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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<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 />Torqueing
<br />Sub-Panels
<br />Air Condilioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rough)
<br />Rough
<br />Service lrileter
<br />FINAL 2// v/2 bln Fl fPtoV
<br />Notes, Remarks, Etc
<br />OWN!'R BI]II,ONR DEI,C KATION
<br />I her.b) rllrm trndd tdahy of p6july rfi.l I on crempr &on rh. contdou Li.me tjw for ihc lollotr'ins r@on 15< 703 1 5
<br />Busin€ss d Prof6sion Cod.): Any Cny or Counr) which r.qulB a p6nt ro coNrrucl. all6, irnpn,vc, donolilh o! r.P3r mt
<br />slnrcruc. pnor ro irs 6sud., also r.qoir6 the applicturl ior such p€mn k' filc . sisncd slarmdl rhd h. or ste b licdsd pusudl
<br />to rhc prolisions ollnc Conrracrois l-icms.i rr* (('hal)le 9. co'nmcncinS silh Salioo 7l-r00 ol Division I oa$. BNin s and
<br />PRJa.sions Cod.)orrhal h. or she is cxe,npl ths.iiom snd lhc basis forlh.allcr.d *dnprion Any violalion oi S.nio. 701 I 5 byany
<br />applicanr for a p€mii subjErslhc aDplicanr ro rcivilPt@hyofnor nrdrclhan fiv. hundr€d dollds($t00).
<br />I. e o*nr of rh. propcnr. or nry c,nploy6 vith \ks6 6 lhcn kk co'np.hs bn. ll do rh. sotk dd thc slnrl@ ( d{
<br />inldd€d or oftscd for sle (Sd 70,14. Busoes &d Prolsions ( od. t h. aonlr.cto.s l-icds. kw do6 nol ,iJpl, ro m oqtd oa
<br />lhepopdy Nho tdilds oi irrrov6 fidon. dd vho dG su.h $!.k himscll or h6ell or lh,DUSh his or ho o\Yn dnploy€6.
<br />pmvided rnar srch imFlvonqls mnol inldid ororr.d roreL li hd{6d, th. hildins or irytolctrEl is sld wirhin oft ra
<br />ofcompHion. Oe o* os Buikld Mll harc tn. bud6 of pmvin! lhal lE or she dil nol build o. improrc llr lmlEly lor lhc purFF ol
<br />l. s oM( of rh. Fopd!. m crclusivcly contaclins vilh licdsd .. ta{o6
<br />'o
<br />.onntud thc prejel (Sc. 7O&, aunne
<br />and Profsioo Code -l he Conr.acrois l-icdse L.tr do6 nor
<br />^ptly
<br />r. .n o*nq of prop€ny who buil& or improvd rhdon,
<br />.nd sho .o.trts for such prcjds wnh . Contr.clo(s) licard pu6u l Io rh. Conkt.tor's Li.m$ tiw).
<br />lan erono undd sori.g &PC nrlhisrcson
<br />O$n€r
<br />]laBrEBfIaflt[ls ro!
<br />OSCI,AAAIgN
<br />I hreby amrnr und€r p€nallyolpdjuryo..ofrh. aollorvins ddlamrhB
<br />I halc ed Nill naintain . Cdriticare of CoGar ro s.lf I Bur. for worl6 cohD<slioo. a Fovidcd lor by Sdrio
<br />lebor ( ode lor rhc Dsfomoc. oflh. $orl lo, \htrh rh. pqn bNU.d
<br />E
<br />:r ha\.Md 'v'll ma'nrdrn *ort6' comp.Barion rNur.nc.,6 r€qut.d by S.<rnrn l?00 oalh. tlborCod..lorltc pofodde ol
<br />lhc ert fo' trh'(h rhis lxm s is.d My sorlqr' onlDcM'on rN!,e(. (oG dd poli.y nunbd e
<br />,^"^ t{-rlt"'d 4..-d
<br />"axrN,.* tottEuA*a$bl- r.rt*,-.8(tzko
<br />I ccrriry rhar i6 rhe pdloman.. of rh. \rork for rvhich l,ris pdmil is is$'ed, I shall nor mplo! aby P6on in any mM.6
<br />$ s ro t .on. sobjel lo the so.t6 compsatioo la$s ofcaliromia. md arre rh0t irl should b..omc subjd lo 'h.Norlm corrpdslion prvisioG ofS.dion 1700olrhc LltFr Cod.,I shall.lonhNith comply wilh lhoe plori.ioB
<br />wALNlNC Fa,lure ro sm *oikds .o,np.Nrion co\
<br />civil fins up lo one hu.dr.d rhoNnd doll6 (lloo.t)Oo
<br />S h.n 11076 ofth.lrborCoda inldGl and dlol]B s lB
<br />eaxc is unlaNlul. d shrll suhj(r d mplols ro sininal psuli.. dd
<br />). in .ddnion lo th. con or codpo$tiof,, d.rugd 6 provid.d fo, lhc
<br />!l-L!LJtt!!r\
<br />I hcrehr- ifltm undcr p$sltvolpcrj,try rh3r : liccne.l onde. pro\isbn ol( h$ld 9 (wnh Salion ?ooi) oaDivisrcn l
<br />/or?
<br />c te-'^ I-Av-tre
<br />qrrslauq oN.EtDllc-acliacl
<br />I hftby aitur undd pe.ahy oa pdjury ihai lhdc is a coGtoclion lddins asdcy lor rh. pstomoc€ ol lhc mrk fot whi.h lhis pdmit i3
<br />issu€d (S( 3097, Civ. C.)
<br />knd6 i \m.
<br />Alll-l( N t DI'i('LARA'tloN
<br />Ihet,atfinf, underpcnalryolpdjuiyo.colrhclollo$in8d..L alions
<br />De'nolirion r'e"nils Asb.st{ Norincariotr rtderal Rc!uhthns (r'ir1..10.l'an0)
<br />R.qui'rd l-c(& olNorincarion
<br />I .slifythd lne federal resulalions lcsddin! asb6r{a remor,lart nor.ppli.ible o rhis pturecl
<br />ffiSl1i n
<br />' ","^u,n^anrrli. ion od sarc irh rlE 'ln\ e inr'om,arion s ron<r I ds'.i h .omplr lrirh all (- y atrd (in'nry
<br />o.diiancsandsraret.a\1n!,lingrobuildii*.onslrudn,n.mdher.byaulNriTcrc0.6cralir.xolrhG(irr-aMaourlvloqlsulx,nlhc
<br />abore moibned prop€ny ro' rispc.l
<br />,\pplic.trl or Ag€tr1 SiSnrtrre:
<br />k., rr
<br />Pole Bases
<br />Meter Release
<br />**. 4/zs/z-a
<br />of lh. Rusins dd ProlestuB Codc. dd my liccns. is in full lorcc d €ffdl
<br />,,cctr(.ii( o
<br />^" f4oia o
<br />Lmdeis Addrcs
<br />/-rk"
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