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ELECTRICAL.INSPECTOB RECORD
<br />APPROVALS DATE COMMENTS
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Salety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bondinq / Groundinq / 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 />Ceilinos (Hard & Sollit Rouqh
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough
<br />Service l\ileter
<br />FINAL l8 \Y.3Y
<br />Notes, Remarks, Etc
<br />OWNER BUII,DER DELCARATION
<br />I hcrcby ailirn undcr pcnalry (,1n rjury rhd I om cxcmfl lror lhc ConlncloF Liccnsc ljw forrhe following EMtr (54.70.31.5
<br />Brsims did Porcsn,n C.d.): An, Cily or Coutrry which rcqunes a Fdn to 6n{tud. ,lr.r, impmvc. dc'rchh o, replt tny
<br />srructurc. prior io ns isu6nce. rho rcquiB rhc lprlicur 16r sKh Frmii r. fik r si8rcd natnEar thll he ot ilt is liftns.{ Pursmt
<br />ro rhe !.ovisions oI rhc Coilrrclrtr s Li.cnpd Law (Chn,'tr L Commins snh Sdion 7000 of Divkion 3 oflhc Busincss ond
<br />Pmtcssions Codc) nr rhlt h€ or shc h cx.mpr rlBrnomand lhc b.asis tor lhc ollescd excnflior, AuyviolalionofsslbnT0ll5brdy
<br />oppliqnl ror a ri..mir subiccll rh. artli.abr ro a .i!il pcmxy or nor norc th$ ,ive hundrcd dollan {S5trO).
<br />_1. as osncr of thc I^,Fnr. or my c'nplo)tc\ *ir h wrgcs as rhcn sb compctrsrtion. will do llE Nork ud lhc $MtE€ is a,
<br />irlcrklcd or oftcrcd for mh (Ss.?()44. Susinc$lnd Profcsions Codc: TheConrract sLic.nsctnwd.cs.olanPlyloano*rcrol
<br />lhc tmlcny {ho builds or tqftlcs rlten, urd *b rk4 flcn hr.t hinaclf ot h.rslf or $rou8h hi or hcr o*n cdrroy..c.
<br />pmla.d lhsr xuch iqmwrnk 4 rcr inrcdcd .r olTehl lor ek. Il lxi$mi dr hitlinB or irqrercmnl is ekj *iihin om Fv
<br />oroflrhriun. rh. owncr auilLr *ill hrvc lfu burdm of prcvinB Ihal lE or shc did n.r r ild 6r i,{'ow thc l'.Fny fo. th. puqns of
<br />_1. a\o(rcrolrhc Imptnt. am.x.lusivcly.ontkri.S unh li.cn{.d canrrdonto consrdcr lhc l,mFct (S.c.7Or4, Buimn
<br />ani Pioli\sinr Codc ThcContacrrn s Liccnrc Law docs nor apDlyro ffo*ncrofpmrrdywho hnildsor inDrovcs thcreon,
<br />lnd sho conr.dc* f( such pmjNts virh a conk!.to(9 liconscd l)usuml ro rhc Co ructoas t-iccrsc trw)
<br />-l
<br />amcxcnrllundcr sccrnn,-. B & Pc fr*rhN rcru
<br />lhl€: Ortui
<br />won<rusit:tlupensllott
<br />llEcLaaarltN
<br />I hcrcb, arndundcr ItnrlrtorFrjuryonc ofrhc rollorin8 dccl"mlions:
<br />I hdvr rnd *ill frrinr,i.aCcniflcarcolCoDsctrr roSclll$urc hruorkc^ conrpcns nrn.d lrovid.dforbyScctionlTu)olthc
<br />tihor C.dc. lbl lhc pcrfomtuc.f thc eod f.i qhich rtu Fnnir is issu.d
<br />lh.vcatrdwillrrnsinwo*eraconlncnsrri{,niNumn.c.!srcqdircdhtStrrionlTfi)ufrhcUtt)!C.dc.lMl,rcPcrlbnrEnccof
<br />flnjl is issucd Myworkcs or.pcnsuriu in$r ccfficr 0ndtlolicy
<br />Y+*ttlr'rz t2cni\i-tN SvzpNC{,,i
<br />uJ6 c-.lol .2 i
<br />-l
<br />ccdily lhd in rh. pcrlbrm3ncc otlhe work lnr trhich rhi\ pennir n,$ucd. I stull tror cmPloy trny PcFon in lny mMncr
<br />$ rsb h$rm {hj(r i,rtL "rrkc(.lnnp.tr\ r tr, l.ss .r Crlifimin. i |l8acrhlr ilI sh.okl h.o'tu subJ..-r rorhc
<br />workcr' comp.nsrriq ln,vilio s of Sc.rbn ]Tm of rhc Lrhr Codc. l \hrll. fonhwirh .o Ulr sirh r ho* rovisiont
<br />IVARNIN(; l'arhr( ki {rurc ( '[cr\ .ni[.i\xr unli{rirl. rtrd \hrll srhicr rn cnrpkJyci k, diNinrl |{nrkic\ rnd
<br />civil 6tr.\ np n, odr honlrcd rhors dollar( lsl (ion r, rhc con otconDcn\rr,o . dr ulcc $ F,vi,l.J li,r rh.
<br />ofrbc uh, c-od.. i erc(rftl
<br />sll$
<br />I hcEbylmrm undcr Fnahrofpcrjxry rh&r I nm li.dn*d und.r ttuvisiotr olCnaplct 9 (commrcing wirh Serbn 7m0) otDivkion l
<br />of rh. Businusa.d Pofcssions conc. ad.ry liccns is in full roro sr.i ctfccr. Szlsw_9,,'cLo ns4=++E-
<br />5
<br />CI}NIIAICIIONIENDIN('.&GINCI
<br />I ncrciydflt und.r Fnalry or l).rjury rhrt r hd! is a connrudbn lcndinS aBcmy for rhc r'.rfom. of $c worl for which lhis Fmil 6
<br />nsucd (Scc 1097. Civ. C.).
<br />A.TPI.IIANLD&CLA8AIION
<br />I hcE5y unimr under t^-n!lry oi pcrjury oE of rhc rolk,winA dftl*rrio.s
<br />De.Dltion Pc.mirlAstEsros N.lil-rctrli,,n FddcEl Rc3rhrid,s (1irl..10.I'd6)
<br />-Rcqutcd
<br />t lrcrolNoriricart,i
<br />I onili rhai rhc Icdrnl icBurrr ions rcBrdins 0sb.s.s rcnmvrlrc nor {pliclblc t,
<br />'his !,n,l.cr
<br />I.c iryrh l hrvc rcad lhh .p,)licrrion and (rlcrh lhc rh)le jnnnnurion is.oftt.r I uBre h .omPly wilh ull Cn, rnd Counry
<br />or nrrk.s xn,lSrrc l.r$\ r.lrr ins co.srrlcrion. ! hcrchyauhrirc rcprcsctrh'ivus .fihis Cit, and
<br />x^r nc rn,kd prcFd) nr
<br />,rll|)li.hnl or'\xrnlSixnhltr ,r., S
<br />rISE
<br />tD/stG.
<br />Site-Work
<br />I
<br />knJcirNonr _
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