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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Lighl Standards
<br />e pas, Pool, Fountains
<br />Signs (monument)
<br />lite Safety /Low Volta
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Groundinq / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rouoh
<br />Ceilinqs (T-Bar Rouoh)
<br />lvleter Release
<br />Rough
<br />Service lVleter ,a\ ^O
<br />I '\F
<br />l-V,ruNotes, Remarks , Etc.
<br />()$NEN BUII,DER DELCARATION
<br />I hcrcty aifin, utrdo pcnllry ()f Nrjury lhol I m €xc'npt fmn the Co rncloc Ltctrrc tiw for lhc lbllowins rc!\,n ( SN.?01 1.5
<br />ausin.ss a Pmrc*io. C.dc): Any Cny or County which rcqui,cs 3 Fnnir r. .or{rucr. rlrtr, nnprovc, dc'nolish or rcp y
<br />sloclurc. pritrlo ils asuoftc..lo r.quncs rhc appha ror iuch Fm[ k, filcasigmd slar.n$r rhd h.or str is lic.nsd puruonl
<br />k, rhc pEljsn,ns of rh€ O,nl,acrors l,jcenscd Llw (Chaptcr 9. Commncins wilh Sccrton 7000 ol Diltion I or rh. Busincss and
<br />P^rc$ions Q,Jcl ur rhJr h. ur rh. i!.rcn'rr rhrrctrunod rhc barn f rh.allcg.ddcoprion.AryviolalionofsdionT0:il5byrtry
<br />Alrlirrnt lora|tirnr subic.l"'t" uppt,.nn,,^ o..rpnor,y"ln.{ rrcErh!n rtrc humlrcd d llr,,$\r't,
<br />It&rrrrlL*=ril*!ii1=rifl;;r1,"""r:.'.:rj:Jxiilrfl*xiir;ir""r:LT:LflHffrri.""Tl.
<br />",rh. rtulEdy who hoilds or ir9bws dlmn. ard who dms strch Ml,l hinsclf.r hcr*lforrhoughhirorh.rowncrployc.s,
<br />pmvidcd rhar stch inFornEnrs m .ol hrcn'lcd or orlcs, ror erc. l( howclci llE huitdins or inrflDrcmnr i! sU *irhin ooc )E
<br />ofoq,hliotr. lh. (rtrn Buildn will h,n lhc bonlfl or tmving 'hd
<br />h. or sh. did mr bxild or ingmrc dr tmFdy for ll* IUrFs ol
<br />-1.
<br />0soqnc.ofthc lmtLny. amcxclusivcly.onthch8 *irh li.cns.d.anrNrostr cons{.t rhc pmrcd (Scc.7044. Bunnc$
<br />anl I\i,tusirn Codc Thc Ci,nh.roi s Li.cn\c Lrw docs n rarplyroanoe.crofpn)Jr. y who hrilds o' inlrovcr rh.rc.tr.
<br />r'(1 who.onrrachforslchpmjmrs-irhaConlmcton\)lntrscdpursurdlonECbnrrudoisLiccnschw)
<br />Itj,t l>
<br />I hercby rlfirmundcr tcnrlryol acqury om olrhc lolloqin8 il.cl.r.hons
<br />lhnvcdrlwillnuinrainrC.nifi. cbfCotrrnrtuSclfln\ur.forwork.r\'conrFnsdi(,n.rsptuvidcdlarbyScclionlT0Oollhe
<br />tr xn C(dc. ro, rhc lcrfonnmcc oirh.*olk rorshich rh. pen,ir k isucd
<br />I hnvc ,ft1 qill nt.inriin wo.k.rs .oq*nsarion insuratu.. rr rrqund by S(rn,n 1700 of rh. ljbur Gdc. fo. th.
<br />'le
<br />ormkc ol
<br />lhc work for whi.h rhis p.iinn ir isscd. My workcm- c.mp.ngr ion in suiim.c .aricr drl FlicynuNbcr m
<br />-Exrirci
<br />is rsucd,I sh0ll nor rmploy !try pc atr in rtry mDnncr
<br />ia. Md lsrccrhrr ifl \lr,uld h.c(rm {hjcd torlE
<br />vorkcr{ rlilp.trqi i.n nmusion\ uf S..rion .l7(X) of rh. l ihtr Gnlc, l \hrll- f{trrhwirh .o rry wirh rhor rruvisions
<br />W RNIN(I ljiilurc ro s..Lrc
<br />.I'Il ,r.- - . "r. '-a..1,::;lilt?t
<br />s.rlcn conrEtrrrri{rr c.r..r!c i trfliwtnl. i shr I {,hi.cr rn cDpl,iycr 6 .ri i' l F rlric\ anil
<br />hou\rnd ol1$ (tl()o,(x]l)). ir !ddition
<br />I hcnht rfln, u d$ I)t lrtf l pcrjury rhrr I r i l'rn{d und.r Iln n orch,fl.r 9 (come*ncing pith Sc.lion ?Ux)J ofDivnion ]
<br />oI rh. lrusirc$. Pmrcssions Codc, { nry liccnse is tu tull ntre. clncr
<br />CUJEIAIqIIANIENDINCJCENCI
<br />I hcab, dn n und$ ,.nalry or p.rury rhd rhft is a conslo.'ion lcndin8 igency for thr !.rformncc of lhc work lbr shich rhis pcmil is
<br />hslcd (Ss.:1097.Ci! C )
<br />g:tr{li',8 r\h(no\ nrnortrlr. n.rrpflicrblc h !hi\ fn,jccr
<br />rhrr rhc rbv. i.fornDri.n is..Nr. 1.8.o ro c.mlly unh 0ll
<br />,\pplirn l.r ,\{tnr Si(n{lur.
<br />^".,':::',''Lii
<br />bl15
<br />Evs
<br />I
<br />u*" u
<br />AITLICANLDECI.AIA]JON
<br />I lslby amm undcr Fnalty ot lcrjlry orc ol lhc follo*in8 deluut ions:
<br />Dcnnlition Pcrnirs-Asbcsros Noriarcation Fcdcrul Rc8uhl bns {Titlc 'llJ. Pi 6)
<br />-Reqlicn
<br />kllcr of NorifEalbn
<br />Air Conditioners
<br />FINAL u\'14
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