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ELECTRICAL.INSPEGTOR RECORD
<br />APPROVALS DATE COMMENTS owNER tll]lt,DEtt Dt),(' R l',tON
<br />t hscby amm unda psulry ol pajury thd I d .tcdpl toni rh. Co.tidon Li.6* L.\! tornE aolk\rinr r..s)n (Sd?011.5
<br />ausin6s and Proaesion Cod.): Atry City or Counly \e,ricn r.luiB a lani h ooslrl,cl. all6, i'npo\c, & !nhl' or rTatr oy
<br />slructu€. prior ro ils i3sum.. also r.(lun6 thc .pplkd for s(h prmi h nb 3 siA.&l sr.randt thd lp or shr t licoMn Nmstn
<br />to !h. prolisioN ofrh. Conrlocrols Liccn*d Lsw (Ch.fld 9. ('oflnncncina Lrith Scclion ?(()0 ol DivGion .1 ol rh. Irusin.s ed
<br />Pm[Nions Cod.) or rh.t tE or shc it .lcmDt thocFom and th. hdis for rh. dllcrcn .$nprbn Anr rnn ionotS&1i(inr01l.5 by,n,
<br />aDplic! tua!.mi$bjdslh. applicrn! ro rcivilp.n,ltrofnor morctlrn fif. honded dolli.s(i500)
<br />Ls ownd oflh. propeny. orny€mployeB \ith \r0s6 as then snc.ouFcnsttion, \ill do ilEN.i[
<br />^trd
<br />rlf, sIn(rrc is nol
<br />n dd.d or ord.d for ek (Se.7o4,r. BBind dd Pl oacnJB ('od. Tn. ( onlridoas I ico* I trs d.s nol +d\ ro in o\nr or
<br />rhc pr.Idy Nho 6uil& d inFov6 rh66n, a.d $lD dG su.h $ot{ nihscll or lE s.ll o' rh olgh his or hs or n crt,l.y.6.
<br />Fovidcd rhal su.h imprevoE.ns u. ml intsl(ld o, oa[d.{ ro. $1. l( ho\.ed. rlt hildir8 or intn\ etrEnl is snd \rillir onc yw
<br />ofcompl.lien, fic (xrd Buildd wil nav. fi. hlnLn.frrolints tlut n. or slE did nol hild or irqrorc thc pnrEly nn rnclltrF,eof
<br />l. N owns oi ilE propoly. am.rchFn€lrconrradins Nirh liccnscd.oira.rosb..nsnnd itulnliNl (scc 7(r'1.1. llL'snrc$
<br />and ftraesi)n Codc: Th. Conta.d. Lic.ns. LaN d.6 nor il)plt o in osncr olrrolrn! \ho huilds or nnf'.\6 rlEdn.
<br />and reho connacbforsuchprcjc.GwirhaConrrncknlrlisensedfunnirhrhc(!ira.ror'sr-ic.ns.l-a\).
<br />I atr.r.Dpl unds Sdtiotr
<br />!9BEEA!:gJ!t!EllAl!!,)!
<br />D}:IIA!AUA!
<br />I hcrcby amxn trndE poallyoapgjuryoncolthe follo$ir8 dNlffations
<br />IhareMd$illinain(aina(difi.d.ol(irsdrroS.lahBr.lo.\ok(scon\Eosalior-asltrovnkdfoihyS..iidr:1700ofth.
<br />t-ahor Codo for rh. pdfonndc. o f rhc $rt lor \$ich rh. tcf,i k i$oed.
<br />I have rnd $ill maimain \rorkm .onDd*arn'f, nEtrr...e. as r qrrtc'l t\ SElion l?u) o r lhc lnlu C.d., nn rhc l)d ntrnrdc. oa
<br />lh. work lor shichlhi.ponrn is isu.d Mt$o 6 conrlEsrlion imu, ancc cui.r ud Fnicy nun,br ,.:,,,.,",94,6^,
<br />,,in\\utr.c, - cllzxtb -lS
<br />I c.niayrhar in rh. perlonnimc ofrhe \ork for \hich rhis r{rmil is issuql- I shnll nor onph\ dnv AR'n ln rn\ nr.nNl
<br />s 6 lo b..o'n€ srbl(t to rh€ tro*61 conDcnsal n,n h\ s ol C.liron,i.- and +,c. ntu ir I slm uld txNne nrl,rccl k' lhe
<br />\ro*6 comp.nsrion r,o!isions olSfftion:1700 olth.l.txrr Cod..lslull.lonh$irll.fnrpl\ sirI rll.s 0r.\isi(nF
<br />wARNtNC: Fail$. nr uu!c $or[.N'cdhlrnsarnJn (o1oa!€ is (nla\lul.( ro onninrl |tmlri: md
<br />cilil find op ro on. hundrn lhotrsnd doll.B l$l00,olr0). nr .ddinlr kr lhc
<br />,,^,". *-72-14 no,_,,,
<br />IIEOJSAII(!!
<br />I h.Ehy ailm u.dq p.nalty of pdjury lhal I an licdsd und€r nrouision ofCnaprd I ((n,ndti.r \ilh sdlion ,ul(]) oi l)ivtion l
<br />of lh. Busins d ProasioN Cod.. ed my lica* is in ftll lorcc .nd .rsl
<br />r.i..ns.(.r.$ L*- 1{plt,i
<br />I h@by aflinn dndo Fn.lly of psjlry
<br />'hd
<br />thc. is . considdion k dinS .Sqcy fo' thc po lon'nnc. ol rhe $n( nr i.hrhi.Fmi b
<br />tsu.d(sd 1097, civ c.).
<br />,u,f I t( \\ r rn.( r. \R \ r l(r\
<br />I ho$y aflinn undd Fnrlly ofpcrjuryonc ofthe fouoving d(la,elions:
<br />D.molilion Pdmits-Asbdlos Norifi cdlion f'.dcal R.sultrrions ( liil€.40. Pano)
<br />R.quircd L.ud of Norifr otion
<br />ulrriensqdningsb.ios'on)1rl c.oritiDlic.l)l.lolhisf'.lecr
<br />rh,\c i',linn'diinr trc.fcd I !,t{k,rf r rlr \ rhrlll l\i Jlootrlr
<br />ir\ ^
<br />(l{'rrn[j r,.fr( trlrnr rlE,i/. 'qr's.n1irns ofrhis (
<br />Apllicnnl orAB. t SlB .t
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />S pas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rouoh
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough
<br />Service N,4eter
<br />FINAL r- ts-/0 )1.r4.)6)
<br />Notes, Remarks, Etc ------v
<br />tD/stG.
<br />Under Slab / Floor
<br />fi\
<br />D/u/z,rc
<br />P€rnrite nnnre (pn r): '
<br />tf z/ ur
<br />I
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