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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OlINTiR BUII-DER DEL(NTATION
<br />I hcrch, nl6nr undcr |xfl,lr, ol tc{rry ihlr I m cxcnu non rhc Conr$trtra l-i.cns Law tu rhc foll'sin8 rcasn (scc 70.11 5
<br />Bu\in.ss rnd Prolcsion Codc): Any Ciiy or Counry which rcquircs ! pcrmir b condruci. alrcr. in]Prt'lc, drftni\h or ruNn n t
<br />{rucrurc. rritr t, ir\ is\uakc. o r.quircs rhc +plicn ror \khIxrmir t) lilcn\i8trcd nrrcmnt lhd hcor she n liccn\u.! t snxnl
<br />t, rh. flovisnnF ol rhc Conracrois l-iccnsrd Lrs (Chlprcr 9. Connncrcing *iih Sccri,,n 7lxx) f Divi\i, ] utrhc BusiDcs {nd
<br />Phrds\n,r\ Cod.) or ihar lr or \lt n crcn\pl rhcr.fm Md rhc hasi\ ftxrhc rlldgd.xcnllrion An!!n dionolScclion?0.11.5hylny
<br />rtDli.r tur r t'.hnn suhjLrh rhc rmlicrtrrto r.ivilr.tr,lryormr nir.rhin ivc hu.drcd dollars (!i5m)
<br />I. rs osn.r of rhc pn,Fnt. or my c pkJyccs siri strEc! ns thcn $b conFnsar ion. sill d. rh. sor k turl rh. nfrtr t nol
<br />itrrc ctl or onc.cd tu slc ( S( 7(x,r. Busincss ..d Pofcsnrs Cdlc Thc Co0r.drtrt Licctrsc L'w docs nor lprrly h u own.r .r
<br />rhcpmFny who huilds o. iny'(,6ltf,aon, bnl slN dms qchw)lt himsclfor hcrrlfor rhn,trEh hh or h.r own cry)loy.6.
<br />povidcd thar su.h inr|,ormnrr rrc mr int.frlcd o' ofl'crd lir qlr Il l$r.v.i th. huikling .i nrysvcnrnr i\ skl wirhin onc ycrr
<br />ofLurplcri,n, thc Owncr Auiu.r *illhrvc rhc hurdcn oflnrinA thlt ht or sh. Jid nor hild or iq,row rhc fn,Fiy fo. rtE purlr,*ol
<br />-1.
<br />ns own$ ofrhc lopcfly, !ncr.lusivcly.ont..ring wnh li.cn\cd.onrdckJs ro.ntridct rtE [orccr (S.c. ?Ol-t. Bu\ifrr\
<br />a l PDrLr\in Codc lhcCdniractn s t-iccnsc l-a* doc\ nor amlyb !nosncrolp()p. y sho builds .r nnl)ror$ rhcrcon.
<br />!trd who.onlmclsforsuchpmJc.hwirhaConnndo(Oli.cDscdl)trBu0ntlorhcConhcroisl,i.cnscl,!w)
<br />I iMcrc.fl uMcr S.crion .B.&PC.lorthisrc.son
<br />t!o R KERS' CONI PFNSI',lION
<br />D.UCL Sduor
<br />I hrr.by rllnnrundcr Jrmlry ol pc'jurrodr olihc lnlk'wing dc.lrrrions:
<br />\l h^ c a,rl $ 'll m mra,n a c.d l.are or con{nr r ' s.lr.ln.uft r.r workctr coqrc.salion, os tovidcd for by Scclion ]?OO ol rhc
<br />L,lbur Codc, t,tr rk l. ru' nffi. olrtc sc* lur }h'.h rh. nflmi h n\u.'l
<br />_l havca willrointrin qorkcm conrlens.ti.tr insurancc, as rcquned byScclion 3700oflieliborCodc. ror ihc Fdirrmn.c or
<br />My Borlcn o.r'rcnsorion imunne crri( and policy numb€r e.
<br />€-tf
<br />I ccnfy rhrr in rhc p.rln.mn.. ofrhc $olk fitr whi.h rhis Fnnir i\ i\sucd, I drdll nor cnploy ony pcrsotr in rny mrnrcr
<br />q, .s to be!!m su$jd lo lhc s.rkcs' conrrcnsalbn hrvsofc0liforn ond osN lhnl iIl should lf,d,tu ruhjccr brlr
<br />$oltcn compcnstion Drovtioni olSstion l'7OO oflhc Lihor aorlc.l shlll. torlhsirh compl, *irh rll){ tmvisn,n\.
<br />WARNIN(;: itrihrc t, {curr wtrkd'\ c.nD.0{di{u rorcrrlr is unhqllrl. n d \hrll Nrhjc.r dr cnlPkirrr ro sinriMl|rukns nn
<br />rivil fin.r up nr onc hrndrcd rhor\rnd d.llr\ (Sl(r)-(Xx)). ir rd.liri('n n, rhd ror ofco rNn\rrio., dinDgcs r( providcd Iq rhc
<br />DECI,ABAIIQN
<br />I hcEby ottirm undcr rcnohy of !.riury lhrr I !m liens.d undcr rrclision ofChaplcr 9 icommncins *nh SNrion 7000) orDivhio.l
<br />of rhc Busitrss sJ Porcasions conc. ud my ltci* is ii tu rorc r.d clgl)
<br />dD 6,o 7
<br />ln
<br />cax[rBucllali1.l;lDtN{j-&ql;lrr
<br />isucd (scc. .lllr7- Civ ( )
<br />AELIqANI.A&EIJBAIIO!
<br />I trn:by mim undcr |)cnnllt of pcrlury om .f rh. iollow ing dc.ld,r ions:
<br />O.m,fti(,n P$nir\ A{bcdos Norifi.dion r.dcral Rcgxhrn,n\ (TirL40. PdO
<br />-Rcauncd
<br />hnn of l'.lotificariro
<br />-lccnifyrharrlrclcdcrrlrcsllri{,n\rcrdingtr\h*no\rcmvrlircnorq,pli.rhlchrlri\!(r!rror..r I a8rcc lo con1pry wnh all C ylndCounty
<br />ncscnhlives of lhk City 3nd Counry lo .nlc. lron tlE
<br />*,",- gh/'r
<br />I c.nilirhrt I h,tr rc:d rht ar,rlicrrn,nmd (rrc rhrr rhL
<br />.{dnl.i,.i.J\rJL'lJtr\ml
<br />'n, i'h,r'ld'nr..Frtu,r,.r,Jtr,ll',rF!rurhnn/r'cl
<br />rr'^t ft,B r,r n.Enr ro,nris,,,,,/t,(",,.,
<br />nooru,"' ", n*., tt ^,",/Lb<|rl-
<br />,.^u**^.'nn^,, /' /*t- L-
<br />Site-Work
<br />Underground
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lile Safety /Low Voltaqe
<br />Fire Alarm i Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bondin g/Grounding/UFER
<br />Transformers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soflit Rouoh
<br />Ceilings (T-Bar Rouoh)
<br />Rough
<br />Service lt/eter I4Df,FINAL 'rx 4Y tl)
<br />Notes, Remarks, Etc. -/
<br />Pole Bases
<br />Meter Release
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