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ELECTRICAL.INSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDZR DEL(:ARATION I hs.b lmrn und6 Fi!h, of lcrjury lhd I h .rdpt frlm lt. ( o EdoR l,icru ll* ro. lh€ folhFirs re. (sd 70.1 1 5 B6'nd! .d Protd'on Co&) Any C , or Coudy trhth rcqun6 . Fni lo .$nntud, 6ld. imprcla darbliih or l+.n ay eMu. Fix rD ir. is!ft.. .k GllG rn .Frlrar f.r skh Fnn ro 6k t sign d iimr rir lE or dE . lEdltd pl,$rr ro rh. Fr.rcc nr rE Co Btdr l.Ea!.d trs (Crq'(6 9. ( offiinB $nh s<rion 70m of Diiri,D I of rh. &ai6 xd ProfNn,nr cod.) or th{ tE or st. b dmpr lha.tom &d rh. h.ra ror llE dlB.d crnFion Any violdio.ofs.dnn 7011 J by.ny dpllliconr for ! p.mir rubjdlsrh€ iprliEnl ro a.ivilp.n.hyofnor mor.lh6 fivc hu.drcd dolld ($500) l.ao$rofilEFDIH.r,orfrymplorc"nh*ry6atlEt$k6nFdhn.rilrbtlE$ctrndErrElEad i,ndrd G oll6.d au rk (Sc 704.1, 6ci!B -d 'iofdioE Cod. TtE Co'i.-rn r l-iq* te dB 6r .rply ro , orc ol th.Fpdt $h.hlill ingbr€ilEo dn *tb &c shf,ut hrellor h*ltor rhmqh hn trlE.w aI'loyG ,rovid.d lh.i euch inFovo6r. E n inEd.d orofisql forrL ll hoBs,lli htildi.s o nlqoEE ir $ld *hhni o.. yq olomrLlhn. th. ()"'E lrril& will h.w tlE hr&r of F!\i$ lhn lt or !t'. dn d h,ild or np.ow lh. Fopqry ror th. F,ro* or l. 6 ou n6 of rn. rrogcry. m .(lun.lr colnrdiry *nh licsE n (onrr*ioE ro col(rucl rlE rioF (Sd 70.l.l. lt!n6 anj PnrEaiir.Cort I h. Conr.cror3 Licoic trw do6 nor 6ptly ro d oNnd .l rmDdy who buil& or improva lh6on. $d *ho .oflEd! lor iuch Ftrjd. uilh r Codncto(r) lkdlal purMI ro th. (-onr6cloas ljcffi L5{) I m .rmF ud.r S<rirn WORXFIIS' COMPF\SATION DECIJAAIIO! I lE bt rrm un& FElry of paruy oc otrL lolbr aB d6lj.lrB I h.r. sn will ruint.h . Cdiarlt. olcoMr ro S.lf-lBur. fm md6 snrEurion. 6 Fovii.d 6r by Scrion 1700 o f th. t$or (bd., for dE prforlMc. oarnc wort for unkh rnc Fnit i isud I h.r. rd *iU tuinl.m qortd .ohF!.rnn r!u.x.. a r.quGd b] Sdhn 1700 of rlE t tlr Codc. tu ilE pqf.llryc ol'i:#EzW3-/na",n l.afi$ rh.r ii rh. Ffo,r1@. of rrE rort tu( ehrh rhn pdoa B isu.<! I .tDllbr qrgloy oy Fe. i. .., @ffi$ d lo tElom. sobjet to th. wort6 @mF8dion hs of Califomn, ed rgE lhn if I rlBuld b..om rubjet ro llE "0r[6' N.mp.Nrio.FNlGiocofSclidn 1700.frh.llhor(.&, r{ull, aodhsir .rply \rnh rh.s rro!Lsions .rull suhj.d d qnphts ro (rllrml F Xi6 nd .iil fin6 up ro o( huilcd thouend dolld {llm,oOo). in addi ::.:-'i a' :^Z+'yH' ^^ c I hmby lmrm undo F..hyofp(jurylhd I m li.ael unda provnionofCh3fl6I (cohmocins qnh S.rlioo ?()fiD ofDivi3tr,..! ol rhc Busins ed ltofdioG ( o.L. dd my licru ir in tull forcc !,n .ffdr E '3) )7b4< 7 /0-7€. / ?lz o zto,l .'6L\. I ncEt y .rm und( Frly of Frjur, th.l lhc n . .ndru.iion lodins +dy fr lh. paIolrffic of th. *mk ft'r trnih $a pnni i! tru.d (sc 1097, ( iv c ) A.EIU(AILDDS.6AAIIA! I hod, rtrm und6 pqalty ol psjury on. ol llE fo lhu i.r d6Lnt,oN D.Rnnon P.mns-A3tBG Norincdion F.dd.l Rquli iom tr dt .10. Pd6l Rquncrl Lcltd of Ndilicalnn I rdri,'rhn rh. f.dcrl r+dld tr, r r+dding rl r. nor q{,litahl. i(r rhn proj.d I cdia! rhd I ha\. rca.l rhb rr'' kdkl. {n (frd l.Eero conldy nnh.llCi! !d Cou ! ordiMc6 Md Shr. t-!trJ rchtu ro foildinu rLa\c ,o!nrcd ll,trnJ tu' rDpli.inr or lsdr shnrrrr.//h /)"-,lt' "*'#:)d:)f* < Site-Work Underground Pole Bases Light Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Voltage Fire Alarm / Dampers Communications Cable Building Under Slab / Floor Bonding / Groundinq / UFER Transformers Torqueing Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Rough) Att2-t24,p&tu I Ceilings (Hard & Soffit Rouqh I -6-zt n"4IE( U eilings (T-Bar Rough)t -6-Z)Meter Release Rough Service Meter FINAL llrlu l*rv,n'*da Notes, Remarks, Etc.It Walls (Conduit) \.lf-/.tt.):Tf1