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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUII-DDR I'EI-CARATION
<br />I hcrcby rmnn undcr pcnaht or p.rjrry rhll I m cxc.rpl irorn Ihc Grtrcron Licc.sc L.{ lor rhc nnk,wir! en$. (S.. ?011 5
<br />ausincs and h.rc$n,n cdL) Any Cily or Courry which r.quk s I lcr.rit lo connrcr. dlrd. nn mv.. dcrmlhh '{ rcFn lnv
<br />srruclure- priub n\ issuakc. $o rquncs lhclDrlklnl ttn sochFirnirro nb0 sisncd $a'cm $d hcorshc i\ liccn\cd rrrsx l
<br />k, rhc pft,lisn,ns of rtu Conxlclois Li.cn.cd ljw (ChtPrcr 9. Comrmncing wirh s.crion ?00o of Division I ol lhc Bu(in.s rnd
<br />Pmfcssiotrs Anh) or Ihar h..r *h. ircrcolpr licrcfion snd lhc ha\n fd rh. dlLBcd crcnrrion anyvioldrionolSNlion 70ll I 5 hyov
<br />rmli.ar lor r lcnnii suhjah lhc lpplictrnr t, a .ivil pc ahy of nol Imtdhm fivc hxndrcd dollas ($5(xr.
<br />-1,
<br />ss o*nc, ol rh. p6Fn). or my cmtloyccs *n,, wrs.\ ri rh.ir $t coml).nsllion- willdo rh. w.d{ dIhcsrErEir ft
<br />i.r.tul.d .r ofcrcd for sle (Scc 7044, Busin.\l aM Pmrcssione Codc: Th. Coorn.rors Li..trsc L.w docs mr ,Pdy ro !r owncr of
<br />rhc flopcny *h] hxildr or invroEs lhcmn, and who dfts such w,k hi'tuclfor hcrsclfor lhmogh hk or hct orncml,loyccs.
<br />,rovidcd !h!r su.h impmwmrG m e, id.nldl o. oficrcd ror ek ll howcw. rhc Slikling or i.{mrcrrnr is sld lnhin om )qtr
<br />ofconpkti,.. rlf, owrcr Buihc. will hsu Ih. blnhn ofrbvind rh,r hc or sh. dil mr tioid or imFrot dr Pmpcny for rh. rxiFs or
<br />l. i\ownfi.rrhep('pcn,. !mcxclusivelycontacrine wnhli.ctrsd.o mdqt !o oNdc' llt PFitr (Sd 70{4 Busnc$
<br />ad PDlcssbn C.dc: Th. Conta.rot s Liccnsc Low does nol lpplr ro an oRns oflnpcny$ho huildc ur imlrovcs rhc.con-
<br />lnd who conrmk lor suci rrDFcrs wirh d Conk0cro(O li..nsd pununl ro I hc Co.r.cior' s Li.cnsc l,!$)
<br />-l
<br />rm cxc rt'ruMcr Sccli.
<br />Dare: O"n.r:
<br />WORKER.S' COITPFN.iT(IN
<br />DEIITIMII!}N
<br />I hcrcby a,tfln uidcr Jf,noliy.rFrjrry oic orrhc rorbwirS dsloralions:
<br />I hale&a]will nEinrair r Ccnifimrc of Consni to Sclalnslrcn, work.tr omplnsarion. !s pmvidcd ror bvSecrion JTl otrh.
<br />UhtrCulc, forrltr pcrioiinanc.of rhcw.rk f.r whichrh.!.nnit is tslcd.
<br />Yn,." ""' "',,-,,,,. *,rc^' ron'pcnn i.n in
<br />rh.\orl htr {hrrh rhn Fnnir rs i\ucJ. M, }nrlcF
<br />r$utr.d hySccri, .l?rl)olrhc lntxtrC.dc.lor rhc Pcrfornrn.c df
<br />i,)n {r rc cotricr r lxniry du rh.r irc:tlpn f
<br />l'zqlo lq
<br />Yl (cdil)
<br />'hd m rhc nc 'turc nl th. wnr\ rnr l hi.h rhi\ P$nir is i$ucd- I \hall Nr clnlloy ,ny ,'.mn inlnyF rn&
<br />", ,,)r" t'c.nm.utro n rtrc *,trkcF . nncn{r'.n hwsofcalifornia. snd trrr. rhd ifI should bccom rubj.cl ro rhc
<br />woAds cnnDcnsalion pDltiois.fSc.rion ]TOOolrhc kh.i O)dc.l \hsll. fonhwithomply *irh r&,{ Psvisirns
<br />WARNINC: Failuic b curc workcs conucnsarioi .okrust h utrhqful. afrl \htrll sub,c.r 0n cmfloycr l{, .riminJ p{flllics atrd
<br />civil lin.s up k, oft huMEn rhou$nd dollar lsloo.lno). i6 ddiln'n lo thc cDsr or.onllf,nstion. da'Esc\ $ Prcvi'l'd lb' rh'
<br />s.rr ion :1076 0f rhc bhy codc. inrcrcsr ond drotuv\ accs,.*1'ltt[s
<br />DECI.AMIAN
<br />I hcrcby rflnm undcr Fnahrorprrju.y lh.l I am lirtr*n undcr Provici,'n ofChoDlcr, (co6'mn.ing *ilh Scclion ?(Xn) 'rDivki'n 1
<br />.f rh.Bxsifts\{nd Pmltsions Codc, aixl nyliccnsc n in tul! iorcc otd c[e.r
<br />z
<br />tr,r":1 h
<br />C0NSTRUClION LFNI)IN(i A(:ENCI
<br />I l*rchy rfinr undcr Fnrlryofpc.jurylhor rh.rc n a con(tu.ri(,n lcidns ra.ncy ti,r rhc t rhJrltDncc olrhc work rd *hi.h rhis Flnril is
<br />i$ud (S.c. :lilq7. Cir. C )
<br />trndcis NJnlc
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<br />randc.. AJdrcs'
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<br />ATILICANLDECIABAIIAN
<br />I hrEbyolim!nder0cndryorpcrjuryonc.ilhc Iolbwiis dd.ldnlrtrs
<br />Dcnxniion Pcrn ls Ashnos Norincarion Fcdcml Rcguhrionsl'Iirle 40, P.n6l
<br />Rcquie{l Lcttcr olNorift,ion
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<br />ccnify rhar lhc fcd..al rc8ll,lions rcSardins ast \hs rcmrvrl m not lppltahk ro lhis nmii.
<br />-l
<br />cedity rh,r I hnrc rcrd this ap,rlicarion od rltl. rhnr rh€ ah,v. inlomalion h cotc.r. I 08rs lo ofllly wirh allCnylnd Countv
<br />ordinrrccsaMsrar€tlpsrchrinsroblildinBco.(.rhtrardl*rctry.uthtritEpE*trr.livcsofllsCiryadCornltlocnl6uponrhe
<br />!hov. rmnriord prc*ny Lr in\N.lion pun scs
<br />L/!Z.d *,"--ll tt I l8
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Liqhl Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Life Salety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<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 (Rouqh)
<br />Ceilinqs (Hard & Solfit Rouoh
<br />Ceilings (T-Bar Rough)
<br />It/eter Release
<br />Rough
<br />FINAL q lt1lt9 ,(2/ tu
<br />Notes, Remarks, Etc l-./
<br />Service N/eter ]B
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