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ELECTRICAL.INSPECTOR HECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DDLCARATION <br />I hcrcb! rnrn undcr p.mlly of Frjury rh8l I m cxodpr ftonr thc Conhcro^ Lic.nsc trw ror rh. rolhwinB rcahn (S.c.7011.5 <br />Susitrcs rn Profc$io. Codc): Any Cily or Counly which rcquncs r lEnnil lo onslr€1. !hr. itrq)mve- &mlth or qat !n, <br />srocrurc, Fior ro irs issurNe. rlso ,cqlircs rhc applicanr for such Fn.ir ro file ! sistud {arcmnr rhlr he or snc ir li...scd puNdnr <br />to lhc pmvnions oi ll* Conlmlols Lic€nscd t w (Cn0plcr 9. Co'mcncin8 with Sc.rion ?m0 of Division 3 of rhc Busincs and <br />Pron$ionsCodc)orlh{l hcorshc Lscien{rr thcrcfromand th. bnsG forthclllc8cdcxcmplion AnrviohlionoaSErhiT0.ll5hya.y <br />U*;'ffi -ffi;ilffi ;ffiffi *':::I;xilni.,'.", <br />thc DmlEny who hoildsor inrprores thm,n. { wtr) dNs su.h w)rk himsclf or h.rclf or rhmuSh his or hcr own .nrph}rcs. <br />provid.drhar such impnrkmnk m nn inrcndcd or oficEd fo, sh. It ho*cs, rlE lxildins o. nnpnumnl ir $ld *irhin orc rr <br />ofcoq'trion. rhc O*ncr Blihs will havc lnc hld.tr of lnoviry lh.l nc or shc dA nol build or in{n.rc rhc popeny for rlt puq-s of <br />-1.!sowncrorrhcr.pcny.a <br />cxclusivcl! conthcrir8 wirh li.cns.d.ont(hsro.onsr cttrElojct(S.c ?044. Busincs <br />rnd hJli\\i Codc lhc Conractn s t-iccn\: llw docs mr oflrlyro !noqncrolrop.rrysho l,uildr or imFov.\ rhcrcon, <br />und who.onrmdrrorsnchprerclswirhaGntmcro(rli.cn$dpunurntk'rhcConrDcroisLi.cnscLns). <br />;:-fo\'ir\ry <br />I hd.br_ dffir r dr ljlnrlrtofp.rjuryonrofrhr folk,wins dcrlrrrton\ <br />I hrv.rid s ill mri'rrd r Ccniin nrc rf Coi{nr t) Sclf ln\urc f{tr qo'kcrr c..rNn\rri( , r\ pn)rnhd frr <br />Lthin Codc.li,r(hc pcnni,nan.cofrhe $.rk nrshich rhc t^-nnir i\ i\sucd <br />- <br />l hivc ond s ill miin(rin wortcn conpcnsalion iNunmc. as rcquncd hy Sccli.n 3700 oI rhc lihor Codc. tu rhe dnntuncc uf <br />rhc work rbr *,hich Ihn pcmit i\ nsucd My w.rkcr' c.mFnsar ion imumtrcc oricr rld Flicy nunrlEr m: <br />.Pnliq \un$.r: <br />-l.rrK <br />/hril"r,^, . "" n.*",** " * *l t . **t ,hii Frmi, h hsocd. I sharr no, .rproy ony pcren in any manrcr <br />fa {. h t mm $hrd h rh. "ortc^ cnmllcnrarnn laws of C.liron 0. .trd r8e lhal if I shuld lEco,rc subi.r lo rrt <br />/F" fl s, mmFnsri"n nrc, i' rn\ ot S(hon 3 iOO.l lhc Latnr Codc. I .hsll. fonhwirh conn,y wilh I hoy rn r ni,,.\ilVwlnirnO' luit,* ,n o* wurkcF comncn\arnn colcra8c t unhetul. and shall \ubjecr s Edplor€r r. dininal Fn,hhs rnd <br />civil fines ut t' orc hutu lhou{.nd dollnm (Slu),fix)). nr ddirbn ro rhc co\r .rconrpcnslrion- danrs$ as [ovidcd tor lh. <br />I hcrcIy rllnorundcr pctrnlry.f txljury rh0r I rm li.ctr{d und.r t .iChrpicr9(.ommmin3wilh <br />qANiIAUCUONJ.ENDINqSCIN!.I <br />I hcrchyrtirmutucr p.n.hyoIpcrjurylh.l lhcrc h trconsrruclrn hfldir8l8cncy l lhc pcrtonnancc . a I hc w.* r(n whihrhi\ tErmn h <br />issxcd (sd.1097, civ. c ) <br />ATTLICAII.IDCI.AMIION <br />I hdrby afllmr und.r p.n,lly olp.rjury onc ofthc rolbsinS dcckrarbns: <br />D.m,lirio. Pernir3 AslE{os N.rifi.dion F.d.ral R.gnlarions (Tirl.:10. Pd6) <br />-Rcquird <br />t ll.r ol NolifEalbn <br />m*;- <br />at rhc ltdcralrc8uhlions rcEarding ash({os rcnNvrl rrc nolrppli.rhlc t, rhn !tur{r <br />lhnrc'c rlrhisnt)t r.trfoi d srrrc rlrrrl'c ixrr i',n is roftccl I aPre lo omnly <br />dc l-ra\ rul ingkrbnildirE rq'rcscnralivcs or rm Cn, <br />rlnrc frnrtr)ncd |x)t.ny l,n i'rspccri(trr <br />\Dpliutrr,tr,\,r.nr \ilnarurr <br />tiJ <br />;TirW*" <br />Site-Work <br />Underground <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Si gns (monument) <br />Lile Safety /Low Voltaqe <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bonding / Grounding / UFER <br />Transformers <br />Torqueing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soff it Rouoh <br />Ceilings (T-Bar Rouoh) <br />lt/eter Release <br />Rough <br />Service lt/eter c -// <br />FINAL b f/xh '[r1-t - <br />Notes Remarks, Etc <br />ol rhc Bu\incs a.J Profcsions Codc, rd nrrliccn\c is in iullaor.c rtolcfl.rr