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ELECTRICAL.INSPECTOB RECORD
<br />APPROVALS DATE tD/srG.COMMENTS OWNER BUILDEN DELCARATION
<br />I hcrcby trfni,n und.r lc.rh, of p.rjury rhar I d cicqrr frnd rhc ConrturoF l.ien$ l,* for rh. tollo*ins,.osn lss7011.5
<br />Busincss ad Prolcasion Codc) Ary Ciry or C.udy which rqlncs a ,snrir to coo{tucr. !lr.r. inl,rov.. d.lmliah or dpan any
<br />{rudurc, rBr to ils issuonlT, als, rcquneslhe applk, for su.h Frn l ro nh. sig.ci *laLtrd rhar hcorshc a li.cnscd purruanr
<br />ro lh. pmvtions ofllr conlmcktr\ Li.cnsd lrw (Chqrrcr s. Commmins sirh Sccrion 7(x)O of Dilnion:l ol rhc Slsine$ rnd
<br />Pmlc$ions Codc ) or th0l hcor sh. is.xcmpr rh.r.fr.m {nd rhc 6rsk for rh. dlklcd .xonpiion. Any violarion ofS.crion ?0.11.5 hy ahy
<br />y'nplicri rer J nrm, \uhKhrhc llflic0n' ro a ctrrlpcnrk, nl n.' mrc'han livc hundred dolhF 'tsmr.
<br />fr\,L**,*^" **"y. o, n,y rmrrnF.\ q h {,*cr as rhcr v,k omprnsdn,n. wi, do rh. $ok and rh€ {nd@ h ftn- ritrDd.J ornficrc,l lor qhis(.?0r4. Bu\im$anJ Plofcsions codd Th. Conlactor's Li.cnr tis dfts .ol apply ro an o*mr or
<br />rhilmFny wh. huilds or mnmw( rhcmn. and rh.&rsschs* hin\.lf or hcis.la.r thm{h hk .r tur own cmnloycc\.
<br />fovid.d rhar such imroErnnsm mr idenltt or oflcftd aor ele. I L hoscEr, rh€ hiHin3 or irpo!€d h$Uwnhinon.yc(
<br />oa conob&,n. rhc O*rer Builds sill harc ll.c budcn of pmvin8 rhd tu or shc dil m' buiu or i.pmr lnc l,tuFnt for lll. pu4rs ot
<br />L r\ .$ncr or r hc propcny. r r.rclusncly contr$rir8 *irh lEnrd .ofta.roN k' con{ruct rh. ln,jccl (sa 7t}{4- Busircs
<br />itrd k)lLsstu G)dc: Th.C.nrn.ttr\ Li.cnsc lnwd.cs tror upplyk,,nosDcr ofpn,pcny whr,l,uil& or n pn,vcs rhcr.on.
<br />a d who conrnck lff slch pmF.ls $irh ! Conrrucrono hcnscd lunu.nt to th. Co racr
<br />I hc'.h, rlltrr trnd.r prnrlry olpojurloN olrhc lhlldvii8 d.chr.ri(rr\
<br />I hnle ad willmoinhin !Ccnitic colConsontlosclf-lns,nitr*.rkcs compcNrtion..s providcd rb.byScction l7([of'hc
<br />Itrlu Codc, for lhc Frfornm.ce ol rhc trolk rrtr whah rhc Fnnir is isucd
<br />Ihv.nndwillmainrrin*.rkcrscofrpcnsart,ninurrncc.!sreqlircdhySccrion.lTlDotrh.liborC.dc-turhcFrfonna,ccof
<br />rhc work lorwlri.hthis Fnnil i. i*kn My workc* conf.nsution nNuranccsrtr ud p.licynumh.r{c
<br />4tiltffi,,--r,,,t'-,.,whirhrhisFrmir i\ i\\u.d.l \hrll ft, d trloyrnrr.rs in rtrym!trNr
<br />n hws of a.lifonrla- ind aarec lhrr if I should blronrc subicct ln rhc
<br />workcB s'nPcnsrrion povnionsofSNrion 3r(xj otthc tjhor Codc.I shall. forlh*ilh comnly silh thos povisions
<br />WARNIN(;: Frilurc t, KUr. {rrkcn co'np.nlrion.oEr!!c r u.lr$lul. rDn \hrll s,hjcct u cn yor t' (ri'niDrLp.nrlric\ r
<br />n) rhd con ofc.trlPcnsrr
<br />I h.rcby rfllrr undrr ll:nalry.fp.rjxry rhar I rn liccn{rl u.dcr pR,vision orChrprs 9lconntuncii8 wirh SNri,h 7fi)0)ofDivi\nr I
<br />of thc B!\i'f,\snl adasion\CoJc. trixt nry liccn\c i\ h tullior.c d cll&.l
<br />colslnlJcu0NLlll)llc_atiEllI
<br />I hcrcbydm n und* Fnrlryofp.rjuryrhar rhcr is a co.nddi.n hndin8 ngcncy for rhc Ii.rform,nc. ofrh. work fttr *hth rhN p.nnn il
<br />issucd tse l097.civ c) ,
<br />sbcstos rc )val arc nor lP, tabh to rhn poj.{t.
<br />lh!! th. olnvc innxmlion iscotEt.l a8re lo conply wnh lll Cny and Coutrly
<br />al,ovc nEtrriotrL.d pmrcny for insrdn r
<br />Alpliconl or AEenl signnlum'(r\b l;:rlb.
<br />Site-Work
<br />Underground
<br />Light Standards
<br />S pas, Pool, Fountains
<br />Signs (monument)
<br />Life /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Bonding / Grounding / UFER
<br />Translormers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rouqh)
<br />Ivleler Release
<br />Rough
<br />tl
<br />FINAL tolU-ll%k+)21
<br />Notes Remarks, Etc
<br />Pole Bases
<br />Under Slab / Floor
<br />Service IVleler
<br />lJndcr'. Addrc*.
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<br />ATTUCAN1DIqI,AMIION
<br />I hdrby dfljm undcr E.alry of FrJury om ol rhc folhunrp dffhrar ions:
<br />DenDhion PcranrAstEstos Nolilictrlion Fcd.rd R.gnl,lions lTnb 4(}. Pd6l
<br />-Rcquned
<br />ktlcr of Norifi calion
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