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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Lioht Standards
<br />Spas, Pool, Fountains
<br />Sions (monument)
<br />Lite Salety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bondinq / Groundinq / UFER
<br />Transformers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />IFactory Wired Unit
<br />I P, 1"--h.rrW "l kl'*.uel\5Walls (Conduit)
<br />u&h-6Walls (Rouqh)
<br />Ceilinqs (Hard & Soflit Flouqh
<br />Ceilings (T-Bar Rough)\JIt/eter Release
<br />Rouoh
<br />Service lVeter k\4{FINAL L-9,-
<br />Notes, Bemarks, Etc.VV
<br />t
<br />OWNETI BUILDER DNLCARATTON
<br />I h.eby amnn under Enalry.r p.rjury rhor I 6 crcn{'r fn,m lhc contmcror l-ien{ tiw for rhc follosine r.!v:n 15( 70:ll 5
<br />Busine$ ord Pror.$ion Csk) Any Cny or Counry *hich rcquitcr r Fnir ro snslrucr- llrci aq)mvc dcmlish or (Pair 0nv
<br />(tu.rrr., ritrlo ns issuad. dl.. rcquircs lhcaprltlnr tor snch Fmr o liL ! sisncd rd.m rinl hcorshe i' liccnscd nunuanr
<br />ro rh. I'olisn,ns ordr Conlru.lois Li.cnr.d rrw (Ch,prcr 9- CommBinS wirh S.ction 7([rO ol Divniotr 3 of th. Businq$,nd
<br />Ptrrf.s\ions Codc)or lhar he or sh. k.xcq,l lhcrcfmm lnd lhc haik iot the trllegcd cicnflion. ny violalhn 6f Sdta,n 703 r 5 hr rnv
<br />,mli.aflr for r n rmil.nbjc.r rhc aptliconr lo acilil pcnalryorhol rmre rhd nvc hundrcd dolh6 l$500)
<br />l, u\ o*trcr ol thc poll€ny. or ny c.ployccs wirh wll8c\ 0{ rhcn rh omncnsarioi. will d. ih. Borl .nd rh. srdurc h nor
<br />in(c'rdcd oroncrcdLrsrlcrSe.7(N4.Brsihc\sdndProltsionsCodc:Th.Cunra.tol\Liensel:wd.csnornPplvroanos.ruf
<br />rhc pn,Ndy wno hilds or impr.lts lhcrcn. nnd who doc!suchwoahi,nsclfor hcrrelr.r rhtuu3h Iicor hcro*ncnd.)tcs.
<br />prcvnhd rltu such imlorcnEl]rs orc nor inti dluroll.tt lor *$ ll k)wc!.r.Ihc huifiins or i'nni(,wm r it hll *ilh onc )tr
<br />oi con{ldion- itE Owncr Buiud will hrw thc ltrtdcn ol Povi.g thar hc or shc did tror build or iq&ve lh. Pmncny lhr rhc !uqn{ of
<br />-1.
<br />as owftr ol rhc Dmpeny, n .r.lusivclycontradirrs silh liLtn\cd conlrncton b co.{ruct ttE rrcjccr (SN 7{),l4 Burrncs
<br />lNl PEfssk n Code: Thc contrrloir L,ic.isc Lau dfts tror.nDlv ro anownd olpn'pcirv *ho builds or iDlrow\ rficrco'
<br />a d sho .onlmch lor su.h,mF.R rith a Conrmcbns) lkd*d puBuanl lo ihc conr&lor s Licensc Ltrw)
<br />l0m.rcilpr unde. S..rio. .B & P C. lt r rhi\ r&nrn
<br />Orn€.
<br />]TO8$8Ji:CAMPINIAITB
<br />DECLABAIAN
<br />I h.rchysalirmundc.Denahyofn rjuryoncollhcnnhwinsd.clf0rions:
<br />I hnvc ondwill mi.ruh aCcnificalcofCon\cnr t, s.lt-,nsurc for sorkc^ coqxnsolion.0s prelidcdlorbvSdn,n3700orrhr
<br />uhd codc, ior lhc perrormnc of lhe wotk for st nh lhc lcmn is nsucd.
<br />I hlvcaDl will rinr,inqorkcrsconFnsarioninsxr.n.c.asrcqutdbysc.rionl'700ofrh.ljtnCodc.forrhcr'd'rmrmcor
<br />llr wo.k lor *hi.h rhi\ Frn l is issEi. Mysorlc^ co.fcnslion insurtrftc cmicr ud policv nuflh.r N:
<br />/V
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<br />- -l ccnify rhdi ir rh. n rfonnoncc ofrhc wotk nx wnict rhn pcrmir t kucd. I shlll nor.nplov ntrv Pcron in rnv nr.ncr
<br />i, ^b hccom subjcd ro th. *orlcn conD€nsaiii,n hwr olC,lifonrin. lnd rsd rhd ill shoukl tf,com hlcd torhc
<br />wf*cm conrpcnstionpovisio.s olS(tiu l?(x)orrht tjtFr Codc.I stull. ronhwirh coflrPlv,irh rho$ Provisions
<br />WARNINC l:rilffc t, surc qorkcn conrcn\ari(nr
<br />. l fincs up ru oi. hundrcd rhouund d.llrrs l$l(xl
<br />sccriur 1076 otrhc ltrbrCodc. inrerc{ rnd urtuy \
<br />ovcmgc is unl.stul. and sholl sub.iecr ,n coploycr lo sihindl pcMlrics end
<br />,000), in addiri6n r. rh. cosl of.ompcnsrion. dumgcs ds lovidcd rbr lhc*ui;
<br />6'?s- tr
<br />I I(:liNsI,iD coN'rRA(t't'()R
<br />ll[l].ll&lMN
<br />I hcchy orfirmxndcr lcMll, ot Derjury rhar 1oft liccNn uidcr Forisiotr of ChaPrer I (.ommmins wirh Sdio. ?Ou)) ofDilGbd l
<br />of rhc Ausiftss ald PmL$ions Cudc, tnd my liccnc n in tull aor.. flt cltecr
<br />Lc u ?7/,t l9
<br />6 ']S'tr.'.,*,*,8-bbut*13L!taroltl kairn
<br />!!)diIBI]qIIAN!ENDING.{AEXCI
<br />l hcr.by !ftl utrdc! tEnohrofp.rjrylh{ lhc.c h.onsltucrit,n Lndin8 lsercr rorrh. Iltfornlrrcc orrh.$ork i'rshichrhi\ frrmil is
<br />hsu.{ (Scc.1097. Civ C.)
<br />Ixtr,lcr ' AJnrc{
<br />]lll:lJ(^.\LllEll &!Iu!
<br />I l*rh]_ ntr,trn,l.rtI nLrJ.llul,trrrn.ol rh.n'lkN trgd.(lrnrir)\
<br />I).(niri,{rI'.nrirsA\h.{.\N.rrlirirnrl.drrrlRc!lrro\(lirlc1l).l'r,ra)
<br />Iir\triir.rl lxrr.r,'f N.rifi.{iotr
<br />1..rrir! rli! rh.t!]cr)!icluIri,, \rr!r trr! '.h({o! r.fnrr]rc i!rtildl$hl. n) rhr\ trolcrr
<br />\r nrnrnnrd pnr,tny ltr iN!.cr
<br />,\policrtrl or Aafll sisnrln
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<br />B
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