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ELECTRICAL]NSPECTOR RECORD
<br />DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torquing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)4t(/az-@/a,,
<br />Meter Release tl
<br />Rough tit{/(t /,t,
<br />Service Meter
<br />t lzli.ilss'FINAL lJO
<br />Notes, Remarks, Etc.
<br />U -t L)
<br />Omlr-BuildB Delddo
<br />I hcrby dfim 6.ld p.n.lry of pajury lhrl I a cx6B fm tn. C6!&los' Li@c Ln for lh. folldirs rqlon (G.70! 1.5 Buliid
<br />axl Prcfc'rion Cod.),
<br />^ry
<br />City @ C.6t, which rtquir!3 ! p..nit ro @3Eut, .lr*, i p.dc d6!Elj3h d r?.ir ey $tucturq priq ro iB
<br />i.!@cq dloEqliB th€rpolicol for ch pmit io til..riF.d rlrrand $!tl. ddE t li6r.d pll!!@t !o th. Foviriw of ln.
<br />conE&ldt Li6nsd Lu (Cn.Bd e, Cmliwinr *itt SEti6 70oo orDivirio I of th! BBitr..s lld Prcf.t'id @.) d l}l.1 h. d
<br />Eic n 66pt rnftam dd th. bais fd lhc .ll.g.d qo,rid .Any vioblio of S4tion 703 l.J by sy ippliqt f.t . Fhil tubjEtr {E
<br />rprlictnt to r civil pa&, of rot mN tha 6rc I'u&.d <bllc (1500).
<br />_I, s omcr of rh. Fop.ny, q ny @plorea with e.Bd s rh.ir slc @E FBatiq, will do rh. work bd lnc ihucr@ b nor i.t nd.d
<br />o ofed fd 3d. ( Se 70aa. BBh6 ed lrctGiont Cod.: Th. C@r&ln'i Li@sc Llw da tur .pply to s oM6 of lh. !rcFn,
<br />who blild! n iopr@q $@@, ud *to ibs luch ,6t hic.l( or h4.lf 6 drcueh his 6 na dn mpldy6, !.did.d rha &ch
<br />imFov.lrml! e not i.rod.d or ofmd fd !!1.. If, howEr, th. buildint d i pdm6t hsld wi6in @y@of cmpl.rid, th.
<br />omr-Buildd will h.vc th. hr&n of pdovins tlllt IE or rtc nol build 6 inpr@. for $. pua6. of i.l.).
<br />I, ! oMd o(th. prcrdty, o dcluiv.l, @F&titra sirt licqr.d dEtaor to cntEucr rhc p6j*t ( Se. 7044, Bqitrc &d
<br />P.of..D@ C6d.: th. ConFacrd'r Uc.@ ta d.€ ,or .pply to u o*rd ofprcpdty who buikh 6 ihpr.G d!cl@ , ed sno
<br />6h&r. fd !u.h ,f.,jeE qill r colt&to(, li@.d lIsuar t $. conEl.id! Li@r. rre.).
<br />I M .xmfl udr S*lior .B & P.C. fd lliis r6d
<br />WONXERS COMPENSAI1ON DECLAR TION
<br />I hcr.by amm undr p.ndry of pdjury M. of thc aollo*ing d.cldalions:
<br />_l haE ud viU dtjnnin t Cc.ti8qlc of Co.mr ro s.lf-h$c f6qct F'co6Fqdi6, ! ,@vi&d fff by s..ri@ 3700 of ti.
<br />rr!o. Co&, f6 l1l. Fafdrue of thc wGt for whid 6. ,anft n isucd.
<br />-urdoa *ittmintt wct<m' cmF oti6 ir@, s Equtcd by slctid 37oo ofth. !r!s cod., for rhc p.rfort6e of 6.
<br />*qk f**nioh Ihir [dmittu irsd My ak6'cmFrdtim in.uro@ *ir.rdpolicy numb e:
<br />?olis, NMtq: ExpiBl
<br />(Tnir E.1i@ rad.orh.co,n lct d irdE Fai. t 16On. hundEddoll&r {tIoo} d1.,
<br />ri.r in tnc p.rfmuc. of rhc work fo ir is!.4 I 3h6ll rcl dploy ey !6e in ey ms..r s s to
<br />.ec. lh.t if I rhould b@ft {bjcd ro lt. wut@'
<br />Seid 3700 ol tn. LEtr cod., I shrtl,
<br />lailuE ro sw wo*6' @hpcBlrid @€!Ec ii unl.wtul. sd shall iubjdt 6 dployd to 6inin l pa.lti6 ud civil
<br />6n. up [o onc [u!dr.d tbouDd dollr! (3!00,000),in dditio', ro lll. @t of coipa$.dc.r, d&i.gG ! prcvi&d fa O. S..sin !076 of
<br />6c t$d co&, irlqBr ed rtl6cy't fB
<br />LICENSED CONTRACTORS DECI^R^TION
<br />I hdcby amn ud6 ,6alry of pajury lhlr I d li6*d udr provisio of Chaptd 9 (c@!Bdng eith Scdon 7000) of Divi3ion 3 of
<br />Cod., rd hy lic6. ir in tuI, f@ d .trrr
<br />soNgElerq{!Erallq-A@ler
<br />I hrct, !trnn un tr Frllly ot pdjury thll 6d i! r c.',rEuctid ladin8 .g6cy fd th. FfolfuG of lhc srrl fe whicr, 0lit ,mir i!
<br />iscd(S*. 30r, Civ. C.).
<br />AIIPLICAT\T'S DECLAf, ATION
<br />D.dolitioo PmlE-Arbqlo. Nodnedd F.d.nl R.i !d6t (Tidc 40, P.n 6)
<br />_ R.qir.d lrt r ofNod6oli6
<br />_I 6ti9 lh.t lh. f.d6.l Esr!.tid! tct rdiir ab6ld movrl e mt ippliobl. to this Fojc.t.
<br />1{*aE t r r,.* n"a Ar rppli..ti6 {.1'l&. rh.r rh. rboE irfGd.rid is ffir.I rare ro
<br />ordindG dd S&rc L.ws EhrinE to buildin8 aunqir npllgtlliv6 olrhit
<br />aloE 'Mti@cd
<br />pr@aty for
<br />A/t tc t-tA12r_ O M.eea
<br />I
<br />APPROVALS
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