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ELECTRICAL-INSPECTOR RECORD <br />COMMENTSID/SIG.APPROVALS DATE <br />Site-Work <br />Unde round <br />Pole Bases <br />Li ht Standards <br />Pool FountainsSs <br />monumentSins <br />Lile Safe /Low Volta <br />Fire Alarm / Dam ers <br />Communications Cable <br />Buildin <br />Under Slab / Floor <br />/ Groundin / UFERBondin <br />Transformers <br />Tor uern <br />Sub-Panels <br />Air Conditioners <br />Roof To E UI ment <br />Factor Wired Unit <br />Walls Conduit <br />Walls Rou h <br />Ceilin hSHard & Soflit Rou <br />-Bar Rou hCeilinS <br />lVleter Release <br />Rou h <br />Service Meter <br />I e-1FINAL <br />Notes, Remarks Etc. <br />()t!NtiR Btrlt.DliR I)EL(:.1RA fl()N <br />I hcrehy offirm undcr t.Mll, or Frlury rhar I ai cx.mpr fbm rh. C(,nr(tn t-i.cnsc Law tor $c follo*ios n'Fi rs( 7n1l 5 <br />BNnrcs ,tu Pmtc$ion Codc) Any Ciry or Counly which rcquirs a Fiinir lo co.rr cr' lltn. inlpmlc dcnDlhh 'tr rcllrn rnv <br />irucrurc, prior b iG n\uarcc. !l{o r.quicslhc alplicdr lor suchFrnir lo ile a \igncd s cmnr rhd trorshe ir lrctrsd pu6!a r <br />lorh€pr.v(ioNol'lhcConhdorst-iccn\.dL.w(ChoPrcrg.Commcein8wnhScclidnTuDolDivhn'nlofrhcBnsircsmd <br />prnfcssidscodc)ortharhcorshcisexcmprthcrcfnmandrh.tusniorlhcrllcScdciemfltrn. AnyviohrionolsccrionT0ll 5hyany <br />orlli.rnr n ! |armir subFch lhc ryplicanr lo a ciril Nntrxy or not mrre rh,n fivc hd drcd dollor l$5{D) <br />-t. <br />,r oNrcr of rhe lmlrdy, or ny .f,plo)ccs Nilh w,s.i .s rhcn v'b co rFnroiion $ill '!o rhc $rtrk nnd lhc slrxrm i\ mr <br />i;hftd ". .fi...d rm s;h (ac. ?(I.4. BNi;cs and PtorcsioN col. rhc conklchr's Liccnsc lrw &cs nor lpt'lv tun o-nc' or <br />rhc rmpcny *ho hild\.t i'qnNs ficmn. srd who de\ s$h *o* hnneltor hc.{llor thnu8h hn or hcr'wn cnrdovecs' <br />p,"iru"a rrrur *.t' ihphrmris m ( i Mde{ n ofrcrcd ror $h. ll hoscvs. rk huiklins or inpmrcEnt is g'n wilhi' otu )trt <br />;fco.{rLrion.rhrOwrcrSuiklqwillhDkrtrbudcnofrmvinarhdhcor\hcdid ol buikl or inln'w rhc Dml'cn, for Itu fdrPr'f <br />l.soqnsolrhefl.rcny..'nctlxsivclyconlra.rin!wnhliccnscdconimcxn\rocunsrru'llhcpn&cl(Scc704{ltu\im$ <br />ond Prr$si,n codc: ih; c;ikrlols Liccnsc La{ des nor sPlrlvro !n owncr ofF olcnv sho builds or in$nrvcs lncrcoi' <br />nd who.onlnckrorsuchfnje.rswilhdConlrkro(s)lic.trscdPo^Mnrk,theC'ntido'sLiccnrtrq) <br />-l <br />am crcmpl ondcr S.clion- <br />Drr.: <br />loltrEBllcoMtEsarloN <br />DECI48AITAN <br />I h.rcby affim undq p.Nll, of pctjury om of lhc folk,win8 ddl,r,rhtrsl <br />lhavc&dwitlminloinaCcnirrlrcofConscnrbselflnsurcto,wotkss@nllx'{lion'0sFovidcdforbrSccrion]7fi}6rrhc <br />hbor Gdq for rhe Frlormnc. or rhe mrt for {hich rh. p.mir is issn d. <br />lhavcnndvillroinrainworkcrlconFB'lionins!6k..8'.quircdbysNlion]70ooflh.bbo'c.d.'lorlncp.rformftcof <br />insuramc ctricr at lni.ynuflhcr !rc: <br />tlo3 -11? <br />I.c ifyrhrlioihcp.rfonMncd.frhcNotklor*hichrhFJtrn'ir ^ F\ucJ.Id''lli'{ 'nlnlo} <br />riynseninrnyrninncr <br />v, rnt-.mut'p.irrt, s rlns,mmPcn\Jrnn hw' nrCrl'rrlnd. Jnd s!fr rh. rfl 'hrrld trrotrr 'uhjnr'orhc <br />!o c.\'co'npctrs.rionpmvtionsolsecrion3?uJolrhcljtrtcdlc.lshsll r.nh$irh 3'nplv wnh rkxd lr risions <br />TVARNINC: fritur. h scurc work.tr .urr|xn\dtun .ovcnSc h !i kDcr lo oi n rl fnrlrid\ nnd <br />.ivil 6Ns up h onc hundred rhousa dolllr\ {$l(x) (xx) <br />sc.riotr 3076 ofrhc titnr Codc. inr.rc( nnd arkr.y's ltcs <br />',,,", b/a;/r <br />DECL{NATION <br />lheEhtultilmundgFn,xyol,Pcrjlrylhall0mlienqlund.rlmvisnlnofchlPtct9(om'kncinssilhscclionT(x)o)',rD'ikion] <br />.r lhc Bu\inc* ind Pmfc*ions Codc. ond nry ii..ns is in aull nncc,rnclfNr <br />GL 7 <br />,^" .4-2,f=i I <br />laNs]&q ANINNDINC.ACINCT <br />I hcrhy rflirn undcr Fnilty of Pcrury I har lh; h, cdNrddio. lcndins d8ctrcv fi, rh' Fdormancc orrhc wort r'r *hichlhi\ I.mir ir <br />is{,cd (Sc.. 1097. Civ C ). <br />DcnNliriiD PcnnirrA\h.{o. Norilicri.n Fcdcrl Rcgultrti{rn\ <br />Rcqrird t^xcr ol Norifi .iri.n <br />l.c il.v rhxr ihc l.{lcr{l rtStrhri( \ <br />.cnif, rhrr lhr\c rcrl rhi\rt iq,l! sirh allcrly rnd Cru y <br />oitliran.csr Srrrcl-tusrc frhis c y itrd Counrylo cnr.r rF rh( <br />t+06 <br />7.17r2 <br />trilo,' <br />I cnd.r'r Nrft' <br />APPI I(]ANTDD(]I ARA1ION <br />Ikchy rmnnundcr p.mhyol lErjlry onc.frhc iollo*ins {l..lirirn'n\: <br />'6-^s7r