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ELECTRICAL-INSPECTOB HECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lile Satety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bondinq / Groundinq / UFER
<br />Translormers
<br />Torqueinq
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinos (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rough)
<br />It/eter Release
<br />Rough
<br />Service lvleter
<br />FINAL h/t(/ls /n ?%
<br />Notes, Remarks, Etc.
<br />OWNTJR BU'I,DER DET-CANATIoN
<br />I hcrchy arfirn uidcr p.ixlry or p.rjury rhlr I rh.x.rpr riorn rhc Contadon' Liccnsc Las for ltc fdk,wins rca$. (sd 70ll 5
<br />Bu\in s ,nd Prol.$tun CdL) Any Ciry or Coutriy which rcqrircs r ,'snrir lo con{dcr- drcr. idprov.. d.mlish or rcp,n ry
<br />{ .turc.pri roits tsurtra. oho rcquncs lhc .lplicnnl for such pcmil tr ,ilc ! siEtd nrr.mnr rhr' h.or shc is licen{d Puruanl
<br />b rnc r.olnions.t rh€ Conrra.ror's l-i.cnsd trw (Chapr.r 9, Co nrncin8 Bilh Scdbn 7otr0 ol Dilisn,n.l.rrhc Bucinc$ and
<br />Pn'r.rsn,nsCodc)orrh{ hcor shc iscxcnDr rh.rc{mmand rhc basn for lhc olLscd excnrptbn Anyviola'ion.rS.ciion703l5$yany
<br />.mlic.nr lor r Fnnir subj.cts lhc oDplicunr lo acivilpcnallyolnor nmrclhln nlc hundr.d dollrs ts5ur.
<br />_1, !r owtur olrhc tioFny. or mycnlnoFs wirh wngcs as th.k slc ..nr!cns0tlon. silldo rhc work tud rh. qrturm ( lxn
<br />iN.klcrt oroficEd ror slc (SN.7044. Buimssa Pmfcs(ions Celq fhc CodEdoi r Li.c.sc ll{ docs
<br />"or
<br />apflr ro !n orEr ot
<br />rhc nm,rn, *ho hilrs or itrqm*e dra)n, n qh, d(Es sx.h wd{ hinsclf or hcrrlr or llnugh ht tr hcr o*n cnylorc!
<br />provid.d Ihar suc[ impmrcrrcnr\rcnn i.rcnd.n orolLrcd li,r slt ll how.w.. rh. buildinS or imPmtmol t sh *irhin nc ,t,tr
<br />olconDlctiotr. rh Owncr aui8cr willhow rhc hudcn olpmvinB thd he or rhc dU no' bxild or iq)mvc $c pmFny for fic puqxx of
<br />_1. rsowncr ol rhc l.opdy. amexch\ivcly confndi'rg wirh liccn\cd co.ticr'^ t' .otrind thc Imrsr (Scc. ?O14. Bu'in.s
<br />arl l,lDf$\ion Codc: Thc c()nttr r.fs t-iccnsc Lrw docs nur rtply b M owncr ofpropcrly who huilils o' nnpnrvcs Ihcrcotr.
<br />and Bho .. rmts lor su.h proFts wirh a Conlncrq( n licctrsd luFutrnr t, rhc Contdor's l-kcnsc LaB ).
<br />lrDc:csnrutrJ.r Sccri,)n- A &PC lurrlri\r qr
<br />u].2ts-[E8!11D!!E!SlLl\llKr [aI(2!
<br />I h.rsl,\ rlli'n trf(lrr Nuhy,,1 |.Utr', o r or rlr hll,,snr! d.( r,xrinr
<br />l.rhr C,'(h. l,i rh. Brn,n Nr f f rlr \dl ln. shkl, rh. t.r n I N $0.t1
<br />(lr \!![ tur $h(h rln\ ])dn[ i\ r\{(rl Nl! trork. r .!n,rrJr ,,' ],{n.trtr. lrnL., rnlll),'l.v ! rh.r m.
<br />c.",,- 2 qn.cYt
<br />toco13o 96 oo3 _Expircs:ro.l /B
<br />-lccnilyrhlr
<br />inlhcpc trrome nl rlr work for ahich thr p$mir N is$cd. l shrll tror cnrPloy an, P.ron h a.y trnncr
<br />$ ns k, b.{.mc subjc.r to rhc w.rk rs comp.trsrtion hus.lColilo ria. and asrc rhar iiIshould h.co,m subjctr ro lhc
<br />*o rr\.ofrp..\arhnrn,visio.(ofScclionlTLt)olihctjiuCodc.lshlll.n,nhwnhconrtlyuirhrlr)cprovisions
<br />flARNINC Frilurc ro *.trrc qorkcr conrpcnsnriotr covcrrgc ir unlaNiul. rid \hrll \ubjc.r rn c rdoycr k, dinrinll Pctrrlri.\ md
<br />cieil ti cr up tr, o.. hutulrcd th.usand dollaN l$lll().lr(xr).ln r dition ro lhe con olconFNrit,i. drnr8cr rs rrovidcrl rbr lhc
<br />S..ri{r:1076 olrl[ Lhn C'(x,c, inrcrcjiMrtronry \ lcc(
<br />s/s /rY n@
<br />UCINTED-IONI8ACITf,
<br />DFCI AIATION
<br />I hcEhy.ffirn undcr pcnollyotperiury rhar I m lie.sd !.dcr Fdvi\n'n.tCnaprcr 9 (c.mmmin8 wirh Sdion 7(xI) orDivnion l
<br />6f rhc Busin.ss and P$r.ssionsCodr. tuxl my liccnsc is nr lullrorcc d{cffccr
<br />Cto C.l6 1So tyq
<br />1, ls o/rt .",r,,"r",, Suntrrrrl i'azS'ta fu
<br />I!}IIIB!]CIIONIENDINC.LAEN T
<br />lhcEbtrlfiirnuidcrp.drlrydfpcrju'tthlIrhscniconslruclionlcMin8a-sctrctlorrhcn.rn,mi.col'hcvolrfowhkhrhhFrnrili\
<br />ksrcd (Scc.309?. Civ C.)
<br />AITLIIANfI]ECIASAII!}N
<br />I rH.by,trmr undcr ,).nrrty ol,icrjury onc ofrhc followirB dalfflrionr
<br />Dcnmlirion Pcrnrirs Asb.{or Norilicoiion FcdcBl Rc8uhtions (Tillc 40- Prd6)
<br />RrqunrJ Lcncr of Norilicrrion
<br />l.caiJrrlrtri rlr l.dcrr rugtrl ri,n,\'!!r(liDgr$o(o\ronn)rxLrr. or rft) rnhlc r, rh\ nmiccl
<br />rLl.cnityrhlr I h*r rcrd rhi\ {pli..rion uld srrc lhnr lh. ahrvc in,oflMti.n is cotrccl lrsrdtuconrPly*irh0llCilyindCounry
<br />odinrrccs ind Srarc Lnss rcbring ro btriUn't n,n. md rEr.hy surhorizc rct'rcscnldiEs ofrhn Cny and Cou.ly'o cnra uron tlI
<br />ahvc rctrriotrcd pnrlcny tu insEcri.n
<br />Appli.nnl or AFenl skn6luE
<br />r,(m,ikrnnn(,,,rin,): -Da**r+ SYarrlaV
<br />*,, ;/z/ttr
<br />I
<br />Sub-Panels
<br />Air Conditioners
<br />Li..tr{ NuDhcr:
<br />I
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