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ELECTHICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCAR",ITION
<br />I he rel,y sflirm hder Fndr, ,,f Frjury rhar I m crcnu fmm rh. c-onrodos Lic€ne liw lor l hc followi.e E,$n lsf,. 70.1 1.5
<br />Busircis rnd Pr.a.s1n C*1.) Any Ciry or Counry whkh rcquncs a l,6mi lo con{rud, alrd- iqtrov.. d.nolirh or q)air sny
<br />srdclur. r.hr lo nr hsu0n.c, rl$ rcquncs rhcapFlkonl for sucn Irrmi lo nlc a sisocd srarcftnr rh,t tEor sh. is liccn*d nursuant
<br />xr rhc pmvnions ofrtE ConrE kr\ Liccn.cd tj* (chryrf 9. co'nmncin8 with Scction 7(100 of llirnirn.r .rrhc Busin.* ttrd
<br />Pmfcrsions codc) or th h.orshcGcx.mptlh.rcfrnnrindthcblsisaorlhculhr.d.rtnprn,n. Anyviol0rionofSccliotr7011.5l,ylny
<br />ffi ffi ffi ,ffi;*;,,dffiffiffi ;":H';i-,ffi .I1,",
<br />lh. nbtf,dy who builds or inrpmvcs thcKi, and $h' d$ $ch $nk himsclfo. hcrcll or rhou8htt or hcr owh cntplr)tcs.
<br />prcvidcd rhni such inrovcrnnrsmmt i.lcd.no!ofllBl lorelc.lt hoNercL rhc hilding.t nqk,kfthr is$ld{nhinom }qr
<br />ofcory,lclion. thc (h,ncr Buildq will tolc lh. ho.dcn ofpmlins rh,l tr or she dil not build o. itrrpovc ln. pruFly for thc purlDe of
<br />l. aso$ncrolrhc pn,pc l.atucxclu\ilcltc.ihdcrl13qirhli.cn\cd.ontrdtr!hconnrudih.p'or..rlS..7lX-1.BuvE\\a*l fh,fc\siotr Codc TlECotrtack ! Liccnsc,-rwdocs norrrplyb rn.wnd offrot'c.rysho huild\.r nnprovcs rhcrcotr,
<br />rnd oho $ntacr\ for \u.h tno!.Bsirh. Cotrtrclo(s) ltcr*d pururfl h rhc Conl[crr's Li(n\c l-rs).
<br />F1vl%
<br />I hcr.hy rlfinn unJcr r^-Drhyoltrrlu.yonc olihc tulk)
<br />-lharcnndqillroinhinaCcniftalcoaCooscirroScllli\urcnnworr.h..nDcnsrliotr.!s!.ovidedri,rbysccri(,nl?0oorrhctjtu codc. rur thc Nrrbmurcc ofrhework fushichlhc pcrmil is islucd
<br />lhavcrndsitlmii.!a,nworkrrscolxnsrhnnEuran.c,rsrcqtrtrcdbySccrion3?OOofrheL'horC(de,frrrhc!.fortunc.of
<br />rh. qorl aushichrhi\ p.rmir is issu.d M y workrN .omr.nsar i(,n rsuBn.cci crel lx,li.y numhcr rc:
<br />Pultr Nunrhtr
<br />W.,""*,**,,,*r,*fofluncc ofthc work n'r which rht p.rmir is issucd. I shrlt nor.q)ldy,ny t.rstr in any monmt
<br />rtc wo&c^ conl,c {rion liws (n Calirornia. nd a!rc.lhul ill should heco't subjdcr to rh.
<br />*ork.n comFn\rn,nn('!isn)tr\ofSc.ou:17(DufrhctiluCudc.I\hill.tunl,sirIcotr,flywi$rlntFrvi(iox
<br />WARNING I'ailurc io $urc sorkcrs compcn\arion cormse is unh$ltl. rfrl \hrll srbr.r n cDploycr ln dnrinrl pcnalrics ond
<br />.'v I rlrr.{ Ld r. un. htrMdl ihn $nd
<br />.,.,,,,,,, "-1,,,,,,J,,",.,*.,.,...",Di.: U lt"))X
<br />dollm ($lotr.ooo). in addirion ro rhe .o\r of.om!.n\aron. dnrEBca !s Imvidcd for llt
<br />I lrrch! rliirnr undcr pctrrlrlol n rjryrhar I J'n li..nkatuftlc vi\i0n.tChnprcr 9 (.unnncNirr hSccri,n7UX,of Divisi, l
<br />LicenECla$:-
<br />CANSIBIJCIANITNDIM.AGDNCI
<br />Itcrcbyafiirnu.derFnallyolpcrjuryrharrhoea\!con{rucrioibndiisagcn.yforrhcpedormnccorrhcworkrotwhi.hrhhFrnilis
<br />nsu.d (s( 109?. civ c.).
<br />t.ndcfsNarm
<br />Attttc NfDtlcr aArll!
<br />I ndrtry afm undcr p.nalty ofpcrjury.nc ol lhc l'ollowinr dcchrxrioi\:
<br />Dcnbli!ion Pc.trireAsbcslos Nolification ftdclrl Resuhlions (Tnt 40. Pii6)
<br />Rcquird ldlcr of NolifE liotr
<br />rc'nnvxlaru mr pdicrhlc n,'
<br />ab!.nrfodrt.n is..rNr. I
<br />rl h.r.h! xlrhon/r rcprc\cir
<br />rtx,k mnlioncd fmFdy ror instErion
<br />,\fl ic,nl or ,\x.nl Sisn,lun 4
<br />n8re ro coryrry wnh all Cnyand Counry-"':.';7;/,;'*"-
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lile Safety /Low Vollaqe
<br />Fire Alarm / Dampers
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding i UFER
<br />Translormers
<br />Torqueino
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soff it Rough
<br />Ceilings (T-Bar Rouoh)
<br />l\/eter Release
<br />Bough
<br />Service Meter I
<br />FINAL 2 d\\q W)21
<br />Notes, Remarks, Etc I
<br />Communications Cable
<br />Sub-Panels
<br />or rhc Busirc$ Md Pmfcsi.ns Codc. md my licctrsc is ir tull lnrcc a cflccr
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