orDivhbn l
<br />of lhc Busincss and Proicssions Codc- und mrlic.nsd t ruu romdld.ffcct.
<br />C9NSIXICIIONTEITBC-&AENCI
<br />Ihcrcbyrlt.undcrpcndlryotNriuryrhxr(turcisa.on$fl.ii.nlcnding{cncyfirrhcp.nilnnRloarl*wolklorwhichrhtFrnrith
<br />irsucd rscc :1097. Civ C.r.
<br />Lrnd.is Nrmc
<br />-_-APIIISAII.PLCLA8AITO!
<br />I hmhy Imrundcr pcnalryotpcrjury ooc of rlE iollo*ifls ddLrtrions
<br />Dcmolirior PdntlsAsbcslos Norirr.ariof Frcdcral Resullrions (TirL 40, Pdn6)
<br />_R.ltuircd t ltcrof Norifrarbn
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Life Salety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding / Groundinq IUFEft)h t,\ t,l lltlqi,t,
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Facto Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilinqs (Hard & Solfit Rouqh
<br />Ceilinqs (T-Bar Rouoh)
<br />Meter Release A L l(,u [4f1)oL 19 AWtr !K7,( til{
<br />A^/kV
<br />Rough
<br />Service Meter
<br />FINAL L 4 (/kE(/1)
<br />Notes, Remarks, Etc
<br />Siqns (monument)
<br />Transformers
<br />-l
<br />c.dify $d rhc fedcr! I rcsulatio ns rc8mlin-q ash€$os rcmovd uc not apPlicdblc ro $n pmF.r.
<br />t ccrriii rhar t halc E d rnis rtplicark,n and idrc lhsl fic lbovc infonsrion n corud I alre ro ompl, *ilh aI Cnv rnd Countv
<br />onlinamcs;nd Sllrc tlws Eltrini io tlildine coi.h.lion. ard hmhy uxrhf,riz rcprcs aliresoflhisCnvondCotr'lvlo'nlsulbolh'
<br />dtslc nEnlion.d pmpcny foi in3pdtio. p!{n*s
<br />Applacul o. As.trt lilsrlue: D.l.:-
<br />-a
|