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APPROVALS DATE ID/SIG.COMMENTS O'\INER BTJILDER DIJL('AITA'iION
<br />I hB.b, amrn undcr p..ally ot porury rhal I d .rcmpl toD rhc Co.rhcros Lic@ rjN lor lhc aollos'ins rcen (sd?oll5
<br />Bsin6s a.d Profdion Cod.): Any cn, or counry $hich i.qun6 a p6mit io connrucl. ahd, improv., d.molish or la.n my
<br />srru!fuc, pnor ro ils isomc.. also,equir6lhe applicd lor such pmil lo,ilea sis..{il.iord rhar h.ot sh. is li.os€d pmuul
<br />to the provisnrns ol E ConrBcrois l-i..nscd Lrw (Chaptd 9, ( onnncncine with Sdlion 7000 of Division I oalhc Bxsins ed
<br />Proac.sbns Codc) or lhar he or sh. is cxcr thdcfrom and lhc b6is lor lh. auesed eremflion A.t, violalion olscction 7031.5 b)dny
<br />spplicanl io! a p.nnil subj.cls lhc applicol kr aciviltetulyolnot morctnm 6!c hundred dollals ($500).
<br />l- 6 o$nd ofrh. pmp€ny. o ny .mploy6 with Nas6 5 lhct $1. conpoi,rion, $ill do th. $ ort dd lhe snr1u. is nol
<br />imo.lai or ofid.d aor elc (Sa ?044, ltusiflB sd ltof.ssioB Codc Th. Contrdoas Licdsc tnw do6 nol apply lo u otr n( ol
<br />rh.poFdy $hr h0il& or hprDv6 rhaon. md who dG such M,! himscll o, i.self or ltmu{h his or nd o$n mploy.B.
<br />providcd thar such imtfrv66ls e nol nlod.d or oflit d lor sL ll ho\r6 6. th. bui!.tinA or itn roroftd is eld siriin on. ,w
<br />oa.onpldion, fie ovn6 B lds willh.vc ttc hrdoolprerins lha hcorsh.dAnor t ld o. inFovc thc propsty for rhc purF s ol
<br />l. asown.r orrh. !pdy, dn.rcldsiv.lycontadin8 rvirh licdsd conlmclos lo cors'rud lh. pmjat (s{. ?044. Bcins
<br />and PNlsionCod.:'l hc Conlr.croas L,iccnsc Law do6 nor applylo @ o$.na olp.op.ny wno builds o! improvcs lhd.on,
<br />a.d $ho cont.ads lor such Foj68 tr nh a conta.io(s) li.Nd puBumr to th€ Coalrsckni l.i.o* t:v)
<br />I d.€rc'npr urd€r S{lion .B &PC forrhisr6on
<br />\\otiktaRs ( (rr\ll't,t\s.\I ()N
<br />DIt( l, RAIl()N
<br />I herebyafin'huidnp.n.nyolpdluryon.ofthelollo$ingdcclar ions
<br />I hav. tud tr ill maimain . csilicar. ofconsd ro Sclf-lnsure aor \!rk6' cohpotsaion. a Flvida.l to! by Sdnrfl 1700 o I lhe
<br />Labor Qrdc. lor lhr psromdce or rh. \.rk aor $ hich lh. tmni b isued.
<br />I hs\. a.d s ill mrint.in workm conrp€Balion iNuraoce. 6 rcqut d by sfrion 1?0o oaln. bbot Code. lor lh. pqf.md.. oa
<br />ff:.,_:;TEKT+comFnsarion iB ran.e.mid {d rFlicynumbs c:
<br />Erpn s i
<br />*".,,rr *a *,r'" p..r"*c. orrh. trork ro, $hich rhb rEnnn is isucd. I shall nor @ploy rny pden
<br />'n
<br />a.ynun6
<br />s\s ro be("mc subJd ro th. mrla comroq'on bqs.fcahlom... md.ererhd rl I should b.(om€ $bjd ro rh.
<br />worhd comp.Hlion Fovisions olsc.l io. l?00 of rhc rriDr cod( r dsll. fonhwilh onply wirh rhos prosioN..
<br />NARNING: Frilre ro s.c!r. worh$' conr-EDsarion covms. is unlasful. ,nd shall subi..r .n erplorn Io si'ninal Ftuhi6 and
<br />cilil fines up 1o.6. hundrL{ rhorsmd dolltus lSl00.0L{)). in additbn k] lhc coslol .omtcnerion. deases as pmvid.n ior lh.
<br />inl6.sr ,nd arloflrc! s lcs i
<br />I hereby ailnn und€r psaltyofpsrurylhal I d ltss.d undd flolGion o Chafls ! (com'n.nrins rnh str'ion 7000) flDilision l
<br />oa rhc BusinB and Prcfsions Codc. od dy Ucose is in lull rorc. dd clld
<br />-'1
<br />..-\
<br />L,censccrns, ! l+ L2
<br />,,," .tlas la"N
<br />Lll."*-fa
<br />I hftby afrrm ond6 p.nahy ol pdjlry lhal rhqe is a onsrrucrion L.dioe agmcy for thc pdfomancc ollhc vort for s'hkh rhis Fsn i!
<br />issucd (s(. 1097, civ. c )
<br />AITIICANLDECIA8AIII)!
<br />I hEd1v afim u.dr pdahr oapdju! onc oflhc followin8 d(ltrfllions
<br />D.toohion Pcmns-Asb6r6 Norin.arion F.dml Reluldions (Inl..l0. PM6)
<br />R!qrncd l rrrcr .l N.lilidi(r
<br />I.difyrh.rrhelcdoalreSul.lions.cs dins dbcstos ronovali'c nor amli.ablc lo nris pmrd
<br />R!**,rhnr lhn\.read rhis amli.rnon mdnar.rha( rhcrli\r irlonn.ri.n iscorccl I a!rel{,rd rtly\'irhall('lt} ind ( ounrJ
<br />ndSlarc Ia\sr.Lrin! b buildiis.onsnudion. d adlmrirret *mdtr6.f rhis ( it E;!bo\. mflrioncd pn,priy for ircpdn n
<br />Appli.nnl or ,\Ecnl SieMl re k
<br />I,crn,irfttrr,rrtlnn): ,ltL Q f; f i (zi
<br />4 *3
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bondinq / Groundinq / 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 Rouoh)
<br />[,4eter Release
<br />Rough
<br />Service N,4eter
<br />FINAL '21t3/220 t ZzflUU
<br />Notes, Remarks, Eti
<br />-+
<br />ELECTRICAL.INSPECTOR RECORD
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