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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNNR BUII,DER DET,CARATTON
<br />I h.rb,,iirnr undcr pcnalry o{ Frjury lhol I m.x.mpr rm'n rhc Coitr.'od l-hci* Irw f{r rhc rolk,sing rcr\.i lscc 7o:ll5.
<br />Busnrs atul Phlcssion C.dc): Any Cny or Counry whah rcquncQ pdr.il ro .onsnr.(. .hcr, anr)vc, dcnFlish r dldtr ,ny
<br />(rucluc.t]ri]rtoils issu{rc. als. r.quins th. +plicul aor such lcmir ro filc r st.cd ( cnEnr rld hcor shc is lienscd ausunnr'
<br />lo lhc pnrvisionl ofrhc Co.rrcnn I Licnscd Law (Chanrcr 9. Cromftncirg qith Sccrtun 7000 of Divkion.t oarhc Bnsin * nnd I
<br />Pmlcsions Codc) or rh.r lLorshc Ls crcnlr
<br />'h.icrr{nnrod
<br />rhc blsis tu rhc allcsed crcnDl ion Any violationolSNlion 70.115 hyany
<br />aflli.anr ror a pcmn sutjcchlhc amlicanl roacivilpcnrxyornor m.trh filc hundr.d dollar\ i5500)
<br />-l.xsowcrolthcDroocny.(trtrrycnr0lo)r.srirh*rgcsrsrh.nv'h.onrri\rnnr.$illdorhcw.trndrhcsrtutrmLnori[oidel or.fleEd lu slc lSa 7(!1.1rtr\iNrs nnd Prorcsri(rs Clxi.: Th. Coita.rol\ Li..n{.1-r* do.s nor amlt b ai osicrol
<br />rhc pmtf,dy wh, tnriklsor innmvcs rlkff)n, ud $hod€ssu$!o* hin$clfor hrrcllorthn)u8hhis or h,r o*n cnltlk)ycc\.
<br />fn,vidcd rhrt such i'npmvc'mnr\m mr idcndldqor,crcd fitrek l[ ho\c!.r. rh. ltuilding or i'nprovcarnr i\{,ld wi(hi',otrc }[r
<br />of.onDbrion. rnc O*nq BuiHr wrlltErc rlE bunlcn of llfi,vir8 rhd lror \hc dil nor hoill or ifl{rtrr rhc pmp.rry ior rhc purlnEol
<br />_1,0rosrcrorrhdl,n)|l.ny.ricr.hsilciyconrr!.iinswilhlic$scd..ffNknsn,..rdn(rrhFiccr(sc..70,14,Btretr'c-
<br />DJ ltrtcsi.nCodc:l-hcConrra.rofsLiccflscl-i*doc\.or,pplyiornowncrofpmFny*hohuildsortnprovcslncr.on.
<br />.trd qho.onficrsru\!.hpmjE(wirhaConlo.b(s)Iiccnscdnur\urnln)rhccoftadofsLi..nsctiw)
<br />I m crenpr nndc, Secrt,n_. A. & P.C ior rhi
<br />I hrrch, ullnr undq NnrllyolF-rjuryonc ol thc folk,win! dcclxrrrnnn
<br />_lhovcond willnNnraiua ccni,icdrcorcon*n' h sclr ln\ur. ior *ukcn conrltnsation. as polidcdhrhyScctnrn3?O0oflhc
<br />Lrbor Codc- fo.lh. p.rfnilExc ofrh. work fd whi.h rhc Fmir is issuel
<br />I hrv. nnd sillmlinlrin sorkcra conrFnsalion insummc.,s r.iluircd by Sc.rion:1700 ofrh. IjhorCodc. ror rhc ,sfo,n,mc ol
<br />rhc work aff shich lhhlcnnil is issu.{. Myworksr $nDctrs,li.n in{fun.c.rfticr Md p.li.y numh.r dc:
<br />Poli.y Nrnbcr:_
<br />-l
<br />ccnilylhd ir rhc |xrlnrmrccof rhc work rn ahi.h rhi\ pcrnir ir i\\ucd.l sh"ll nor .nplo, a.t pc.on inrny,tunNr
<br />$ rsfu ltco t {hJc( to rhc workcs .annpctrsarion hws or crli,nn ,. 0,rd l8E hd iil slmuld h..om subjc.l lollr
<br />$ukd^ d p.n\aiiirpR,vi\ioD\ofsccrionlTtJOoltlE Lilln O,lc,I $dll. fonhBnh.onl,'ly snh rbr p i\ions.
<br />W Rfll (;r F,ilurc ro {.or. wurkcr(.oq,.nsrion covcmBc is unhwrul. md shrll sutrlrr in dnploycr ro dmin0lFnrnics ond
<br />civil fin s ut ro or hundEd lhousa.d dollus (S,(
<br />S.cthn 1076 oa rh. tib.. Codc, a.r.cn lnd rnocy
<br />Dal.:_, Appllo,t:
<br />)0-000). in oddirion ro rhc oiconDcnsilion. drnuscs
<br />DECIABAII!]N
<br />I hcrcb, aftuD undcr Fndhyorp.rjury rhar Lm liensrt undcr Eovhion olCh@rer q (comtuftins wnh Sr.'rio.7000) orDivhion l
<br />of rhc B8ift* ,od Pdf*rions Code, ard ny ltcns n in full aorcc sid crd
<br />C!}NIIBI]CUTNIINDINGACENCT
<br />I hcehy afirD undcr Fnalry of pc.jury rnar lhnc k a $nsddao. t ndirg agcncy ro. lh. Frommc or rhc mrk for shth rhis tffin al
<br />nsu.d (S.c.1097. Cav C.)
<br />ATI:LICANLDICI.ANAIION
<br />I hcrby uiimr rndcr nctrnlry olrcrj!ry onc olrhc hlhwina dcclrnrn)ns:
<br />Demlilion Pcrnrirs.AsrEsos Notification Rdcrrl Rcluhrt,n\ (Iirl. 40. Pad6l
<br />Rcqut d l-cllcror NdiiLlltlr
<br />I rdifyrl'xr rhc li&nlrgoLrnx,r rgrrJn,! r\h.sro\r.nF\!l!rc Dor rppli.rhlc n, rhnF)lc.r
<br />-l
<br />enity rhar I lEvc rcrd rtis amli.ltion ad slerc rhar rh. {tDvc inforrorion is .omcl I aEN lo .omFly wilh trll Cily lnd Counry
<br />'dina(c\ ud Srdc Lr*s Ehrin8 ro ttrildin8 connrucrion,-afri h.r.by dulnorir EpEscnr.livcs orfiis Ciry and Couoryro enr$ uF,n lrr,z-:;;il;::;":'K---/- D.," 5 \2, \ rB
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />S as Pool Fountains
<br />Life Safety /Low Voltaqe
<br />f!1e Alarm i Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bondin / Groundin / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof To E UI ment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilin S Hard & Soffit Rou h
<br />Ceilings (T-Bar Rouoh)
<br />lvleter Release
<br />Rough
<br />FINAL ilsl6/ I Wht6,(n )
<br />Notes Remarks, Etc I
<br />Siqns (monument)
<br />Service lt/eter I.iccn\c Clisl
<br />-l.rc.
<br />\. Nuin{r:
<br />t)ule Grnr.rcr{,.
<br />rrnde, . Addrs
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