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DATE lo/stG.
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Torquing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />')-
<br />Rough
<br />Service Meter n
<br />FINAL kz2--o rYre
<br />Notes, Remarks, Etc,/
<br />Om.FBuildd DGclr.$on
<br />I hs.by rfllrm undE pcn lry of ,..ju.y tht I E qcsp fom th. Coslrrlror,' Liee Lw for th. follo*ing lg&n (s.70ll 5 Altins!
<br />Md P,of.$io. CodG) Any Ciry or County which rcqui!.r . pcni! ro @.ruuca dl. , i6pr*, d.moli or r.p.ir ey ltadsq p.io. to il!
<br />n.usre,.l!o rcquir4 rhc.pplic&t for sch pmt !o 6lc r isrEd d.lMr {[lh.ordEIlienxd pulldt ro rh. ptuvilio of$.
<br />Coor'rcloarLia.dLrw(Ch.pld9,Com.ncingwilhS.dion,000ofDivirio,Iofll.Buind.ndProflsioDCod.)ord.th!or
<br />sh. n d.f,p th.rcfron sd th. buit for th. dl.g.n a.nprion ,\ry vi6l.rion of Sdion 701 I 5 by D, .pplic.il fo. . p.mk &bjccl! 0!c
<br />.ppli4!! to i civil p.dry of nor moE lhm fvc hu.dE! dollE (lr0o).
<br />_I, a oMd of$. prop.ny, or oy .nploye wnh u8a r! th.ir bl. comp.n!!.ion, will do th. pork.nd thc,octu. n nol inrc.dcd
<br />or otr rcd lor 3.i. ( Sc 70,14, Buriiot Dd Proflrron. Cod.: Th. Conk d t LieB l-rB dB no( rpply lo & omd ofth. prcp.iy
<br />wh. builds o. inpr@s (n.@,\ Md l4o doc! Nch sorl hinr.lf o. hc6.lf or duou8h nis or hd M .mployd, provid.d th uch
<br />imp.ov.ociB u. ror i.Gnd.d or otracd for rd.. If, ho\Bs, $. brildins o. i6D.ovca.nt ir lold withi, on. y* of @npldior\ dE
<br />Ow.rBuild.rwillh!v.th.burd.nofprovinSth.lh.or.no1buildorimprowforfi.purpo4ofnl.).
<br />_I, s oM6 of thc trcpdty, .o dd!n!.I, @ir..diig wirh li@nrld @nrncloa to @.ru!d th! p.oj6t ( s€. 70aa, Budr6r ud
<br />Pof.sion cod.r rh. Coit.&ror'. Lian& trw dB nor .pply ro & owr ol prcpa, who build. d inproq thc.@n , Md who
<br />@.l!lcll lor scl' poj@t! wnh . CorI,!ctd(, li.6ed puBan to lh. Co.nrq.fr Liei& L.w )
<br />_l d .x.mpr undd S.<rion B &pa a.r thir r.Mn
<br />WORKERS COMEENSATION DECI-AR TION
<br />I h.r.by !,n rm und.r p.mhy of p.rjury on. oa tn. lolloyinS del$rioN
<br />_l hrv. d will srinrin r Cdifiqt ol Con*.r lo S.lf-le.G fo, s.lqC comp..urio4 s provid.d lor by S6rion r?00 ofr!.ffifor rh. p.rfom!.e ol $o wo.k fo. which th! pdnl i! i!!u.d
<br />vill htinltin work.rr' @hp.n3.rion insru.@,.r r.4uir.d by S.ction ]?0Oofrh.LrborCodc, fo. th. psfoman.. of th.
<br />My wotk.rs comp.nsrion cri.r ud policy numb.r !r.
<br />r for Oi. huodr.d douu {sloo) or
<br />_l edi8 lhrt ih rh. Frformrna of rhc wort fo shich rhi! ,.on h kD.4 I corloy .oy paen ir .ry 6.ms to u ro
<br />b4!m. tubjd b !h. &rldr ' @hp..[tio. hwr oac.lifomi4 ud agra I bdom. iubjdt to th. workdJ
<br />S.cion lTOO olth. Lbor Codq I rh.ll,
<br />aio
<br />to r.curc *o.kc,! @6p.nr.don i3 unl.*6r, ud rh.ll tubj&r d .nDloyq ro ofria.l p.nrliis .rd civil
<br />lin6 up to o.. Fdrdrcd tnolsnd dollE (! I0o,000),ii rddnio. lo $. @, of @np.n[lio^ d.6l8d a prcvidcd fo! th. serion 10?6 of
<br />rh. Llbor Cod., inldql md lnon.yl fer
<br />LICiNSID CONTRACTORS DECL R TION
<br />I h.r.by .ffirm uids pc.dry of p{jury th.t I m lisnql und.r ptu irioi of chrptd 9 (@nd.n.ii8 *hh s.ctiori 7000) ofDividon 3 of
<br />rh. Buiin.$ .nd Profc$ioB ! l dy lic.e i! ir tull for@ rrd.ftcr
<br />LienE Nunba C83 L( ?
<br />zo l@."",**.Ewl'a-\/1 (.-
<br />I h.r.by rffim und.r F iry of pdjury th.t U,@ ir. @.inction l.ndiis.tcmy f{ $. pqfoltm@ of th! rdl fo. which thir pmh i.
<br />irD.d (S@. ,09?, Civ C).
<br />A.EIUCANIJLDECIdEAIIAN
<br />D.fiolilion Pqhi1!-A3b.rtor Noilicrtio. fcd.al Rcgul.tion! CritL ao, Pat 6)
<br />_ R.qut dt nclofNo ,lc.rion
<br />ffithrt rhc a.d...l r.gulArions rcg(dinA !sb.$or r.movd u. no. lppliclbl. b rhis prol4t
<br />thr I h.v. r..d rhir.pplicrio, Dd is @r.ct. I .g@ ro 6mply with lll Cny.nd Counry
<br />rnd Slr1. L.wr r.l in8 !o building Epra .rivc! of thir City md Costy ro 6rqupon th.
<br />ibov. mcndon.d prop.dy fo! inrpccion
<br />L 7
<br />O"n t{
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<br />ELEC-TRICAL-INSPEC I OR RECORD
<br />M:\WPs1\Por.nil"1nsp@0on Foms\El.clr
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