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APPROVALS DATE ID/SIG.COMMENTS
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Sions (monument)
<br />Life Salety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Translormers
<br />Torqueinq
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rouoh)
<br />Ivleter Release
<br />Rough
<br />Service lvleter ^\FINAL L,'224,uldo\dl (vu1
<br />Notes Remarks
<br />OWNER BTM,DER T'ELCARAIION
<br />I h.rcby afllrn1u dcr Fnalry.r Frjury lh,l I dm.xctrU rnnn rhc Co tad.s l-i..ns. Law ror rhc following rcr$n (Ss.7)11.5
<br />Busincs Md ProLssiotr Codc) Any Ciry or Counly vhich rcquncs d {Ern to c.nsrrud. ahcr. improle. demlnh or Ep.t m,
<br />iocr!,c- !ftr ro irs is\usrce- al\o .cqltcs ihe arplicanr lor luch lrmir lo filc r ri8ncd surcmnr rhd lr or $. i\ Iic.nscd pursuMr
<br />to lhc pmvhion* ofllt Co.lrrctnls Liccnscd trw (Ch0pr$ 9, con.rncine wirh Scc'i.n 7u)0 ol Divhion :l ol lhc Busioc$ 0nd
<br />Plolc$ions Code) or thal hcorshc iscxcmpl rhcrcaronr ofrl rhe tnsi ior lheallc3cdcxcnDtbn. AnyriolalionofScclionT0.ll.5hrany
<br />.mlicrn' r.r a p.6n suhjck rhc ,ppliMnr ro a .ivil pe.ulry oi nor rmr rhn fivd hundftd dolldr (!50o)
<br />-1,
<br />!s .wncrolrhc prolrrly. or nryenul.yces wirh wa8cs N rhct $lc conrpensalio.. *illdo ltE work ard rhe nturE i\ rol
<br />idcflLd or oficrd for srlc (Sd.?044. Busi.cs lnd ltolcsions Codc Ific Contrckn \ l-icen* Uw dds no! .pdy k in owrcr .l
<br />rhcpmp.ny sho hrldsor inDmrcs lhcNin. rnd $ho d€s su.h sork hims.lf or hcr$llorthou8h hn or h.r own cmplorr.\.
<br />prcliddd rh,r s,ch in,r.,rftnh m rn inrc*lcd or oltmd lor srh ll lNwcwr. rbc hx ihing or irwmwnrnr k v,tl wirhin , 'nc )tr
<br />ofco,nrlcri,n. rhc O$!er Builder *ill havc rhc btrrdcn.l provin8 rhsr hc o! rhc dil not hui! o, improrc rhc lrDp.ry for rhc l),rllos ol
<br />-l
<br />amcrcmpl undcr S(lio.-. B &PC lnrrnh,clwn
<br />Orner:
<br />tlof,(ltlroltErNsA:ItoN
<br />IIiILABAIION
<br />I hcrchy ailnm un{lcr pcnrllyolpsjuD ore orlhc i.llowin8 dNlomrions:
<br />Ihr\cJxlsilln inrrin rCcnificarc ofcon\cnr ro Sclf ln\urc l{n rorks conf€n! on.rs tn,vidcd ftrbyS.cri, ]700ofrhc
<br />lf,tx,Gxlc. id rhc pcrlbnMncc of rh. soit for shi.h rhc $rnrir is i\sucd
<br />I havc dtrd willmninhir vo.kcrc.onrr.nsrrnrn nr!u6n.c. as rcquircd h! sNlbn 1700 ofrh. L.b.r Gdq t]r thc perlornEncc ol
<br />rhc sork lor whi.h rhislrrmn is isucd. Myworkcs .onrp.n$rn,r ir NU r.fcc cafticr nM policy numbs dc
<br />-l
<br />ccnify lhtrt ir lhc pcrformm. ofdc work lnr Rhich rhh p.rmi k issucd- I sh0ll nol c.rloy ony tnson in rny nranncr
<br />v, as l(, bc(m subFct lo the sortc6'compcnstion lsws orclliromia. aod asrcc rhat ifl should h€conr subjcct l" rh.
<br />workcr.oq)cnstionpn,vhionsofScclionST00olthcL,borCodc.lshrl,.Ionhwirhcnnpllviththxcprcvisions
<br />WARNING: Failurc r. *.urc w.rkcn c\,ry.Nrrn,n ..v..rsc is unh*ru| md sh,ll suhjct an cmplolcr io aimin.l Fmhics snd
<br />cilil fincs up lo onc hundrcd lhousrnd dollus ($10o.00o), in rddirioi h rhc.osr oi.ompcnsntio , donEBcs os Foviicd ror rhc
<br />Ssrion 1076 oIlhc ritnr Cdc. inlcEn 0nd lllomy s iccs.
<br />UITXSEDSTNIXAqIOB
<br />DECIAMII!]N
<br />I h.dhy a,Ij,o !.der pcnalry of p..jury rhsr I m liensd lnder rFvisio. oa Chxptcr 9 (.nmftn.ins wnh sRri]. 7000) of Divi\ion .l
<br />or rh. Slsircs afld A.fcsio.s Codc. and Dy liccn$ is in tull fore m'd cffar
<br />CONSIBIJSIIQ]iIENDINCIIiIICI
<br />I hcnby 0rfirm und.r lInlhyolFrjuryrhd $dc is r conitu.'bn Lndine dgcfty lor rhc pcrformmc oirtc nsk tor *hich rht [Emil h
<br />hsxcd (Scc :109?. Civ C.l
<br />Lf,ndsls Name
<br />-
<br />AfILICANI.!!;I;I.AAAUQ!
<br />I hdd,y,nimund$ ptn,lry oap.rjuryotrc ol'hc rouowing dcchnri.ns:
<br />Dcmolirn,n Permih Ashci'os Norifi.arn,n FcdeBl Rc8ularions (Tirlc 40. P!rr6)
<br />_R.qundd L.n.r ot Norifddon
<br />c norrytli.ahlc lo rhn pmjccl
<br />lonMrion n comcr. I aBre ro conDly * irn all Ciry rnd c{,unry
<br />scnr.tnes olrhh City rnd O'lnryb cn'.r or.n Ih
<br />t o
<br />*-*\..",,/r, Clani s 4 ,1rr
<br />c/t"/d4s--o
<br />ELECTRICAL.INSPECTOR RECORD
<br />Site-Work
<br />Sub-Panels
<br />, Etc.
<br />-1,
<br />6 owncr ol rhc !rcncnr, amcxclurivclrconr,lcrinBsirh liccnscdconrrrroFrocoidruc' rhc pmjc.r {s( 7044. BuNncs
<br />md Pibfnsirn C.dcr Th. Conrac(r's Li..n\. Lu, doe\ not,ptly ro an.uicr.fpn,Fny *ho builds oi inpr.v.s rhcrcotr.
<br />und who conba.ls lnr su.[ I,ojcch wnh r Culracton9 li.c.\.d puffirnr k, rhc Cotrlfrcktr s Liens tiw)
<br />Pol,.yNutr$.r Erpnds:
<br />Liccni.Clrssr Liccnsc Numb.r:-
<br />D.tc conim.tor
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