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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWNER AUILDER DELCARATION <br />I hemhy atfirh r cr FnJ(y oi tlcrjury lhnr I nn cxcmpt riom thc On actm Lh.nsc tre r rhc lollowinS tcobn (scc 70ll 5 <br />arsinc* und Pi,,rc*ion codc) Atry Ciry or c{Dnl, which requnc\ r Fnnit Io con(rud. lltcr, imProvc, d.Bri\h or mp0n otry <br />nturrurc. priorio irr isuotrcc. alv, squncs !h. rrDliranr ror \uch p.imi o nb0 siBmd sr cmnl rhar Lor sh. n li.cnscd pursuMl <br />h rhc F,virions lrhc contr&ro.s Liccnscd lrw (Chr er 9. Commencins snh s..rion 7filo ol Oivhi.n 3 olrhc Busincss and <br />Pmlcsrion\ C.d.l or rhd hc or she ircxcmrlrhcrclionrlnd rhc ha\t nr rh..llcecd cxcmplin Any violaliondrsc.rirn 70ll.5byany <br />!ppliconr tor r Il.mrit subjccrslhc apPlicani ror.ivilpchrlryol mr nMc rhnn livc huidrcd dollnr: (S500r. <br />I, N owncr or rhc pruJEdy. or my cflploFcs silh vlges us th.t {,lc comt nv iotr. *ill do th€ *or* llld rhc {turm i\ nn <br />i c c{ or olttrcd for $lc (Ss 7(}44. Busincs d.d hdisionr codc Thc Conrrclols Liccns tl* des nor lpply ro {n oNmt oi <br />rh.pn'Fnt sh) huilds or nntons fi.mn. lrd who d@s such wlt hnnsclaor hcr*lrdr rhmuSh his or hcr oun emPloycc\. <br />proridi rhar such inl'Dwrnrs m frn imcndcd oroficrtd ibr sh.lf. lrrscvcr.lh. trihing or inDmvcmnr t $lil wirhi. otu ytn <br />ofo,r{hri[ rhc O*ncr Buitlcr sill hlrt rnc hordq of l,o!i.8 Ihtrt h. or sh. dxl nor truild or imtnovc rhc ,'rlgly for rl* IjDrpo* of <br />l. \owtrdol'rhcIJr'rcny.rncxch\iv.ly..ftddg{irhli..n\cdco rndrs lo con(ru.r rhc phJccr (Scc.7(}1-l.llxsir'c$ <br />r t ltrissi)nC.lt ThcCoitd.r.as Li.cflsc l-au docs nor rDplylo !.owncrofpn)|x ysho buildror inrpmvcs ricrcon. <br />rtrd qho Nfln rrs r'or such pmic.( sirh , coihdon s) li.cn\cd tursurtrr tu lhc Qn ra.ntr s l.ic.tr{ IiN) <br />IrncicD UndcrS.ciion .B &PC lnrrhi\rcrvnr <br />lyllBtrEElila[lrENSAIIgN <br />I)E(Lt&rIlaN <br />I hcrcbyrilirnrundcr p.tr.lryolpcrjuryo tof rhcn,ll.singde'lafuri,rN <br />I hnlc frl will nEi"llir a Cen iltirc .l (uMnr b SrllrlNud tu sorkcn coDlcnsol ion, as Fovidcd tur by ssr ion 1700 o I ilE <br />Lutxtr c.J.. r(tr rhc p.rrormrcc of rhc qork for shi.h lhe Fn.n h nsuc <br />I h.v.and will mi rin sorksi conrFn\rrion insufu'x.. us rcqtrtcd ny SRr ion .l7m ol rhc I trtDr Cod.. ror rhc pcrlo.nnncc oi <br />rhc sork lnr shich l[h ri.nnil i\ hsuc{ My workcr'.oi1p.n\rrion insuiitr.ccorid x] plicynunlhcr rc:k <br />5 ()30 <br />-l.cniiylhal <br />h lhc Nrli,rtunc.ol rh. work rdNhi.h rhh lcflni n issucd.l shnll nor dmploy rny$rs,n in lnynutrncr <br />v, * t' tdr,ft srhj$r r) rhc *ode6 conlll. sllion lar'\ otcllifonil r'd ald rhar,fI stuukl b(com subjccr io rtr <br />*o*c*'corpcns,ionfmvtionsoiScclionST(xloirhcLahorC(lc-llhall.ronhqilhcorplrwilhlhoscPmvnbn\ <br />WAI{NNC: liilulc nr Ecurc Norkcn $nrt r\rrion .olcflsc is utrhwtul. lnd shall slhjccr !n cmploycL ro dnnnEl Pcollrhs (nd <br />civil !inc\ ut lo onc hundrcd lhou\rnd dollars aldirsn h thc cosr oi comncn\arn,n, damPcs as providcd hr rhc <br />scclnr 1076 of lh.litu Crxlc. inr <br />"",", -slzlt* <br />Ihcrcbyaitr!frlcrprnlxyorpcrjurtrhdIlnrliccnslundcrnovi\i.trorChrrrd9l.onnrncir8wilhSNlhnr00orofDivtio':l <br />.l rh. Ausircs ond Prolt$i,)ns Codc- tr &y liccn\c i\ in full f(rl{ dd c lINt. <br />;7 <br />I <br />I <br />hsucd lS\.'. .1097. Civ C ) <br />APIIICANfDECI.AAA.IION <br />I hry rtrm und.r penrhyof p.riury one orlh€ lolloqin8 dElanrions: <br />Dcmolirion Pcrmns Aili$os No'ilicarion Fdcal RCEU larions (Tillc tO. Pun6) <br />-Rcq!ircd <br />trrrcr ot Ndinc,iion <br />I c.nify rhrr rlr l.dcrdrc!uhtiotrs F8nrdinS rlh-(os rdr$vLrlrc tror rU,li(rhlc I' rhn nn)jccr <br />-l <br />ccniiirhd I harc rcad rhi\ tr ri(r ndinrcrhlrhcrhncrtrlornrri, i\..n..r lalr--ir(o !n,sirhtl Ciryxnd(inn v <br />ordinln.es urd Srarcl$r rcbii4r connrud ion. r,rl hcr.hy nurho,izc reFc{nuriv.\ or rhk Cjllrnd Counr} to enr$ uFrn rlt <br />trholc nrcnrionld pnrpcny ibr i <br />,\plli$ l rr Asr lSiAnsl <br />aan ?ua3c,4zl g <br />Site-Work <br />Underground <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Lile Satety /Low Voltaqe <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bonding / Groundinq / UFER <br />Transformers <br />Torqueinq <br />Sub-Panels <br />Air Conditroners <br />Rool Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilinqs (Hard & Solfit Rouoh <br />Ceilinos (T-Bar Rouqh) <br />lVleter Release <br />Rouoh <br />Service lt/leter <br />FINAL c ll0ltr 1 <br />//,{l/lk/W /6t,, <br />Notes, Remarks, Etc.v-". lL'