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ELECTRICAL-INSPECTOR HECORD
<br />DATE ID/SIG.COMMENTS OlVNEI' BIJILDER DELC RATION
<br />I h.rchy rfiinn utulc! pcnalry or Frjtry rhr' I 3n $c"r|n tmn lhc Co rncktr\'l-iccDsc li$ nn rhc n'lhwin-q ruv'n lscc 70:]1.5
<br />Burircss rfld Prcfcrst Cod.) Any Cirt or CoMry uhkh rcqunc\ a lf,rnir k, .onntud. rlrcr, inlPtuvr, dcm)lish ,tr rNr | '
<br />itucrrrc, pri,trro ir\ i\\uaMc.,ko rcqtrnc\ rhcnp i. r lor suchlt nirr,lilc r \ gncn (arcnEnr rhirhc.rshc n li.rn\cJ rtrrund r
<br />t' rhc pmvisnrns ol lhc ConlEcro.s l-iccnscd l-!s (ChaDro 9. C.nnrcncnr8 qiih ScLlion ?(xD of Divni.n .l oi rhc Bu\incss ud
<br />Pturc$ions Codc) or rhrr hc or \he i\ crdopr ihcrcli.nrnd rhc haris li)r Ihc!llc8cdrxcnDlion Anyyi,'lalionotSccrk T0.ll5hyrny
<br />ll)tli.nd n)rap.nnn suhrc.*rhc nmli.rnrr, rcivilllnrlryotrcl nnrc rhrn ll\. hlndrcd dolhr(!50O)
<br />-1,!s
<br />o$nc..flncpmFny.ornyemplorrcswirh*o8csasrhcns,bcomp.ns in.willdo Eworkrnthc ndwhml
<br />inrcnitql or oalcrcd tor $lc (se ?0r-{. B!\inc$ nnd PronssioN Codc The Conlr[lol s t-iens ljw docs nol apply t, an .,mr or
<br />rhctreJ{ny who builds or irymvcs Ih.Nn. Nfilwh. dcs chtu&hnns.lforh.(clforrhmulhhktrhcrosnln{rloyccs.
<br />fovidcd rhar such imlmw'mnk dc nor inrcndcd or ottrcd lirsalc.ll hn*cvcr. thc hliLliu or i,r{wvcmd h eld wirhilnnc rm
<br />ofRnlplcri@ rlE (rmi Buiucr Nill harc lhc trr'lctr olrovinE trDt lf, or shc did d tDild or irq'mvc th. pmrmy lor rhc purFc or
<br />I. n\.wncrotrhc[l(,Ptdy. !mcr.lusivcl,.o.rra.tins qith li.cnsd co mdon l. <mslrud lhc pDject lsec 7044- Bdsim\i
<br />aM AofLs\$n C.d.r ThcContrclor's Li.cnsc Las do$ norsrplyb rnos..r.frrot yNho huililr.r imrrovcs rhcr.on.
<br />and {ho conr,Grslor sncn rnj(h oiih 3 Corrraclo(I liccn{d puFuonr rorheConrr.cror'!l-iccnsc ltrw)
<br />I rflcrcnpt unds S&ri(
<br />UAAtrI&T:SJMIjNIAIIII!
<br />DECTA&I]IAN
<br />I hcrchyrllrnutucrtl.trtrltyolpcrjuryon ofrhrlolloaingd..lx'zrnnr\
<br />l hdlcandsill Li.r"i',rCcnifirJrrofCon\.nrhScliln\ur.lin$or(cnconfcn\!i{'n.r\nmvidcdturh,S&rni.17(x)ofrhc
<br />l2}rr Cdc. iarlhc pcno nlnccofrhc+ork r'or snich rhe lcnnil n i$ucd.
<br />)i-" ,, , -,,, .,,,,. ..rrr^' q,n,fli\rrtrr, ,n\urrmc. t,s rdqurcd by sccri,)n.r7m or rhc br,oi cod.. ro, rtu p.r.rn,m. or
<br />rhc".rkrcrqhir.hrhnF'nn,'.nsAlMyu.'k.F--,mnrnsrn,ntrtsd,Jrrini,1ril,x,'i.,nu,nhlr.
<br />C 7fi4=s l/tqp/sfi a/o
<br />l*'".;**,
<br />-l
<br />ccniiy rhrl ir thc pcrformrcc oflh. work for whkh lhk p.rmn r issu.d. I shall mr crploy any
<br />$ a n, b.drE {'hjcd n) lh. s1tr[crl co'npctrv ion l!w\ ol Crlilomir, n rarccihal ir I shotl(l h.conE \rhFcr hrh.
<br />wo'kcrs .o,p.nslri.nrn,vili{,nsotSccri,D:17rx)olllrLrt r (tdc.l $all, l'(lnhwirh .omply silh rlxrE rrovi\nn,\
<br />WARNING: Frilurc ro s.ur. wurkcrs tun]l.n$rtun cov.asc is rnhwrul. Md shall subjc.r ,r cnplo}tl h rinnml lEnrlriq and
<br />civil nn.s up ro oft hundred rlDusrnd dollm (riltlo.00o). in nddirnrn ro rhc con olcoml,cnsdiotr, darMscs !s prcvidcd tu rhc
<br />Scclion 3076ollhc tjtnr Codc. inlcrcs and altonrcyt tc4.?-?n-/8 Applicsnl:
<br />tllENtlllcgNt&t(loa
<br />OECI.ABAIION
<br />I h.tohy aflirtr,nnd.r FnalrJ.f tf,rjrry rhd I !m licn$d nndcr pmvisio! ofCh3l,cr 9 (comnktuing sirh Sccri,n 7(XX) orDivi\id:l
<br />of rhc Bu\inc$rnd Profc$ions Codc- and mr liccnse n in flll lnrcc lnd cltcr
<br />Czb o
<br />,,,,," 7'ZO'/8 -4_-.
<br />ca$tlalsllaNu,NDlllj-arillrr
<br />I hcrch!alft undcr Fi,lry.Il)crjury rhdr rh.rc k a conedcri.tr kndiog rC.ncy r(r rh. fdLnlrncc of$c work lor shich lhis lcnril is
<br />nsmd lss .1097. Civ C ).
<br />hndcr's Addc$
<br />-
<br />I ccaiftrh rhc fcdcrrlr.trhrnnrsr.gJKii'rgrsh.no\ rctr[vx]x'r n.rr|]Ilic blc r) rh\ ,[ird
<br />-l
<br />ccnlyrhar I hdvc Eod rhis,pplic,rion.nd{allihdr rh.rh)\r i.n,m nr irconNl.I ngrNb.omplywirh rllCiry0 Counry
<br />ordin.rccs 0nd Srarc rjwsElnrins lo huirding conslru.rio.. ,n hcrdby.urh.rD. rc,,cenrorivca ('lthis Cnyand Counlyb cnlq unoo rhc
<br />rh,vc Dcnrt cil F,p.ny f.r inrN.r
<br />]\pplitnnl orAg.ntSiAMlure ?e7 f/a,t*s ",,"?:Z'1&
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lile Salety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding / Groundino / UFER
<br />Translormers
<br />Torqueing
<br />Sub-Panels
<br />Roof Top Equipment
<br />Ectory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rouqh
<br />Ceilinqs (T-Bar Rouoh)
<br />[/eter Release
<br />Bough
<br />Service lvleter
<br />FINAL
<br />Noles, Remarks, Etc.
<br />APPROVALS
<br />ATTLTCANLDIII,IM.II!]N
<br />I lmtry rninn x.d.r f.nalryofp.rjxry on. ofrh. fdlosing declaErionr:
<br />Drmolirion PermirlAsb.sros Notificlrion ltdcnl Rc8ultrtions (Titlc 40. Pln6)
<br />Rdquncd I.ncr or Norifi$tion
<br />Air Conditioners
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