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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.OWN[[ BUILDER DEI,CARATION
<br />I hcrcby rfltr undcr pcnrlry or p.rjuy rh( I tun.ren!,r from rhd contadon Liccnsc ll* for rhc lollowi,rs tca$i (sE7011.5
<br />Burirc$ 0n{l Pn'tcs\ion Codc): Atry Cil, or CouDry whi.[ icquir.s I [lcrn]il lo .on{tu (. rlrcr. nnDrovc. dcmnish 'tr rclar Jnv
<br />{ncrurr. rn.r tr irs is\r3nN-ako rcqriros rhcapfli..nr itr such rcrmir b fihd 1i8trcd sialcflEnl rhll hcor shc n hcn\cd Purqlor
<br />l{, llrc prr!ision\ of Ilr c.nr0clois Licenwl l,as (chrpr.r 9. conrnrncing sirh sc.riotr 7(x)o of Division :l orrh' Btrrim$ rnd
<br />Pr.l[sioDl Codc) or thllI hc o! sh. i\ ddnDr th.rcn om ind lhcMsi\ turrh. rllcgcd cxcm ion Anrln,hrnrofscction70:r,5hvlnv
<br />rrllic,trr lor a p.flnir subjcch thc {tlic.nt lr, !cililpc"alrrofnor ixtcthM fivc hu ndr.d doll6 (s5u)
<br />-t.
<br />owmr or rhc pmtEny- or nry cnltl.it \ wilh wagcs ,s lhcn sh cofrpcn{dtr. Bill d(, thc wor* aid rhc sndE i\ nor
<br />idrfrkyi.r.ffcrcdli,$lcrsd?O{4.Busincss.ndtrhfc$ioosCodc:Thc(tMldoisl,iccnsctjwdocsnollnplvto ownftor
<br />rhc pmpcny sho huildr or iry)nrvcs rhcren. ud who docs $.h wolk hnnscllo. htmllor thou8h hh or hcr own cntllovctl.
<br />trioridcdrhir such inrpownrnh ft..r i, .trdcdoroltc$d t'eb lll k,wc!!r thc ttriklin-! ot tq,okm.r h rld wirhinon. rir
<br />ofcomthrhn. fic O*rcr Buiklcr *illh,k rh. hord.n orpmvinA rhJl lt or \hc did mr ttrikl or iqlow rhc rolriv fo.llE purrxE ol
<br />l.asowrcroirhcpmp.ny. rcklu(ntlyconlrrcri',3 sirh li..n\rdroturcrtrsrocorn'a.r rht FmicrlSr-. 7(lrt Bu\tro$
<br />trtl ,hnassinrCodc: Thc Conrrrroas Liccnsd L'* do.\ tur nptly 1,, un own.r.lfoPcrry wh() builds oi nnpmvcs lhcrcon,
<br />.nd Nho conlrrck in su.h r,oi.rs sirh r CoNr..lr,(\) li.en\.d nursnnr 10 lhc Conr,.d s Li.ctrs tir )
<br />I nmcxcnrDr undcr Sccrii,
<br />W0RXTl.S' COIIIPFNSAT(IN
<br />}DCLiAAUQN
<br />I h.rcny ainn undcr p.nalryofpcrj!rronc orrh. r(rn,qi.8 dccldali,)n\
<br />I hrvcur4will maintain , Ccnilicrlc ol Consc r(,sc[:nNxrc for sorkctr mhp.n\ i{,n..s Pmvidcd fttrbvScrion 1700orrh.
<br />hhor codc, for lhc pc,forronc or rhc wort ,or $hich lhc lEnnii k kiu.d
<br />-l
<br />havc rnd{ill ridrin $o cRconBnlrri. irrsur.n c. sr requtcdhtSc.rn :trr)()ol lhe I abitrCodc. forlhc pc rmi'(hr
<br />rhc lvo rdshi.hrhis pcnnil ir issucd My workds- ..nEn!rr ion ir\uratuc.rri$ dr.licy nrnb.r uc'
<br />F-r.\
<br />e,,ryn ^r.i. $d!@!lY"7 a)L-,rpo* , 6'2''
<br />l.cnify rhal ir rlE pcni)nniiccotrhc \r.rk lnr rvhi.h rhis Pcnnir n i\\!cd l dnll.or c ,fk,trn) !c^.n in3nvmnnnrr
<br />v, $ro htorE s$jccr t,rhcsorkcr comPcnsali.n h*sorcnlirdnir. n r8rcc rhrr irl should h.ronrc \ubjd blh.
<br />snrkcrs conrp.nsnri trovsionsofScclion:17( of rnc Lrhtr C'dlc l rhrll. tunh*irh .onlt,lv wilh rh.{ pmvniotrs .
<br />WAINING t'{ilurc ro {core workr^ .otrDcnsali{,n c.vcrrsc is trtrhslil. rtrd shrll luhj.cr arr cnr o}tt t' dinrin.l P.nollics and
<br />ro nnc hundrcd thousdtril d.llrs lslm-oo(D, h diri( ro lhc cod ol .o tl.i{rion. l!m!8.s rs [ovltlcd for rhc
<br />Scdi.n 30?6 ofrhc ln&tr Codc. ir crc(rrd
<br />U^., 1t,tIq
<br />^ppri
<br />Dlictllt:!.ltaN
<br />ol !h.h^n.sr iiP'ons\o0\(,rlc xn n,ylirr \( n rtrll liR. rnJ .,l..(
<br />-1
<br />L* ta ./-.,..'..,"".4P*L't(
<br />'7 1,1
<br />(]oNS't.RUCl'IoN I FNDIN(; A(;ENCI
<br />I hctuhy alllrm umlcr rcnnlryof t)djxry rhd ihctc is a consrtucrion Lndirg.Scn.y lor rhd P.donrmcc.l rhc *ork f(n *hich lhis nernri n
<br />i!\ucd rscc 1097.Civ C J
<br />APPLI(]ANT DFCI,AR-AI'I(IN
<br />Ilrnbv lim ufrler pcnllry or iijury onc.l thc fdlosing dcrhrtriotrs
<br />Dcmoliri P(.rir*Ash.nosNolillcdrinr Fcdcral R.Suhrn,ns('lirlc40. Pd6)
<br />Rc!rncd I clrd.rNorill.lli,tr,
<br />l.ciiifythrr llrc tnc.rlrcPUldnrsrludinAr\hcdo\ rcflrnlrrc n.rr|]plLrl,l. r, this nroiccr
<br />l.cniiyrhxrl hrv. rcl(I rhisrptlictrrionUxliar.rhd rhc.lYxr inlnrndtni h corcct lrsret,..nrllvEnh0llCirv,iJcounrv
<br />onlirrtr..\ rfrlSri.lrN\ rchrrne I
<br />ihi*r nrnt iom(l pn,pcd, fd i.
<br />t^
<br />rir . xl hcr.htxurhornc rcPrcrcnr iresotr haC rrnd CoutrrJ !' r d uF{r rh('- /,../^ttnte Lt .
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Lite Satety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bondinq / Groundinq / UFER >'29-/?I l
<br />Translormers
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduil)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Soffit Flouqh
<br />Ceilinqs (T-Bar Rouqh)
<br />Ivleter Release
<br />Roush lcLA WZl',t9 v"/t',{il
<br />Service l\/eter {-a-t?l4l n.rt
<br />y-21-l'1
<br />Notes, Bemarks, Etc
<br />vlv
<br />6'+h J
<br />COMMENTS
<br />,IFINAL:rnH
<br />l-cMci\ Nrnr
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<br />trftlc''q Aildrc*'
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<br />-T
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