|
ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS ID/SIG.COMMENTS OWNER BUILDER OELCARA'IION
<br />I h€Eh, aftrn u.lcr Fn,lrt or p.rjury lhd I m cx.mt fn,m lhc Co radoF l,ic.nsc lxw ror rhc rolbwnrs rcln,n (Sa?O3l5
<br />Bu.incss rfl] Prolcssion Codc)r Any Cit, or Colnry rti.h rcqutc\ . Frmit ro consldcr. slrs. imrovt, d.mlirh ' Earn any
<br />stdcllrc. prior to ns issuurce. sl$ rcqnnca rhc amlhanr roi su.h Firnil ro 6lc 0 siSned sr emnr rhdr t or stu is li.cnkd I'usulnl
<br />ro llE pmvisions orrtE Conkrcrols Liccnsed Law (Churrq 9. C.imn.ing sith sc.lion lujo ol Division 3 ofrhc Busin.* and
<br />Pmfcssions Codc) or thot hc or shc n crcm/ rh.rcfon and rh. blsh ror thc allc8cd crcmplhn Anyviobrion.ts..rbn?031.5 $y iny
<br />applicad n{ a pemn sobjers rh. amli.am ro r .ivi I ,.Mlry ol no( uore lhrn livc hundr.d dolltr. ($50O.
<br />-1.0\oqncroiIhcpmnn!.ormy.nfk,rtuswirhw,!.sr\rhc,sncc.nwnslrion.*illd.rhcsork
<br />Jrh.{mrurcirrn
<br />inronlLi oroltc'cd fn srlc(SN.?o,!l, Bu\incs ind Pmlc$6ns aodc lh.Conrrrc(trst.ic..\ctrwdocstrordnl'lyl,'!no*rcr.f
<br />rh. Dnr*ny whohuildso!inmrcsrtr@n.adwnode\strch{tdhn.s.lroihcr*lforrluoushhnorhcr.Nncn.y..s.
<br />prolidcd rhd such inprolrmnk ft frn int.ded or oficrd f(n vL.ll tx)lc\ c.. rlE h{ill ina or impr,rcnrnr i\ $kl wirhinonc ycrr
<br />ol.onlnhri'0. rhc Owrcr Buikier *illh{w rlt hrnLnofproving rhd h. o' \hc dll nor huild o. innn)vc rhc lmtsry lor rhc purrxN. ol
<br />l. r\.wn.r orrhc |a.lxny. nncrclusivclyconr6clirs wirh liccn conrndo*h.on(rud rh. I'(+cr (sc. 7044. Bu\in.s
<br />,n.wncr oipnrpcny wlD builds or nnpi{,vc\ lhcrcotr.rD(l l\i,lisi, (inlc: lhc ahtrrrx.ktr \ l-,c!n{ t-rN doc\ nor rtp
<br />a d who .onh.rslitrru.ipn,lcclssithrConraclor(s) licc n,rh.a, rid.r'! I i..trr I lwr
<br />lrn.r.nnr u.ri.rserion B
<br />I hc'ahr rfi n r u .lcr NMhy ol Frlury oN ol rhc lnlk)\'ing dccl
<br />Ihrw! qill Enn.in ! Ccrl iarorc of Conrnr ro scll lnsurc rn sorrcN .onlrnsal ion. as povidcd au 1,, sNrn,n r7u) of lhc
<br />Lah.r C.dc. for rh. p.lfonrorc ot lhc *ort tor which rhc Fn,il i! is\ued
<br />-lhrlclnd
<br />uillnainhin sork ^ .onn ns[nr insurdncc. rs rcquircd 6ySc.ron.]7fi)ofrhc l-rborCodc. forlhc Pclfomnmrc of
<br />rh. w fir$hthrhis p.flnir ir is$dl. My workcrc' conrFnsir ion in(urMcc .aricr nnd Fnicy ntrmh(r N:
<br />I..niry rhlr ir lhclr.loir.anccollhc wort lor*hichrhis prnnir i\ irsucd.l sholl nor cmI,k,yonylc6oi in rtry nutrncr
<br />$ $ro bccoN ohJc.l t, rhc wortc^ conlpcNdnm hwr orCilifomia. aM asrcc rhd irl should tt..nr suhjccr lo lht
<br />workcrs co.,Fnn i.nrovisn,Dsof Sc.rn,n:l70Oof rhctitrtrC(I \lnll. [onhsirh conllrly *irh th.r |{ovisi,nN
<br />WARNN(i: hilorc h RUrc work r conr|{nsltn,n .nvc!
<br />civil fii.s rp ro onc huDdrcd rhousitrd dolllrs lSlm.(xXr).
<br />Sccri(nr :1076of rhc t]brCn c.inlcrc{rtrd!rlorncy slics
<br />ful. Md (hrll rubJcct !tr cnrtlnrr ro dnnird p.mllic\ rnd
<br />rJ rh..os ofconEns0rnnr. dlnuse\ as ptulidcd lor thc
<br />I hrr.by nlltr lndd tl.rlryor|crjry lhir I am liatrrn unrlc hiotrorChrpr.r9l(nnnf,n(in8*ithScclionT{XX))ol Dnisirr l
<br />of lh. Busincsslnd Pdc$n,nscodc. drl 'nyli.ctr{ n in rull hr.c ml clic.l
<br />-Liccn{
<br />Numb.r:
<br />-
<br />calirf,lJsflaM[N],uNc4ilNcr
<br />I hcrcbt 0,firn trndcr pcmlly otFrjuryrhal rh.re is a conntu.rirtri Ltrdin8 0Bcncy lor lhe Isturtun.c orrhc work for shich lnh Pcn,ir is
<br />h\ucd(SL{ 1097. Civ C I
<br />dtPLllANr.!rcLaEAIIQN
<br />I Hry dtim undcr Dcnalr y oa p€rjury ot .r rhc tulosin8 dslnr ions:
<br />Dcmlilion Pcrmils-Asbc(os Norificarirn Fcddral R.grl,rionr (Tirlc 4tr. Pan6)
<br />-Rcqlncd
<br />Lcllerof florilicdrk.
<br />l..nify rhr ih. fudcrrl tuBUlrri(ff ashc{.s rc.x,vJl rr. Dor rj,flicrhlc t) rhit |nrlcd
<br />!.cnilylhrl I havc rcldlhis trlplicnt rh rl( !h'vr i'nonmri.tr \cor.cl I rgrNl.dnnplfwirhrll C[yrtrd Cnu0ry
<br />.ilmrn.cs Md Srrrc t-rwsrchirg k)(tucrion. arxl hcrcby,!{horr. Etrcscnroliycs orrhis Ci', dnd counlyto cnls ullonlL
<br />rhnc rtrri(nrd lrt)p.ny lrr iN
<br />,\pplicnnr or ,\rcnr SiAnnlurt
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Life Salety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding i Grounding / UFER <7*/b ar EDlh,t*
<br />Transformers
<br />Torqueino
<br />Sub-Panels
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soflit Rouoh
<br />Ceilings (T-Bar Rouoh)
<br />Meter Release
<br />Rouqh
<br />Service ltileter
<br />FINAL <,/t/\t/lq s)E \t-#4
<br />Notes, Remarks, Etc
<br />DATE
<br />Air Conditioners
<br />kndd \ Addrc$.
<br />-
<br />-------T------
|