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ELECTRICAL.INSPECTOR RECORD
<br />ID/SIG.COMMENTS OWNAN BUIi,DER DELCANATION
<br />I hcrcby alfmn undcr lEn.hy ol pcrjury thol I m cxcmpl fmm lhc Conlracto6 Li.c.sc L.r aor lh. followinr r.t$. (se 701!.5
<br />Bu\inc$ lnd Prcl€ssion Codc): Any City or Colnry which rcquircs i rEm ro co.dd.t. rlre.. ir{'r.vc. d.mlirh or rcpon any
<br />slrucrur.. prbr ro nc issuam.. aho rcquircs rhc amlica.r for such l.mh ro tik 3 sigmd sl oftnr that tr or shc h liEncd puruanl
<br />u rhc ttovkions ofrhc Co.r.a.roiF Lienied ljs (Chaprcr 9. Commncing *irh Sdio. 7{xn of Divhi,n I oi rhe Busincss ftd
<br />Pn,fc$Ln Codrr.rth.rhror (hc hctcmlrth.rcfnimdndrbc hlsis for rhc dkgcd cx.ftptun. Any violtrrionofscclion T0ll5 byony
<br />/1#li." r"r. pcm .ubrc.Frhc Jpnhcanr,o ! ,lncnah) or no, nNrcrhan fivc hutrdrcrd"lrsr\,151l(),
<br />/r#,r,*r:rr,r,*r,r;&Trlfi;jr';xf:#rHri#riii#J,ir;,1"*iT.rtflillililrT*T1.,,,,
<br />rhc pbFdy wh.t ilds or inp6B rhdsn, ril who drs sh k).t hin(lfor h.i\.lf.r Ihrough his or hcr ow. cnrployccs.
<br />providcd lhd such in{ntrlnEnls m mt inlcndcd or ofcrcd fttr sb Il k Rcki rh. boildin8 or inpmwmnl is sld within onc re
<br />ol onf,Llion. rh. Owmr auil:Lr *ill haw th. hurdo of pmvinB rhd hc d shc dU mr boild or ilrlhv. rhc pmltn, for lh. pufne of
<br />-1.
<br />$owmr ol rhc !mpcn,, amcxclusivcl, co.terin8 qnh li.ctrscd conlrocron lo con(rud rlE poj6l (Scc 7M4, Bu\itu\\
<br />aftl A\nLsiD Codc ThcConkactr'sLi.cnscLawdoesnorapplyhonowncroltrop. y who buildr .r improvcs rhcrc.r.
<br />rid sno coor,a.h Io such proFcr\wirhaConrrucro(s) licclsd puruanr ro thc Conrrucro s Licens lrw)
<br />_l _.8
<br />I hdr.h, aflirn utrdcr runrlrloft.r|u.y.nc.lrhc l.ll{)
<br />-lhlve
<br />ind will'Mn airsCcnilE.lcorc{,ns.iroScll-lNueror*orkcn.ompensulion.rs providcd r'o, bySc.rion]Tmorrhe
<br />Lnbor C-odc. irr rhc ldform c ol rhc *oi( ror whih rh. Jxmir ii t\u.d.
<br />-l
<br />hak a0d willnrinllin *olkcn comp.n\Jrt'n ir\urrrEc. r\ rcquirc,lhy Srrri(r:l7l[)olrhc bhtrCodc.l.rrhc Ndatrn(mc of
<br />rft xqk li)r *hth lhi\F.mir is isu.J MJ,*orke compensrlion in\ulldcc crricr rxl ,oli.y nunn*r dc:
<br />rh.$ork tnr shich rhi\pcnnir i! i\!ucd, I nrll ior .mdoy nny p{Fo nrtrnynrnrcr
<br />..nrr.nsdio6 hw\ orCrlir.rnitr. ..d +Nrhll ilr should t.om suhrccr ro rfic
<br />cdion:l7mof ,he I-rhor C.dc.lshnTl. fonhwirh.onrrly *ilh Ito{ pro!kn,nr.
<br />WARNIN(;:Frihr.kj\ccurr1v.'kcr\coflncn\dn.ovcnsclsunhtrtul.rndslrll\uhlc.ra'rcord.ydrrdnnnrlFnnlric\rnd
<br />r9\ffiM**
<br />kr rhc co( ol cohrc.\rrnnr. ddtrr8.s .s provi cd for th.
<br />I hcrchy arfinn undcr ptn0llyoiperiuryrhrl I an liensd undcr n ol Chrlr.r 9 (commncing qirh Scc
<br />of th. BusiNs and Pmlcsions Cod.. 0'n my [.cnsc n i. rull rd( d .ntct
<br />Lr \c Nunrhci
<br />( onrHror.
<br />d.ttl,t(A.:{LllEcl. .8[raN
<br />Ihdtltnllnn,D dcr nnlr!ott)c'lurr.fcol rhchlk,{n,ad(hrrli(nr
<br />lxnn rii)n I'ci,nir\ \trdo\ Norili.rri,r licJcrrl Rrgnhri,r,\ flirlc tlr. I'rn6)
<br />Rcqui,cd lxlrr of Norillcrri{'n
<br />.cnify thnl rhc lcdcnrl rc8lhtions rc8uditr8 ashcslos rcnDv.lrc mr aptlicrblc ro rhn pml.rl
<br />I Mvc rcod rhisapnlicalionandslarcrhal rh.0h)vc inrb,nari.n h consr l,g@rocomply
<br />'#iii)t/'!tres ond Srarc l-ows rclui in3 ro huildi.g rion. r.d hcrchy .ur hnrizc ,c,,c rnrd ivcs o
<br />nh.vc nE iotrcd pntE y nn insp.diotr
<br />,{DDli.nnl or A*enl Si{noium
<br />tDt
<br />Sile-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />L!!!, Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding / Groundino / UFER
<br />Translormers
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduil)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rouoh
<br />Ceilings (T-Bar RouOh)
<br />lVleter Release
<br />Rough
<br />Service ltrleter t1 /1,,
<br />FINAL
<br />Notes, Remarks Elc.
<br />APPBOVALS DATE
<br />i/Pt//t \--a4d vahfra
<br />CONiIA!]CU1}NIINDINCACENII
<br />, hcrchy lllrm undcr llcnllryofp.rjuryrhar rh.E is a.on(rucrion bndinE lg.ncy tx rh. pcrforronc. ofrhc wor* ror which rhi( r.nnil is
<br />hsucd (Scc 1097. Crv Cl.).
<br />I. ,jc' . \J '.
<br />tral.i. Addrc{s
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