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ELECTRICAL-INSPECTOR RECOHD
<br />COMMENTSDATE
<br />Site-Work
<br />Under round
<br />Pole Bases
<br />Li ht Standards
<br />S FountainsASPool
<br />Si NS monument
<br />Lile Salet /Low Volta e
<br />Under Slab / Floor
<br />/ Groundin / UFERBondin
<br />Translormers
<br />To ueln
<br />Sub-Panels
<br />Rool To ut mentE
<br />Facto Wired Unit
<br />Walls Conduit
<br />Walls Rou h
<br />Hard & Soffit Rou hCeilin
<br />Ivleter Release
<br />I LBouh
<br />Service lvleter
<br />FINAL
<br />Notes, Remarks Etc
<br />l)$ N!:R Bt n,I)rR DEl,l .{R,\ l l(}N
<br />I hcrcby !ii[m !.d.r !..dly or p.tjuty lh.l I m cicnlr fmnr rh. Conhdon Ltcn\e Lj* for lhc tollowi'8 rcasn (s( 7]l I 5
<br />Businc$ ad hor.ssiotr Code): Any Cil, or Counly whi:h r.quncs a Fmil lo con(d'r' dlct. imtrov' dcmlish "r tul,n otrv
<br />siocr!,c,tiortonsissumc.alsorcquiesrh.lPplic$llorsuchlEnnilrofilcosisd$trcmnrlhsrtEorsncisliccn*dpuruanl
<br />to ihc povhions ofuh. conlmcrolr Li...$d L,w (Chtrr.r 9. c.mmncing wnh Sccrn'n TlXn of Division I o' th' Bu\in'* nnd
<br />Prcacsionscod!)orrhlrhcorshehcxcrlplrheetsonrndrlrhoshfdrhcdkedcrc'nrrionAnvriolarionolssrionT0'll5bvlny
<br />aprlicrnl for r pcrnir rubjcck lh€ apPli.anl x, trcivilpcnulryotn.r mrclhd tlvc hundrcddollds($50o)
<br />-1.
<br />a\ oqncr ol lhc propcnr. or my cnPloltcl *irh v4cs as rhcn sh comrcnslrn r. will do thc w"k dt lhc srndm k n'
<br />inreidcd ororcrcd ftr slc iid.7oi4, Busincs,nd Prcfcssn,ns c.dc rhc conlBcttr s Liccnt Llw docs nor lPllv ro nn owmr or
<br />th. tmtEny sk) t{ikrs oi in{mEs rhedin. tfll who dNs sch w.* himscliorhfiPlfor lhrcu3h his orhcro{n 'q)lo}tc\'p",rt.O rrru ,u.rr impmh'Bns m mr inrcfrLd .r ofrctcd for $lc !t howcrcr. fic hlitlin3 tr iqmrtft k stl *irhin orc )ts
<br />;a$mplcrbtr lhc OwE Bnind will hre tlr burdcn or Pmvins rh,r rr or she did br boild or imomrc r lmlElv ror rhc rdrl'E o'
<br />t. $ owncr ol rhe F,p.ny. om .xcl siv.ly snlEdiry sirh li..nsd conrrrrDn ro conslo.r rr' pmi\t (Ss 7044 Bu\ifts
<br />n rnrfcsi, c.dc ihc conrractor s Liccn$ l,ue dms mr .mlv r. a. owtrcr of Por.dv who tuilds or imrovca rhcrcon'
<br />and who conlmch for snch pojErs qnh a Conhdo(9 licciscd pusuanl h rh. Contmcror'r Liccnsc LivI
<br />I r cxcDrpl undcr Se.r ,.ll & PC ntrrhi\ rcr$r
<br />WORT(F I{S' COMPENSAT'ION
<br />D&CLABAIIA!
<br />I hdrby .lfim undcr Fnalty ot p€rrury on ol dc lollowinB d(ldtlions:
<br />lh'!c'rnuillminlain"ccniltllc.tcotr*roscllln{rcforrorl.cR'c.D.nsalio..!!pmvid.dforbyselion:]7fi)oflhc
<br />Labo, Cod.. ln lh. rcrfo,]1ec of lh. {ork tor wnth lhc Pcmir it issu.n.
<br />I h0vc od will tui.(,in w.,te6 compcnsarion insu6nc€ as (auired bv S.dion l?00 of th' bbor @c for lfic Frrorromc of
<br />rhc work ntr *[ic\rhn pcnnil
<br />I eniiy lhar in rhc !fiformne orlh. wort fot sni.h this pcmil k irsncd. I shrll nor cmllovanv pcNn n rtrvnrnmr
<br />g, s ro lf.om $blcci re rrr wortcF ahFnslion Io{s of Clliromi, .nd lsEc rhal if I slnlld hccom subicr to rtE
<br />woltc*'sft!.nsarionpDvisionsotseclio.lTcroollhcLltqCod..lslEll-fonhwilhsmplvsnhrho$lmlnnrnJ"
<br />WA[NIN(;:F lurcloecurcworlc^.{mpcns,lion.ovcBscirunlaqtul.tridshallsuhj'rrdcmPlovc!rooininal|tnalricsnflt
<br />civilfincsUploorchl.d'.dlhousanddolles(slm.ooo)-incddilioarolh..onof.oarltngtion.daroBcssslnlvid.dlorlhc
<br />s.i'on ,ur6 ofrhc litur codc.,nrcrq rt flrormy . l(.
<br />Dal.:- APPlldl:
<br />, rcr,,rscnt r,rrucron.-
<br />DECIASAI]AN
<br />lhcrcbyafftrmundcrpcnoll!ofp.ljurylhlrI!6lienldundcrpmlisidoofchlPrcr9(fumEmin8*ilhs.clion7000).fDivtnln]]
<br />or rh. Busincs lnd PDrdsions Codc. sd fty li..trrc is in Iull loEs d'd etfccr
<br />6 7
<br />""," bvq ?4\g """,^"",,
<br />CONSTRII(:TION LENDIN(] A(;ENCY
<br />lhcrchyoffiimtrndcllcnallyol.Pcaurylhullhgci*,.onnruclionlcdingaSencyf.rlhcpc'foi|lunccofthc{orkfdwhichliirpcnnilh
<br />i*ucd (scc 1097.Ci!. C )
<br />t ndclsNa'm:
<br />I rnJc,s 4.ldic{
<br />ATILICAIILDIEUBAIIA!
<br />I lEL.t y dnnn uMcr Fnalr, oflf,rluty orc ol'rh. ftnb*nrg dslnationrl
<br />o.ftriiion Pcirni( Arb.{os Noriticariotr rcdcrul Rcsublnrnx (Tirlc40. Pd6)
<br />Rcqnircd lrtrcr of Nolifsrtnr
<br />-l
<br />c.difyrh nrc &trulrcguluions Egudina .shc(ol rctrnrrl nrc tror 0pPlioblcn) lhis Prol'cr
<br />I.crily rhnr lhxrc rcnJ rhk aaPl
<br />oldnDncc\ rtrd Srtrlc t]ssrtxrirrg lo
<br />icrrnrn,i{dlclhxrrhcnh,vcirrlonnrri{,ri\.on..l.Ir!r(k,.onlplvsiihrllCirlrodCoutrr!
<br />rucrbn, lnd krcbyrulhoriz. toIrcsctrldi!$ oarhn Cilv und Counr, to.nrn uPotr thc
<br />,tbvc nr nned ln,|]{ny for in
<br />A pplicanl or Alol SlCmtuE:-,",twl1ng
<br />ID/SIG.APPROVALS
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Air Conditioners
<br />Ceilinos (T-Bar Rouqh)
<br />T 1,\{<t
<br />:fitr{
<br />I
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