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APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underoround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Salety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Soflit Rouqh
<br />Ceilings (T-Bar Rouoh)
<br />Rough
<br />Service It/eter
<br />VYtu\rc^FINAL lolt1lUI,./>>
<br />Notes, Remarks, Etc I u)
<br />OWNER BUILDER DELCA'UT!ON
<br />I hcrchy lffim undcr pcnslrt .r p.rjxry th,t L crcfllPl !io'n th. ConracroF l-iccn{ u{ ror rhc knlowirs rBs! (Scc 7(l:ll I
<br />Bu\in.ss dd P(,L$ion Codc) Any Cily or Counl, shtch rcquircs a Jrrmir ro on{fld. alrci inlPrcvc- dcn,lirh or qtir iny
<br />$flcturc. priM to irs hsuance. fio rcquirc\ rhc lPpliclnr ror skh |rcrnrit ro filca \i8trcd sl cmnl rhlrh.or\h.nli.cnscd lunuMr
<br />n, rhe ptr,vision\ of rh. G,nrm.rr's Li.cnrcd Lrw lcn!|lcr 9. Connncncing wirh S..rt 7fix) of Divni .l ofrhc Bu\incss rnd
<br />Phrclsions Ctd.) orrl hcorshchcxcmprlhcrcfrom,idlhchs\i\ntrrturllcgcdcxcnrtlion.Anyli.lariotrofsccrn'n70ll5bra.y
<br />.pplica tu !frnrir suhFchrh. imlicanl ro rcivilpcnulryofnor rmt hln fivc hundr.d dollds ($5CrO)
<br />L as owncr of rhc ,mFny. or my enlLrccs * irh *asc! $ rhet {,L .o,nlEnrariotr, qill do rhe w. ul rrr (dur L\ nor
<br />n cndcd orofcrcd lbr slc {Sa 7{144. llosincss d Prorc\\ionr colc: Thc Co trocrois Lijcnsc bw docs nr,lPly to mo*ner ot
<br />rhc propcny wtx, bxilde or itrDoEs rtuBnr. and who des nr.h s.rk hi'n\clfor h.^rlfor rhbu8h hh or hc. own cmplorccr.
<br />providcd rhar ruch i'npiovmnG m ior idcMcd d ofcrcd ntr silc ll. ho*crcr. rhc hoilding or imprc!.ntnr is srld wirhin onc ,cu
<br />oiconrllhti,r. rhc O*ns Buildd wiU hr\c lh. hufthn.l !tuvir8 rlnr hc or shc did nor ttuikt or i'rrpr.k *r Pm!.ny ior rhc lurPs nf
<br />-1.
<br />dsowmrot rh.!,mpcny, !mcxclusivelycontracrins sirh liccn$d .ontrcro^ ro onsldcr rhc Proj.tr (S--' 7 4, Bu\m$
<br />arn P,Df.ssir Codc Thc Conrracnn r l-icdi\c I-,w dms nor rynly ro oqncr of lrorrr y sho hoildsor inrbvcs lhcrcon.
<br />lnd *ho comBcN ror cuch rmjccrs wnh o Co.lmdo( s) liatrsd puBum k rhrcd r{roisLtcnsc tjw)
<br />I xn.r.m.r un,hr s..rion
<br />()*r€.
<br />]}AXTD&II;qUIENIAION
<br />DF(II ARATION
<br />I hr.by rlnnnu.dft |xnrlryol lErjuryoncof rhc foln,$i,,9 Jc.l]rrri,)ns:
<br />I havc sri'l*illnnidldnaCcnificilcofConscnr roScll lNurc n, $orkc^ smPenstion. as providcd tn by s(rion -17tD ol thc
<br />Latior CdL. lbr rhc pcrformrncc ol rh! sork lor which lhc pefl r is issucd,
<br />Ih.\crtrdwillnrn ain workcrr conwn\arion n,\uranc., a\ cquircdb!SLrrion-171X)oarhcLf,bo.Codc,ntrrhcPcrlbnlrnccol
<br />r sorx for w[icnrllis!.nnil is isu.d Mrk.rkcd ofrpctrsarn,n in\ur .ccrnicr inl lolky nlofic. dc:
<br />I.cnifyrhrri'1(hcp.rfoflnrnccol'lltrwo forshichlhnlcmir i\i\\ucd.Irl lltrorcnrPloytrnyPcronnrdyi1 trcr
<br />eJ ns ro h...nr \ubjccl k'lhc worksi con,Fnsrr idr !dw\ or Crll tunri.. and .3te thrr il I dx)uld bc(rr {hl.d brhc
<br />sorkcrs cotrrtrn! rior pmvi\hns ofSc.rn,n.l7(nofrhr l;fin Codc.l \tull.lidhsirh conrply sirh rhot rn)vision\
<br />WARNING: FrihE ro rcm worrcn
<br />cilil fin.s up r. onc hu.drcd lhous0nd
<br />srtion covcnl8c i\ uola*ful. a \h ll suhFcr an cnrDloycr ro d'ninal FMkEs ind
<br />(Stor.(xro). in lddirion ro rhc .o{ of co,npcnsarion- dantr'r.\ rs rruvidcd for rlrc
<br />Sc.rn :I)76 rfrhc Lrbr Codc 6-t"'Sg/z-q
<br />u(xrsrD_rcllI lll2B
<br />uDCLi-EA-UAN
<br />I lrnhy illiD utrlcr ncn!lryol liens.d unncr pmvision ofChryrs 9lconmming wirh sccrion ?Om) olDivi\nrn -l
<br />oi rhc Burirc(\ rtrd PrcltsionsCo,lc. ud nry licen\c i i',llrllr{,r.a cftacr
<br />253 Lgb
<br />Lq 6 4-
<br />(l)!5l3lilrclLllDll1i,r1iri.[(I
<br />I h.rhy .fiinn uMcr Fnahyolpclury t a m.{acri)n h.dinBqcncy lor lhc pcrfunun.c ofrh. sork for shich rhn lEntir i\
<br />hsu.n (Scc. .1097- Civ C.)
<br />trMcr's Niflrc:
<br />-AITLII;ANLDECI/A6IIOX
<br />I horhy rtrim u6dd pcnnhyofp.rjuryonc otlhe iollowing d.<ldrdbns:
<br />Demolirion Pcrnriri Asb.sos Nolifi.alion Fcdcml ReBuhtions (Titlc 40. Pdn6)
<br />RcuuiRl trtrff I Nolfmnon
<br />sb.(oi rcmvdl m nor +rlklblc lo thh pmirr
<br />rhai rh. lh.rc inlomtion is cor(l I aeffi lo omply withrll Cnytid Counry
<br />dion. !.d hcEhy luthorizc rcFc*nrarir.s.flhis Cilyard Coonly ro cnrc. ut$n lh.
<br />Z*"E "4q
<br />,,,", ,81zsz<Agls:@--rnerir-,r \xmr )hnl)!s
<br />r'"-r,""1.**, p/",,' /trot ^*5 tollin5
<br />ELECTRICAL-INSPECTOR RECORD
<br />lvleter Release
<br />2
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<br />T
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