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APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Lioht Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Life Satety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Bondinq / Groundinq / UFEFI
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)^t4,. L-1-
<br />Walls (Rouqh)<.1 )*/\
<br />Ceilinos (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rouoh);-?-\s \)e!r'rPfu )
<br />Rouqh
<br />Service [t/eter //"'\
<br />FINAL /d.-tl./ tr *-uJ)0
<br />Notps, Remarks, Etc.\J
<br />f<-r-1-o )
<br />OWNER BU!LDE" DELCANATTON
<br />I hcrchy ,lttm und$ pcnrlly of pcrjury th l an cxempt frDnr thc Cotrhdo6 Li.cns Lls for rfic tollorins EiI*. (s.. ?0.1 1 5
<br />B!\incss oml Proic$iotr Cdc) Any Ciry or Cour, which rcquia\ ! F li' ro consru.r. dlr(, iniprcv.. d.rnnish or E!.n lny
<br />stru.rurc. riorro its hsu0n.c,,lso rcquics th..rplicmr tbr su.hFcmir ro filc0 sian d shrcnrnr thar lt or shc h licen\ca pu^ulnl
<br />r. rhc trcvisn,ns of th. Conr.cror's Liccnscd ti* lchapicr L Comncn.ing wi$ Sc.rion 70fi) or oivision 3 ol lhc Ausiniss lnd
<br />PolcssioNCod.)o.rtu(h.orshcis.xcmull..rclromandrhci'nsirlorrhcallcscdcxcmplnrn.Anyviol&lionoflc.ri,n70:lltbyrny
<br />aplliconrloror.rmilsubjrclslhc.mlicanlroacivilpcnolyofnotnnrclhanfivehundrcndollan($500)
<br />_1, !\ o*ncr of rhc ptr,IEny. ,r oy .ntlorBj\ wirh wagcs as rhcir s,lc ..m,.nsari.n. will do rhc wo* dd fic srruclurc h mr
<br />ifi.ndcd or oltard f.r slc (Se.7041, Ansin.s ond Pmfcasions Codcr Thc Contactols Liccntc Low docs nnl arrplylo an osnc. of
<br />lhc pmtcny wlo huilds or improws lhcmtr md who des suct wo* hinNllor hcrclior lhrt,xeh hh or hci own cmobyccs-
<br />[ovidcd thur su.h iDpmrcmnh m mr intend.n n orcEn for soh I t ho*Ncl rhc triuir8 or improrcmd is $ki *irhin on. F
<br />of.onDLrion, llr Owftr auilld will hrvc rtE hud.n of nmvinB lnd hc or shc dil d b{ill or iqmrc lh. pmlcny aor rh. purlbr ot
<br />I. $owncrofrhctmpcny,.mcxclusivclyconrracrinS wnh li.cnkd.onrrucronlo connrud rhc lrojd (Scc 7()r.4, Bu\n'cs
<br />xnd PFlssi Co,lc:'lhcContacror'sLiccns.Lrwdocsnortpplrrotrio*n.rorriopc ywhobuildsorimtrcvcsthcrc.n-
<br />d who o rets ror !uc[ trojsts wnh , Cu rucrods) liccn*d pur nnl ro rhc Conrracu\ l-ian* ljw)
<br />lrDr\. rd utrd.r Sr.r
<br />laBxlrBlrollft Nsa-lIaN
<br />lrEllAndu!.tN
<br />I hcrchy nllirnrundcr pcnrlryolrcriurvom ol dr. hlh*ir[ J.chruriotr\
<br />_l h!!c ond$ill mintain a Ccnifrare .r G,tr{nr k, S.lf lnsure tu }ork$f .onp.nsar io.. is pmvidcd lor by Scclion:17U0 ollhc
<br />L.bor Codc. rbr I hc lcrfoilurc! ol the sod( for which thc ,crmil ir hsucd
<br />I hrve i +ill nuinrtri'r sorkcri .o,nt^-n\rri{n, i'xurrD.c, Js rcqut.d hySccrnn,:l?U).lrhc I-rborCudc.lir llt r^-rlornnnccoi
<br />rhc {ork tur wl,ich rhn pcnnir is i\\ucd Myworkc^ (nnNn\ ri,in i'Aunn...iricrtu Fni.y Nnrl/-r irc]
<br />s s to h.com subrd lo nrc qolls( .omncnslltun h-sofCllilornir. lnd uBEc
<br />$orksr $nrJ{n\didr Drdv si,)n\ olScclnn,.l7(x) olrh.l,xIxtr (ixlc.I
<br />Wr\RNlr_(i I'rir. n, {rrt \ork.r{ ..'\uhlrcr rtr cn,Ihrr n, ri'nnirl Nnilri.\ r {l
<br />.ivil lnr.\ rp k) onc hrndrcd rhouln dol nsrrion. danr8cs r\ trovid.d for rhc
<br />s.crnnr \)760frh.I ahtr
<br />,r,,,"05
<br />I hcrchy rtlnm undcr pc.!lly o,
<br />of rhc au\imssnnd Profd$i(Jos Codc. and myliccn\c n i.
<br />ol
<br />I hcrct'y rnnn undcr pculry ol pcrlury rhai rhdc i\ r
<br />isucJ (Scc.3lx)7. Civ C.)
<br />ditu.rion lcRli'rgrgctrcy ld rhc J[r nrr.c , rhc work iitr *hich rhn ,tnni i\
<br />ATILICANLDECLAAAII]N
<br />I hor{,y allnn under pcn0lly oi lcrjur, onc ol'lhc foln,wins d(lamttuns:
<br />D.nmlilio. Pcnnils-Ast {os N.lificction ltdcrc I RcSuhl io ns (Til lc 40, Pan6)
<br />R.quncd L.ncr of Ndifi Mlion
<br />iiy rhar rhc ledcrrl rcEuldn n\rrc norrrpli.rhlt k, rh^ |micd
<br />n,lndtrri(,r s..rd1 lretur ro..mfly s rh flll Cnyr.d Counry
<br />rDd hcrch,rurktr'zc topr{nrd iv$ .1 rhil Ciiyr Coutrlyt,.nrc'uB,nrh.
<br />,,,,,@?-49c.
<br />ELECTRICAL.INSPECTOR BECORD
<br />Under Slab / Floor
<br />l\4eter Release
<br />Policy Numbcr:Jrljr.s,
<br />-
<br />_I.cniry rhnr in th€ perrolrun.c oflh. *ork ror whkhrnk l,.rnir i. hsucd.l snall nol cmplot any Frsn in.ny duft.
<br />L.ndcl" Addrcs:
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