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APPROVALS DATE ID/SIG.COMMENTS
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Salet y /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bondin g/Grounding/UFER gtr)?r?
<br />Transformers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rouoh
<br />Ceilings (T-Bar Rouqh)
<br />A
<br />Rough e-291y v.vh.d
<br />Service Meter
<br />FINAL s-29-tV VtLld
<br />Notes, Remarks, Etc UU
<br />OWNER BUILDI,R DELCAN"{TION
<br />I hercby ,rrm uhdcr p.ndry or p.rjury lhd I d cicmrr riom rhc G,nrmcroB Licensc tiw lor rhe tollo*ins Esv,n (ss 7031.5
<br />Btsinc$ snd Pn,fesion Cdc) An) Cily or Coutrry whi.h ..rtuncs a Frnrir Ir) .onstdcr, alt.., nnprorc. {,crclish nr rc03n atry
<br />srtucrum, Plbr r. iri nsuatu.. rl{ rcqun s rhc ,rplicant for suh pc.nr ro nle a si8red surcnrcnr rhar h. or shc licen*d pusurnr
<br />ro rhe pNvisnrns of thc Contmclor's Liccnscd L.w (Choprcr 9. Conmcn.nrB vith Scclion ?otx) ol Diviion 3 oflhc Busine$ snd
<br />Piolcsi(NCod.)orrhdrhcor\h.ndcmprrhcrcnonrondrhclxshforlhculkscdcxcryrion.AnyviohrionofScrionT0ll5byany
<br />lppli.rnr roraFmir sxbj.crsrh. rmli.,nr r. acivilp€nalrrofnol mrcthan filc hunded dolh. ( $500).
<br />*;:;oknDr ofrh. F,!cny. or my cn'floyccs,irh u8cs rs rhct snc $nncNdi,rr. +illdo rh. sort onl rhc (elurc is nol
<br />oro,turcd for sL lSN.7U{4, Burin sc dtul Proltssions Cnic -fhc Conra.nn \ I-tcn\c Ir* dr{\ tun ryf,ly rJ an uwNr ol
<br />rhc pDncny {tb builds or im,mrcs rhcNr at vho drs rNh kir* hinMlf or hcrsclior lhmuBh hn or hcr owncmplolccs.
<br />,rrovidcd rhrr st.h impmvcmnk m nor inr€nLd or olitEd 16r $h. lt hourEr rhc building or inDmvcflrfi h sokl wirhin onc ro
<br />of.ofrphrin rhc O*ncr Buildcr *ill hlw llE ttrrdcn of pmving rh{ h. or shc dil mr huit or in{(*r thc l)n)Fny fttr rhc nuqns of
<br />l. \otrmr.r'hcpn,I.ny.n .r.lusirtly..ntKii,r! $irh licen\cnconrrxcb^bcoi{tucr rhc p(),ccr (s& 7(}rJ, Bn\inrs
<br />uxl lti,icssio, Codc lhcConrrrclolsLiccnscLDwdocsnoraflrlyro osncrorpn)Fnywhohuikkori'ntrovcslhcrcotr.
<br />rtrd who co.rrich r(tr s&h pn,jNh wirhrConhrxn(s) licenscdpu^uinr rorhcConrrdor'\ l.iccn\c l-u*)
<br />I '<-PTz"Lka
<br />DICLABAIII.IN
<br />I hcrchyllinmundcr!.nrllyof pcdlryoncofrhcrbllowinSdccl dioN:
<br />-l
<br />hrtad will minllin a Ccnincatc ol Conr lo Sclf.ln\urc ror wo'kds conqrcnslion.0s nrovidcdlorhySNri.n1700oflhc
<br />hbor (ndc. for thc lcrlbrmrmc ofrhc w.rk fo. whi.h rhc p.rmn il issucd
<br />I hrrc rnd*illnBintrin *.rkera compcnsarior insurnncc. !s rc{tund hyScdi.n.l?(xrorlhc Lahor Codc. li)r rhe Frf.nmncc ol
<br />rh. lork lbr whichrhs pcnnil i\ tsu.d My wortcrr conrt--nsrri({ nsunnrccrris. Fni.y Nnrbs r.
<br />PnlryNumbn- trl'rc\
<br />Vccd'b rhd
<br />'n,he ntrli''tuilc "rrhr srrl n{ \hi.h rh's r.m'i n r\ucd. rlharrnorcDrpk,y rny p.Nnr rn rny mncr(:,\if6io
<br />",uhlc.r hrht tr oAc^' c.n'tcn{irr rr L*\. rc.'l,hln'r. un,lrsN rr. rlI.thuk }rc.rm.uhrccr r.rhr
<br />wort.s .onrprn{(ionpmvisionsolScdn'n37(xJolrhc LnhnC.dc. I shrll h$irh conrply s,ilI llu\c |nrvi\iox
<br />IY,\RNIN(; Iixilurc k, \.curc *orl(l^ (onlrn\]li{n, .olc'rgc i\ trnL\f
<br />.lvil tur\ !F n, onc hr drcd lhou\rid
<br />zc,!V-noo,,
<br />L&MiU!aNTAA(1AA
<br />l2[!IdBdrIoN
<br />I hcrbr rl1]!, undc. pcnahyolpcrjury rlur I trm licosc(lundcr lmrisi(nr ol'Clnpr.r I
<br />ol thc Busiric$a Pr'lc$ions Codc.0nl nry li.c sc is nr fullhrc.nMcllNr
<br />Contdtiorl
<br />IONIIIBUEI]OIIENI)INI;-AIiIICI
<br />I h.rch, lrfirm undcr Fulr, ol pcljury ri rh.rc is a con\trucrirn Icndins lscnc, fu rhc lr.rrolru.c. .l rh. *ok r.r shih rhis l.rnir is
<br />issucd (Scc -1017. Ci! C ).
<br />AfIUCANLDECI.AXAIIIJN
<br />I ho$, anim udcr pcnalty oI rdr ry oe 6r rhc lbllo*ins d(hrut ions
<br />Dcmlirn,. Pcrnih'Asbcsros Nolilicllion lcdcrol RcBuhlions Ont 40, PanO)
<br />-R.q!iEn
<br />bttcr of Norifrarin
<br />-l
<br />ccnilrrhir rhc icdcral rc8ullri{n'\ r.ludin8 a\h.{o\ rcmrvrlxrc nor rnfll.rl,lc k) ihi\ nnjrcr
<br />mli..:ll*l I tuvrtu,l rhnrtlnli.rri(,r i\comd I rgre ro.onrly with 6ll Cityand County
<br />,cF.*nrnriws otrhis Cnyand Counrt lo cnrs ulrn ur
<br />Jk,vc nEnli(,ncd pmpcny
<br />Applicnnt nr Aeent Sigtrstrm
<br />r"*iI* ,"*" rpa'o,K G\/ J t
<br />*,"'@elk'
<br />ELECTRICAL.INSPECTOR RECORD
<br />Site-Work
<br />lvleter Release
<br />Lrnd.l' Addrcs
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