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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />I ight Standards
<br />S pas, Pool, Fountains
<br />Signs (monument)
<br />Life Salety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under SIab / Floor
<br />Bonding / Groundino / UFER 1 t ./-/441 f)
<br />Transformers
<br />Torqueing
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilin gs (Hard & Soff it Rouqh
<br />Ceilings (T-Bar Rouqh)
<br />liileter Release tol4 tg /{/41 4q)
<br />Rough
<br />Service [t/]eter
<br />FINAL "uAq I /))
<br />Notes Remarks \-
<br />OWNER BUII,DER DEI,CA IAI1ON
<br />I hcrcby artrn u.dfi ,r@lr, ol p.rjury rh,r I m cx.drr from rh. C.nrddoB l-ic.nsc Law ror rh. followin! r$bn tscc 7031 5
<br />Busincs arn Profcsion Codc) Any City or Coutrly whi.h nquircs ! IBrmiUo con(dct, lllcr. impnv.- dem$h or rcran any
<br />srtuctrtc, 0rior to ns issuancc. als rcqlncc rhc arplicanl for such Fmrr ro tilc a si8md sllrcm rnar tE or sh€ i li.cn*d puKuat
<br />lo lhc pmvisbns ol ttE Conk.ntr\ Lianscd tjw (Chnpr.r 9, ComrEmm8 with Scdion 7fiI).f Oilhion I of rh. Busincs and
<br />Pm{€$ions Codc) or rho' lE or sh. n.ic,ql rhcEfrom ind tlE basis lor rh. allcscd ci€rq,rion Any violn,ionorSccrhn T0ll5Sy,ny
<br />aFrli.rnr aor a p.mn subj(k rh. amli.mr h . ciril n.ndlt! o( nor morc rhdn iivc hutrddl dollrs (55m).
<br />l. ownerofrhc poFny. or n,t cnirl,,rrcs {ilh *lgcs as thcir s,lc conDcnslrn'n. sill&, rhc work ud lhc (turn n 'rillolr.d ur off.(d f.r ek (sd.7(),l4, axsitu* aid Profcsions Cnde: Th. G'ntrck, \ Li.cnrc lis do.s n.r atply ro !n owner or
<br />rhc pmrdy who tnrilds or inlnm!$ tlEtu\in. nxl wll) docs ru.h *.lk himscllor hcrscll or lhouBh hh or tur osncmnloyc$.
<br />[ovidcd rhnr su.h i'npn,wnrnherxn inbid.d orolrcrcd for salc ll: howc\rr. rhc hoildi'r! or nnfovcmir hsoldwirhi'r.trc ,\.r
<br />of.omtlcrion. rhc Owncr B0itlcr will hak rhc hurdcn olproving rhar h. or sh. dil rn buiu or i'Dt(,!e rh. popdt lor ih. nurfr$.r
<br />Lasowncrorrhcpmp.dy.,mcx.tu\i!.ly..nvrringqirhlic€nrcd.ont k,Ft,.o.no.r rhc I)rojcd (Sd.7041. Bu\irrc$
<br />md PmlBsion Codc: Thc Conltscln s Licctrsc L{B docs not aprly ro an o*ncr ol nrop.rly wlr huilds or improvcs rhcrcon,
<br />ond who..nrncrf.riuchl)ft)lc.hwnhBG,hrncronrlicnscdpusu ro rh. Conti.r.is t-icctr\c tiw)
<br />I iflcrcinpt undcr Sdion .a &Pc f.rrlnrc.\otr
<br />troBxE&ttouflNsAlt0!
<br />DIiCIABATON
<br />I hcrcby anirm undcr pctulty.r r'.rjry.nc.r rhc lulhNir8 dL{hrrrion\l
<br />-lhrvcMlwillmoinhitr!CcnificllcofCooscnrrosclrlosurclorwor*cr'omp.trr0tion.aspmva.dfo,t'yScrion.lTrx)orrhcriborCodc.forrhcpc.formnccof rhcwortfor whichrh.ldmil i\ ksu.d.
<br />_l hivc nnd Bill mrinlair workcn conEnsil ion insummc. rs rcquncd $y S(l io l7l x) nfuhc L{ho! Codc- t{, rhe pcrformuc. ol'
<br />Ihc qor* tol which rhisr.nnil is i$ncd Myqorkcrl compctrqln i,r\urnncc .triricr 0nd Flicyrumbcruc
<br />I c.nify rhr ii rhc pdformH. or rhc work ntr *hichrhis pcrmir is i\su.d,I \hrll nor .npl,)y .nt FNrn in ,ny nan.cr
<br />e as tr ti..o'rc subjccr ro lhc Borler omp.trs.ridn Irws or Crlifornir. and aBE h ifl dn,uld b€om sul,jd loihc
<br />workss omlEnqrion ,)m\ isions of S.cr ion l70o ol th. Lxb.r codc, I shall hnhrirh.onlply w hlhoE pmrhions
<br />WARNING: Failrc b a{ric work ri conFnsdt'. covcEgc is unla*ftr|. lnd \hall subF.r m cnplo}$ ro diminol
<br />')culras
<br />ind
<br />.ivil fincs up ro o c hunddl rhousand dollrs ($100.{D0). in adJirn,n i(, rhc.o{.r.omJr.srlion, damecs as nrovidcd l'or lhc
<br />.:lZtS\L :#[tm,f*5r^ao/ (Ue-€-le,
<br />DEcr.aBAroN .-_.il-t-
<br />I hcrctyrmrDundcrncmlryofpciurrrhol I !n liccnsd undcr pmvhionol ChtrJrrcr 9 (conmEm ilr8 wirh S.clion7000)orDivisn -l
<br />ol rhc Busincs and Pd'c$io.s Codc. nd nry licctrs h ii lnlltilmdldciicr.
<br />C_\D '1o LqQ B
<br />-",1-\R:\t:x=Lo,r
<br />CONIIAUqIIONIENDNIi.A(iENCI
<br />I hcEby arrm undn Fnahy of pcrJury th.l ltcrc is . onstrudi,n klndinS a8cmy lor lhc pcrfomEmc of lhe $orl lix whi.h rhii Fimir k
<br />isu.d (se.1097, civ c.).
<br />ATTII!:ANLDEq.AAAIIQN
<br />I hcn$y,Jrmn undcr p.n,lly orpcrrury om ofrhc rollowing d*ldalions:
<br />Dcmlirioo P(mirs Asbcslor Norificdrii,n Fcdcrrl Rcsularioos (tnk 40. Id6r
<br />_Rcqlned krrcr of Ndincdirn
<br />I ccnilyrh r rfu fcdcrulrrStr!ritr)n\r8nni'tr9 rslrno\ rc'novrlrrc nor tflnrll. ri rhF tn)ic.{
<br />I ccnifyrhd I hrvc rud rhh.pllicarion.dnarcrh0r rhc,bvc infonMrion n cond. I n3ra ro comp ly *irh aU Cnr d Coonry
<br />yand Counry n, cnrr uFn, rhLordinnnccs a.d srare bss rcl,rin8 ro huildin8 c.nnrudion. arn h.Bby aurhtrnc
<br />ilFvc rnri(ftJl)n)pcnylnr -1-ttr-\?
<br />O,\ppliuntsr ,\Ecnl SiAn turr
<br />ULf
<br />Sub-Panels
<br />Air Conditioners
<br />rcllltv -
<br />Etc.
<br />50
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