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ELECTRICAL-INSPECTOR RECORD APPROVALS DATE ID/SIG COMMENTS OWNER BUILD'.R DEI{ARATION I lE hr .rm un& Fslly of Fju.y thd I o .ropt tln rh. Conl[clm L..M t w aor rlE folh*ir8 t6n (S-.mll.5 Bs'.* &'d P,okbn Co&): Any Cny or Coulry rtih r.qui6 ! Fnn b @'dnEr, .lrs. irFove daF[tn or're.r @y itu<rc Fn. ro il' iruaq rlo Gtuis rh. ltlasr tor rNh Fnn ro 6L . 3bi.d nn.rEn Or lE or dr b li.6.d FElr ro rlE FlvirbB of $. Conr,rrdi Liau.d t w lor9lq L ComdirS $nh Sdbn 7000 ot Divirion I of rlE &!ils ed PrefsrN Co<l)d rhrr lEd JE a d6rB rha.rrom rd rbcitturlEdhcdadFbn Anr vbLrbn otsarDn 7011.5 by &y .ppli.dfor.Fnirubi<r.th..rplic.,rro.ollp.olyofmrmrcdtufi(huld.ddollrB(1t00) _1, . o|e olrhc FoFry. @ o, anph'6 wnh *!s6 s lh.n $t onFBiio'i. *ill dr rlr rql rn llt nnti@ i! @i lndrlal or otrdrd for $L (Sa.r04.4, Usin6 dd Pr.fdio6 Cod. Tn Co, r..lq r Lt@ Lr* 66 mr ?ply l. e orE of rh. FFry who hririh or ihFo6r,E6( lrd*ho d6uh K hiro.lf or ha*lfo' rhrcush hq or hs om @pL,y6. Pmvidcd rhll $ct inFo@E e d i.no'd.d n olIsld tor sL lf. hw. $. hrildiry or ihFffil i FU vnhin orc )s ofcompkion. lh. O*E Builds will hrv. llE hmlar of FD\ing $d tE or 3lE did mt hrild or inqlv. lh. FoFly 6r tlE pup.s ot -l.60*T6 oflhc prcpsly. m qcluivcly co rdin3 rnh icaE d.oniEro6 to onnrud IE rmJd (Se 7044, tlurmB .rn [Fk]i.n Cod.: Th. Conhcroi, t-icdr tr* do6 frn .p9ly ro o o*n6 of Fopd, who boildr or inprord rn6on. !.d *ho coffrrs for s(h Fojet3 *nh i Co'{rrro(r) lk.$.d poBwr rorh.cod.rdv'r l-icoB liw) Il & l'C forlhE rar)n $O,rI(FRS' COATPENS TION DICIJAAIPI I hn.tr ,llm und6 Fdy of pdjur) oft ofl,E follo* ins &(lslrioB _l h.rr sd * ill mi' .i! ! Cqrifrnc otcoMr ro lilf-lEe fG wlqa @mp.,oiioir E Fovi.Ld to. by S.crrcn 1700 of th. tltor Cod.. lq llr Ffm of lh. srl for f,ni.h lh. Fhn i! LBu.d. I h!v. and will maimain wolt.ri comrENrion iNur.n.., 6 r.!uir.d b, Ser ion l7m of rlE t,bor (td.. for lh. Ft()lruc. ol thc $ ort aor *hich lhir pâ‚¬nit t i$.d My vorkdr compaMion iBJmc. cei6 ed polic, nuEla d.: Poli., N0mb6r_ErpiE: _l .difr rhll in rlE Ffoffi. of rhc worl for shah rht Fm n isu.d. l shau mr n phy ey Fen in ry mM s s lo bdor sbFl lo tlE wr6'orlpqea. Ls ofc.lifomiA !n {re rhr ill thuld tEom {bjal lo llE sort6' omFElrbn pro\trB orsdion l7(D of ttr Lnr code I JEIL fonh$nt onply *'rh rln- ForitioB.. WARNTNG FntE |o gu. Nrtd' @oFBrion mrsls. ir uhrtuL rlld 3n I eli(n D dphrq ro cimin.l F.rb {d rivil iin6 u9 io oc hui<h.d rnouqld dollr! (ll@.000). itr lddirion ro rh. @i ol.onF@rDi. dar.s6 a ForiLd tu rh smEn 1016 ol rrr Litor Code doq id .ndrD'. rc u(Eli!!-(oNraAqraa !!{:I48AIIAN I h6.br allr6 uidd F.alt, ofFrjury rhd I o licd*l und.r Fovi3io. ofch!p16 9 ({mMcins wnh s&1ion 7000) ofDivision 3 or lhc uNin6 erd PofdioB Codc. ud my licru ir in full forc. dd .tIâ‚¬cl co!$a!9rc!.ltlllMJcEBct I h6!ty t,lm ',r& FEXy of FJUry rllr fis! ir . odMio. ladiB .Bdy for tlr Ff(,ffi of llE u!* tu *ti} lti! FD. a ist d (se 1097. civ c ) ABIIAM.DECI.AEAUqB I h.!by !trm undd F!.n, of Fjuy o.. ollhc lollowin8 dclrd iod: D.nolition Pmir!A3b6r6 Nolifi. ion F.dd.l Rcsulrlion! {Tirlc 40, P.n6) -R.quir.d l.llaoaNotfi cdion - I cdify rhd rh. f.ddl r.SuLtioE E8a'nnrr ab.(ot rdro\.1 &. mr applicabL ro 'hii Fqat -l coril lh.l I hrc red thB lpdad@ t'd 11. lhr lh. r!ov. infondion ir cGril. I r8re to omdy snh .ll Cn} ..d Cou y oidine6 ud 516l. trs EllilA ro hlildiis co'nrucrio( .'d lscby tlnL@ rFelin6 ofrhi. Cny $d Cou,ny ro da l4.. ttE .bor. trE ion d Fopqly fd iB0arion F,FE Appli..nl or Ap6r shnnum Site-Work Underground 4/thq l8l{lov Pole Bases Li ght Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Voltage Fire Alarm / Dam pers Communications Cable Building Under Slab / Floor Bqnding / Grounding / UFER Transformers Torqueing Sub-Panels Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rough) Ceilings (Hard & Soffit Rouqh Ceilin gs (T-Bar Rough) Meter Release &ough s/,2-e /rc tu"i/.) Service Meter FINAL /t-D-/+b,, /.t Notes, Remarks, Etc Li6c CL!:-Lic@ Nufrba: - Drr. _._ Conl' cror Air Conditioners