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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE COMMENTS OWNER B(IILDI]R DI]t,CARATION
<br />I hcrchynfln undcr pcnalry of p$Jury rhir I an crc'nrr fbn rh. C.itrd.k a Li.ctrr bw for rhc hlhwin8 rcrn,n lscc?olll5
<br />Businc\( nnd Pdt$ion Cod.): A.y Ciry or County {hkh rcquirc\ r rEirnir ro oNlrucl. lllcr. niDnvc. dcml^h r rcnrn rny
<br />{odrrr, prirrt' ir\ n\uMcc. rko rcqu t i rh. {Ilicanr tu such lErnir r,, I lc r \i3ncd {rcfuor rhar hc or sh. ( li.cn*d, Nrsu.nr
<br />ro rhc nmvisions ol lhc Cofiadois Licc.sed li* (ChEltcr 9. ComnrNins vilh Sccrnnr 7(xx) of Divnion :l ol(h. Bu\inc^ rnd
<br />Pn,fc$i.nsCodc) or lhar hcor\h. iscr.'npr rltrelroma.d rnc br\is lirrh. allqcd c\en,Irkr Any!t,hrnrnolS.trk,n70:ll5hy0ny
<br />,ppli.!nrlnrr p.rmt \ubjcr{rhc rptlicrtrr k) r.ivill.trrlryofiorninurhrn fivc hundr.d dollr\ (15m)
<br />-1.
<br />$ owner of rhc popcny. or nry cmnk,y.es eirh sr8es ds rhcn sot dnnpcnsal ion. will do ltE strk ud rh. (turm il nor
<br />inrcndcd or oftc.cd fitr slc (Sa 7l}l.r, Ausinc$ lnd Profcssn'nt Cdc lhc Contsclois Liccne tie docs nor +dy ro,n oqncr ol
<br />thc l]nlrny *h) hoildsor nq,mrB rItN,.. tun wh. d6skh s hnnrlr or h$*lf or rhmqh his or hs o*tr crylorccs.
<br />pn,vidcd rhnr such iryrokmnn m fr inrc l.d u oflern f(, slc ll', tx,turr. rli bxitli4 or ir{Rrlmnr is $E wnhin on. )ru
<br />ofcor{,lcri,n, rhc O*rcr Slildcr *illhak $c h .norFolinsrh, hcor\hcdil mrt ild or inpdk l}r.InrFry roi rhc,uIFeol
<br />l. r\o$trd.l rhc lroNny. an.rulusirclyconlrn.tng wirh li.c \cd c.trt.cktrs ro..tr(flr.r rhc nrojccr lScc. ?0.14- n!{n.s
<br />aBi llr.lc$il Codc lhcConhctn\l.iccn\cl-0*docsnoropplrro!no*trc,olF{,!. ,sho huikhor nnptuvcsihcrc n.
<br />rnd who conrrrrfffso.httul..iswirhaCoiinrkr(rlicci\cdIur\hntolhcConti(ntr'sLi.oDscLrw).
<br />I Jm.rrnrnr undcr Sccri,nr- B &P(- ttrrhnRrvn,
<br />Doie, , Ovn€.:
<br />rvoRxl'trs' (:irMPiNsarxrN
<br />DICLABAUAN
<br />I h.rcby rfllrn und$ p.alryorFrjurrorcoflhc rbllowing d(!r,rions:
<br />lluvcuid$illnuinrainrCenilcurcorCon\c rnScllln\!rcnrrrorkc^co'npcn\dn,r\tr,!trlurlrorhyScctiotr3T(l()olllE
<br />l.otu C.ilc. lnrrhc n rfonnatrccolihc work ntruhich rhc pcrnril n hslcrl.
<br />I h.v. n*l will mni.rain wod(fJ conp.nsation insunm., as oquind hy Sel ion l?m ol rhc tibor Code. ror lhe rErfonudc or
<br />thc *olk rorrhth'ht pcnbil is nsucd My wortcn comrcnerion i6srr.mcc6icrat polky nunrbcr a€
<br />-l
<br />ccnilith0l in rhc rcr,hrmonccofrhc *ort lir w I shrllnor cnDloyrnyf/:sotr ir rtry.r ncr
<br />(, \1o fu.,trnc {rlr]ccrh rh.ror[.'\ ro ]Nr!.grcc rhar ifl shou hccom subjd lorhc
<br />{o'l.r\ lrnrt).tr\xri,nrImrn,) \orS..r(fl 1701)lL hnhwnh.omply $ith rtur povi\i,rns
<br />WA|ININC: l'diluc ro surc qorkcr'conuEnsalion ovc nh*tl. rnd shall suhjLcr rn onployrr t, dnnd,irlra\ rtrd
<br />.ivil iincs ut ro om hundrcd lhouslnd do nl€c\ r\ nnrid(tl lnr rhr
<br />Sc.ri'r, ll)76.l rltr l;,ti{ Codc. inr.rc{ rn,l rrr
<br />I lrrhydln ,un&r p. altyufFriuryrhrl I lnt li.ctr undr pn'vhid olthrpltr 9lconnmncirS wilh Scdion 70mr ol Divi\n,n l
<br />ol rtu 8u\ir.\s ! l holtssi,rs (i .. tr,r li.ctr\c i\ i! tull lb'.c rRlrllrrr
<br />C :3
<br />Ob--oL-A
<br />CANSIBUqUOU.ENDIM;.dGNNCI
<br />I hctuhy bflntr,lndcr Ftrxhy.l pcrlury lhd lncrc is r.o srru.ri(,n Lndnrg r8ctcy lor rhc ncrlhnNrc olrhc $.rk for *hich rhh Nrnrii i!
<br />nslcd (S.c.3097. Civ C.)
<br />ATIUSNLDICI.Af,{IIOIi
<br />I hc'r+y allinn ufrlq FDalry oI pcr)ur, otr. of rhc folk,wiig Jcrlmri(nr\:
<br />I)cnx,liri([ l'cnnil\ A\h.{o\ N0r Rcguhri,itr\ r'l irL. llr- |rn6)
<br />i',9 r\b.d.\ rcnxnr rc nor xt,|l'.rbL. k, ihN Im,t.cr
<br />h rtu rhn. in,o3,L i(nr s..rL\r I
<br />5ni Colnry t' cnrcr ulx,n iht
<br />,\ppli.rnt or ABml Siln.l &rc-
<br />Site-Work
<br />Underground t 4\.tg \ a\ffi
<br />Pole Bases (/'v- try
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Lile Salety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unil
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rouoh)
<br />lvleter Release
<br />Rouqh
<br />Service lvleter A\
<br />FINAL to*lt - tK 'Y,V-,|,W
<br />Notes, Remarks, Etc.vv
<br />ID/SIG.
<br />Cmi.r: -
<br />*-,oei&"4
<br />L.nd.lr Addr.s
<br />-
<br />^," oroz24
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