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ELECTRICAL-INSPECTOR FECORD
<br />APPROVALS DATE ID/SIG.OWNER BUILDER DELCANAT!ON
<br />I hc..hy nrarn xndf ,.hrl(y or prrj!ry rhar I ui.xcmfl imnr lhc ConrrcroE t-iccn* Ljw for rhc tououinC r.n'n lsd.70:r1.5
<br />Dusincs anl Proacsion Codr)r Any City or (t,unly whi.h requies . !.nni! ro co.srrud, alrci inrrcvc, dcfrrish or Eplir iny
<br />(rucrurc, rrrhr to irs issu cc, alF rcqutcs lhc.ptli.atrl ior such Fflnir to lilc0 ri8ncd (alcmnl lhd hcorshc is liccnscd punulnr
<br />h rhc pmvisioni ofth. Conta.ktr\ l-ifti\ed lls (Chanrcr 9, CommenciiA wirh S..rii,n 7(Xll of Ditisjon I ol rhc Busincss .nd
<br />Pmlc$ionsCodc)orthrihcorshcis.xcnrlrthcrL.nomindrhch{risl rhc nllcecd .xcnDrion AnyviolarionofSccliotrT0ll.5hyany
<br />applicaor for a Fmir sul,jccls rhc applicanr ro acivil!.nallyolnol nrrclhln filc nundlcd dolh,s ($500).
<br />-1.
<br />!r owm of thcpreJlny, or nV cmploFcs wirh sr8.s * rhcn s,hoNF.ns0lron. prlldo ltE wdk {rt thc NMrc is ml
<br />inlcndcd orofltrcd lbr *lc (Sa.7o14. Busnrs rnd P,or'csions Codc Ihc Co ra.tols Licetrsc Law dcs not spplt ro !n owncr oi
<br />rh. pmFny who hiltr or i'rqr)ws dmtr Md wh dm {ci *)d( nimsclf or hcklf dr rhdu8h hh or hcr own cmfloyccs.
<br />ptulidcd thar suci impmrcmtrrs m mr inrcndcd o, olilNd fo. $h ll houcvcr rhc tDiklir8 or nlrl)rcvcmnr t $ld wirhin orc ycr
<br />or conll]krbn. thc O*rcr Buildcr will nlr rtr tur'lcn ol rmvinB rhd hc or $c dil mr hiti or nlnmrc thc pruFny aor rlt pull'c ol
<br />-
<br />l. as owncr oi rhc pmFny. nn crclusiuly conrrktin8 wnh licctr*d conrm.r.s r0 connrucr rh Dmjct (Scc '7044. Busimss
<br />,M P$fe.rirnCod.:'IhcConrrdoa\l-i..n\clisdoctnorlpplyt,aaosncrofpropcnyehohoiklsori'nF)vc\rhcrco,
<br />and who conlroclsl'o.sucht'mjcctswnh.Contmcrois)lic.tr*d pusnr r.rhrconrrtolsLiccnsc lra).
<br />-l
<br />rmcxcn,pr utulcr Sccrion-. I & P C ntr lhh rerson
<br />Irale Ovner
<br />TOAXIBII:AMIENSAIION
<br />DETLAXAIIIA
<br />I turchy,iltm undcr r,rDully ol pcrju y onc oi lhc nnhsirB de.hrnri,rrsl
<br />I h,v. Dftlsill mrioirinaCcnificareofCon{.r to Scla lnntre for wortcr'compcn\aiiinr. a\ polidcd t{, by s&ri.n.]?(xl olrhc
<br />bh,Gnc- tu rhc Dcrtormnccoflhc work for which lh.naml n issucd.
<br />Y*r rtrd will 'nriflIn worlc* conrlrn\rriotr i'rsurancc. a\ rcqunrd hr"Sc.ri :lTlnofrhc Lnbor C.do. forrlt Nrioiimk.of
<br />for shi.hrhi\ l.rnir is i$!.d Myqoilcn onlpcn$rnr in\ tr rancc .,rid ,nl Flic, nx rbci m:
<br />A,btri-raa^o
<br />a2A
<br />l.cnifyrhar inrhcFrf.rnunccofrh. work for $hich rhis p.nnir i\ issucd.l \hrll or rmplotant p.son inanylMnncr
<br />s' r\lo becom suhicr lo lhc wo*6s omncnslrnn laqs ofCrliroh'r. and aarcc thd ifl *ould tcconrc suhrrl lo rtr
<br />warkcr comFtrsolion tovnionsofSccrion lrmolihc btnr Codc.l shall. fonhwith conrply wirh lh.E prorisioni.
<br />(irl fi r\ r0 r. ,
<br />'c hdi,lrcJrh,,d\J 'Js-,,". nrh,tr . rrE-,h,tr -h-{
<br />,,.e: c/telL
<br />hall \uhJ.rr Jtr c ,thycr k, dnninrl lrmlri\ and-
<br />darug.s as pmvidcd for rhc
<br />I hrEh, rinn undcr pcnlhyofpcrjury rh.r I um lien{n Chrprcr 9(.onnxncing sirh Sccrirn 7flX)) ofDivrn,n:l
<br />ol lhc Busincs 0nd Prelcssions Codc. dt nry licc$c h in full n".c,rxr cllcct
<br />C
<br />-L
<br />r41-)67'6 /e ry4
<br />I hethy ofirnundcr pcnallyofpcrjurr rhar lhcrc h a conslrucliol
<br />ksucd (Scc.3097, Civ. C ).
<br />r8cn(y br rl[ Itrlnnnrncc ol rhc s.rk l(r shi.h rhis r^-i!trir i\
<br />AfELICANLDICI,AAAID!
<br />I hsrty ufm under pcnllly ofF.jury ooc oalhe fo,lowin3 dcclaroliotrs
<br />Dcnnnilion Pcrmils.Asb.nos Nolifi.nrion Fcdcrll Rc8ularions (Tirlc40. Pdt6)
<br />-ltcqutcd
<br />Lcrrcr ol Norif orhn
<br />I c.n ify r hrr rhc r.Jcrrl rcgu l ri{'n\ rcBuni'U a\hcno\ rcnr)vrlarc mr xpnlic$1. b ihi\ prujccr
<br />W.n,',,,,"n is conccr.I rgN b..nDly wirh allCilyand Counry
<br />firvc aEnlinmd froFny ftr
<br />,'\ppliconl or Ag€nl Si8n.lurc
<br />'*'*^*'-:,".,':u;f;-
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fi re Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Groundinq / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />lqof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soflit Rouoh
<br />Ceilings (T-Bar Rough)
<br />Meter Belease
<br />Rough
<br />FINAL r-5t-fQ'\M-{xL)
<br />Notes, Remarks, Etc.v
<br />COMMENTS
<br />Service [r]eter
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