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ELECTRICAL.INSPECTOR RECORD <br />DATE ID/SIG,COMMENTS <br />Site-Work <br />Underground *lt"i/ tr('-.a6'{ <br />Pole Bases <br />Light Standards <br />Spas, Pool, Founlarns <br />Signs (monument) <br />Life Safety /Low Voltaqe <br />Fire Alarm / Dampers <br />Communications Cable <br />Buildinq <br />Bondinq / Groundinq / UFER <br />Transformers <br />Torqueing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilinqs (Hard & Solfit Rouqh <br />Ceilings (T-Bar Rough) <br />lt/eter Release <br />Rouqh -A <br />Service l\rleter (zt ) <br />FINAL ?-\b(6 }d/r'otn4 ebr -' <br />Notes, Remarks, Etc. <br />OWNER BUiLDER DELCARA'TION <br />I hcrchy lrfirn under Fnahy of pcrjur, rhar I sn qcnDr ii.rn lhc Conrracro^ l-iensc uw ror rh. rolb*irB rc0o. (Scc 70ll 5 <br />Busircss md Pr.rr\sion G)d.l Any City or C.unry which rcqun s , t flnil k, con{flct. ,xcr. inDrovc, dcmlhh nr rcrrdt lny <br />sIrucrrc. ttrior to ns ir$amc.,ls rcquircs rhcaptltanr for such Fnni lo nb. signcd storcnEnr rhd hcorsh. h liccncd plrlaol <br />ro th. provtions ofrhc Conracrois l-icn\.n hs (Chaflcr 9. Comnrcncing wirh Sccrnn 7000 or Dilhnrn I of lhc ausirc* di <br />Prcrc\sioN Codc) 6r thar lt or sh. t crcnfl rhcrer'Dn dd rhe hsis ror rh. !llr!.d crcmplion AnyvnnarionofScciionT0ll5l,yon, <br />apnli.$t tar a p.flnit subjc.h lhc applicanl lo!.iviltctrrllyol rci morclhan fivc hurdrcd doll{s($500) <br />_1, r\ nsnc. nl rhc pr,pcdr. (, my .'rpk,)es wirh war.s a\ rhcir v,lc comp.rsr'ioi. will d. lh. work ntu lhc smruE k mr <br />inrlntoi o. oficrcd r.r $lc ( SE.?014. Busim$ a.d ProLssionr codc Thc Contu lois l-ien* ljw docs nor lprlt io an o*Mr or <br />rhcptuFny *ho build. or in{d$s (h.(,.. Md wlar do.s skh wo* hirnsclrot hcnclfor rhmugh hn.r ncrovi cntlloyccs. <br />proridcd r,ur such nnrnrcmnh e mr hrcnd.t or.fttrt ttreh lt hoechi rrr tDiklinE .r irlmvcnrd h $k qilhin orc Fnr <br />or.uryturhn. lh. O$ fti auiud will h,v.lhc turdctr oapoving rh, h. or sh. did.or build or impmrc thc pmFny for lh. purP)y ol <br />l. * .*nfi of rh. t ,Fd y, am cxclusivcl! conrr.n.E snh li.cnscd co.lmcros ro onslncr rh. proFr ( S€c ?(xJ. BuiR\l <br />lnd hDfc$ion Codc: Thc Conrrscrors t-iccosc Llu docs nor !rpl, b flno*nfi ortmNdy who huilds or nnprovcs ihcrcon. <br />and who comB.'s for ruch pr.j.rts wilh 0 aronhcto(s) ltcnsd lursuml lo lnc Conrrlcktr s l-iccns ljw) <br />I hcrchy!llir undcr JEnrllyof <br />lrl.l:lLBAlroN <br />-l <br />havc .nd will minhin a C.rr ifElrc of G,nsnr ro Scll.lnsurc to. wolkcd con9.n.arkJn. N Fovid.d ror t'rScdion3?mof lhc <br />titrr C.{c. for lh. ,,crfonMm. ol rhc qolk for whi.h lhc p$ni k nsucd. <br />I hrvc and sillnairtair tro cr\'conpcnsarn,n in\urrn.r. r\ rcrtuncJ hySccrin:r'TUlofrhc l-rh.rCodc. Lrthc pslhrnrrccol <br />rhc $dk lnr which rhis pcrnir is ilsed My workcB ..nrtr \arid nr\uratr.. .rd.r u Flicy nnn$cr c <br />I.cdify rhd in thc p.rtoirhrtrcc olth. work for whi.h rhis l.nnn is i\(ucd. I shrll nor cmploy 0ny pcrv'n in trny nuin r <br />s rs to $conE subjcl lo lhc $orkcs' c.mr.tr$n,. hws of Culirbiii{. and isr rhd if I sh,rld h.coft $hic.r Io rrE <br />qorkcs'compcnsorionprcvhiotrsofScrionS?00ofrhcL.horCodc.l\hrll.lonh*irh.annplywirhrho$flvisions. <br />civil fim\ np t' on. hrndrd rhousand dollir(in dfn r r' rhc cosr ofcon nslrion- dlnrE$ 's p(i!id.d fin rhc <br />s..rl.n ll|76 nrrh.lahr(.d. i'ncn:( rmlrr <br />/V77n <br />I hcrc6y ui,nm unJc, |Enrlr'.tlr.rjury I I rm |tutr{ utrtlcrpn,vi\i(nrol(hrnrr9(.rm rncnrg FirhSLrti{ 7(xx)).il)inifl.l <br />cQlsrBucugtirElDMi-&cENtr <br />I hcmbynmrnud.r pcnalry.tl.rjxiy rh <br />'hd. <br />i{r consrru.tion hnding,Scxy lor $c p€rlormncc ofthc wo iorwhth'hi\ p.frir i\ <br />tsucd lscc.3(,7, Civ. C.) <br />AIILICANLDECIABAIIIJN <br />I h.nhy lllim xndf p.nahy orpcrjuryonc ollhc lolk wnrS dcclddli.nr: <br />D.mlirion P€rdis A\tEsros Notincarioo F.d.ral Rqtrlnt ians (Iitle 40, Pd6) <br />-R.q!ird <br />l.ncr o{ No{itrdion <br />I .cdify rhnr th. rcdcrJ rc8ularions Eglrdine astE{or rmval m nol q'rlic0bh lo lhh pmlccl <br />Mk#sri\c'lNd <br />lhavcrc.d rhi\.ptltrlion0nl{lrtdhd rhc ltn\c inlormalior i\comcr I !grl! ro comply *irh rllCiryand Counry <br />ivc\ ofrhh Ciry uid Cuutrry lo cnrcr nFJnrh. <br />^/.'?'/ <br />I <br />APPROVALS <br />Under Slab / Floor <br />I <br />ol rhc BDsincss md PofcssionsCodc. lnd nryliccnsc i\ ir lull Lrcc oftn cflecl