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ELECTRICAL.INSPECTOR RECORD <br />COMMENTSAPPROVALSDATEID/SIG. <br />Site-Work <br />Underground <br />Light Standards <br />Spas, Pool, Fountains <br />Siqns (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 />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Rouoh <br />Ceilings (T-Bar RouOh) <br />[\,4eter Release <br />Rouqh <br />Service fvleter ln^ ^W4//lFINAL2/.,/4/ A <br />Notes, Remarks, Etc 77 ,1, <br />--> <br />OWNER BTIILDER DELCANATDN <br />I hd.by amm unda pmahy of pdjury lhal t m crcmpt lrom lhc Conlr..ro6' Licn* trw fo! lhe folloNiry r.e. (sd 7011.5 <br />aBin$s d Prolsstun Cod€): A.y Cily or Counly $hich rcquns s Femn ro connruc( alt6, improrc, dnolish or repan .ny <br />erucru,e piorro its issuece, ale rcqut6 th. alplicMl nn such p€m t lo fi1. . sitned slahd rhd he or sh. is lic€trecd puNant <br />ro rhc provisions of lhc Co ,ador\ Lic.ft.d trN (Chapr.r 9, coflncn inS vilh Salion 7000 of Divtion I of lh. Susines dd <br />Prcfsioos Cod€l or rh,l h. or she ir .rcnfl rhd.nom ei thc b6is fo! Ihc all€sed €r@prion Any eiolationotScclion?011.5 n! any <br />aptli.adforapennsubjcbth€applicantloacivilpuallyofnornor.rhanfiv.nuf,dr.ddollac($500). <br />l. as ornr olrhe proFny, or my .nlPlore Niln w.S6 s lh€n eE compdsatlon, \ill do rh. work &d thc struclr. 6 nol <br />inroddl or or(.d for sl. (5-.7044. BBins ad Prolssions Cod€r Thc Contradoas Lic€M kw do6 nol apply lo d oMn of <br />rhe p{opoly $no buil& or imprcre ths@( &d who dc su$ srrt hitrclf or hcelf or lhrcush ht o, hd o$. dnplor.e. <br />pror id.d rh.r soch imOD\ oMa 6. ml inta(6 or or6ql lor el. ll hore6q. rhc t ildi4 ot inpNroEi is eld snhin on. )d <br />ofcompktion. th. Gvn6 auidq vill navc $. bu.d6 ofprovi.s rha h. or sh. did not tuild or imForc tic Flpsly tor rh. Ftrpor of <br />I. as own6 ot lhc prolaly, m.xclusivclyconractin! wnh ficds.d contado6 ro consrtucl lhe proje.t (Sd 7044, R61nN <br />dd Irohsion Codr: rh.Comra.rois LicoscL.*doe ot arpl,io d owns oaprot.dt *ho l)uildsor improvcs1h66.. <br />and \vho .onrBb for such pojrrs rvirfi a Cont cro(, li.@rcd pxuu.nr ro rh. Contraclois l.ic@ b$ <br />I an cxempl undo S(tion <br />}OAKEAlC9IITENSAIIO! <br />D!'CIAEAUA! <br />I hrcby.fiirD unds porhyofpdjuryon. ofrh. aollo*in8 dalrdioN: <br />wARNtN(;: Failur. h sure solk6J comPsaion co\crase is u.la*iol. and sholl subid a! onployq io d'nindl P6rhi6..d <br />ro onc hundred lhousand dollm lll of comp.netion, daragcs e proridid aor th. <br />lo <br />t)1.( t,.\RAtt0\ <br />I h6.t'y sfiin. und6 p..alty o lFjury lhal I e li.ds.d undn polision of Chaptd 9 (coonocide vnh sd ion 7000) of Dilision l <br />oa rh. Busine sd Pm tNioN Cod.. ed dy li.@ is in tu ll forc. dd.rct <br />-cto <br />***, <br />'<-colsraucl]aN.tElotlc-acllcr <br />I h.Eby aiii,n undd pcnahy of lsjury that lhdc is a @nslruclion lddinS as.ncy tor ihc pqlom6n . of rh. $ork lor shich this Ffln b <br />issucd (Scc 309?, Civ C.) <br />AITI,rcAILDECIASAIIAN <br />I hd*ry dfrm uid6 F.ally ofpnjury onc oalhc follovin8 d€clt iont: <br />tLmolilion PmitsAsbelos Norification Fdfrl R.erlalions (In840. Pe16) <br />R.!un€d L.rtf ol Nolificaio. <br />,,cfiiryrharrh.rdld.lrcgulsrio.srcsfldinrdbsrosrernovald€norappticahlerorhis/oj€cl <br />*#*r*t I lEvc rcad rhs rprlicalion &d 3rar. rhd rh..bo1c infomalion Ls cord I aEE t Nnply sith 3ll City and Counl, <br />rarc Ii\rs rcl ins lo h'ildinr .'n{ru,,'o( m,l hn.b}.urh.I/c r$r6d!dtr6 olrh(. ) <br />abd!. Bdrio..d propdy for impElion <br />,\t,t,licxtrr or \Bdr Sisni{tr,t <br />* <br />1 <br />4aa <br />Md Cortrly to dl6 upon thc <br />n-lpltt <br />Pole Bases <br />Air Conditioners <br />-l <br />havc dd *ill minrdin a C.niatral. ofcorodl lo Scll-lNur€ lor Mrt6' comp.mdtion. B Flvid.d for by Sdlion 1700 of thc <br />lrbor Codc. for lhc polomdc oalt wort aor whicfi rt p6nn ie issutd. <br />I ha!. ed sill Dlinrdn work6 cohFEllion iNa.c., s r.quircd by Seti.n 1700 oflhc Llbor Cod., tu thc F omM.. oa <br />rh. *orl for wh(h lhi p.mn i! Bud I\r' worl6 comp.ctt'oh Eutuc. ffi6 ed polb numbo m,*" - Z{r"^Qt-.UPolryNrmb6: Etp B a <br />I .dit $ar ii rhc Frloll@c. of lhc wor* for which lhis Pdnh is bsu.d. I shall ml mploy uy psen in eny de6 <br />$ s to beoD. subjdl ro th. m*6' @dp6B6tion b$ olc.lifomie md egE lnd ifl 3hould bdonc $bj.cl to ltE <br />workd' comp<cslion Fovieios otsEdo. 3?00 of$c Lrbo. Cod., I sb!I. forlhp h onply eilh lhoe pEvi.ioE . <br />,***.-*at_19 <br />,",. tz-lro/ 11 <br />t-t-)