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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS <br />Site-Work <br />Underground <br />Lioht Standards <br />Spas, Pool, Fountains <br />Siqns (monument) <br />Lile Safety /Low Voltaqe <br />Fire Alarm i Dampers <br />Communications Cable <br />Buildinq <br />Under Slab i Floor <br />Bondinq i Groundinq / UFER <br />Translormers <br />Torqueinq <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rouqh) <br />Ceilings (Hard & Soflit Rouoh <br />Ceilings (T-Bar Rouoh) <br />lVleter Release <br />Rough <br />Service lt/eter <br />FINAL )./<//g sD<t <br />Notes, Remarks, Etc <br />OWNER BUTI-I'ER DELCARAIION <br />I hcrchy lmrm undcr rEn y or lcrjury rnar I m excryr fmm rhe Conrrcros Lk.nr Llw ,.r lhe rollowine rcasn (SR.7031.5 <br />Busitrcss md Profcssion Codc): Any Cil, or Couly *hich rcqlirc Fmir b consrrucr. rlts, imptuvc. d.mlnh or rcn3n stry <br />\rtocrud, rn, ro ils isslan e. also ,cqxi6 rh. ,pplic&t r.r sx.h Fmir ro lik a siSncd slIcmfl that h. or dE n lien{i phaair <br />lo lh. psvisions ofdr Conkmrols Liccn*d l,w (Chapter 9. Commrcins wirh S.cri..70fi) ot Divhirn 3 of'hc Busin.ss d <br />Pofcssnns Codc)or lhal hc or shc h cxcmpl lhc.clron and lhc bash lff rhc rllcgcd cx.nflion. Any vi)hriotr of Sdbn 701L5 by.try <br />rnDlicsnr fu a pcmir slbjccrsth. lprlicrnrroucivilpc.,lryornornDorh fih hundrcd dolles ($500). <br />I. 0s oqmr of lhc pmpcny. or my cnployccs wilh w.Scs !s lhcir slc conlPcnslrio.. will do lhc wolt uxl ltr (tutm is nol <br />intcndcn or oftred for ele ( Ss 7(}14. Busincss and Pmlcssions Codc Thc Cbnr..hr's Liccns tiv des nol apply ro u osn( of <br />rh. t$|tny sho huilds or in+rmvs lhc@.. dxl who das s$h mrl hiosclfor hc(dlfor rhftugh hh or hc. owncnployccs. <br />prnvidcd rhrr rh nnpro!.nrnrs m mr inrdxllt oroflmd lor$k.ll howw. rhc toihing or impmvcrunr issldrirhin.tu ttr <br />ol.nflpttbn. lh. (rncr Buildq will h.vc rlE t{rde. ol pmving lhd tE or dE did rer hoild .i ir{mvt rh. pmtfn, for lhc ltr4ns of <br />_1. as o* mr of rht pror.ny. um cxcld\nel, contrrins sirh liccnsed conrE r,^ b ..n{ruo th. !oi! (Sc ?l},lt- Bu.i'E\\ <br />Md Pnna\\h Codc: Tho Conta.nn s Li.cnse hw dm! nor lpply lo !ros'ncr nlprcIi.ny*l{l huilds.r iinpn,vcs rhcrcon. <br />rnd lho s'nrrhcrs tu such pmjcc( wirh r Cohts.t,(s) liccnscd pur\uitrr b rh. Contrfhls Liccn{ l-l* ) <br />_l oicxchu r lcr Sc.ri{n, . B. & PC furrhir rc$otr <br />lruatrE8s:rl2llttN,\IrrrU[(IA.B.II]!)I <br />I h.rcby oilnnr undcr l]cnaliy ol Frjury one of lhc follotr in8 n(lIdtun\ <br />_l hlvc ard will minrair a Ccnific corco.\..rbs.lfl.\!rcr.rw.rkcrs onrpcnstion. as rmvidcd n, by Sdion :r7m .r rhc <br />L,hor Codc.l'or thc p.rforrome olrhc uort ro, qnich rhc ponir is is\ncd. <br />lh rr r.d willmrint id workoJ .onDcnrdit r Nurrncc. rs r.qtrncd byS(iimllTlx)olrhc ltrtxtr Co,lc, lar ihc t)crfonhrmcol <br />rhc work fd*hi.hthi\ pdnnir is issu.d My qorkcr' com|[trs.riotr nrnrrtrccc!tricr !frI lo licy nrhhr dc: <br />Pol ic y Nlmber:-Exp <br />I ccnilrrhd h rhc !.rrormmc of <br />'hc <br />w. l'or which$is pcirnil is issucrl. | \h3llnor.frplota y F*.n inonyn'inncr <br />$ Nro hc(nE \uhjccl lo rlN *oll.r cdDp.nerion lass ofCrlin'fria, md iBrcc rhd ifl should lEom subFr lo rtr <br />workcn cotrrp(trsulion prcvision\ olScdion.lT(l)ofrhc lrh.r Codd.l sh.ll. l'onhwirh.omrly *irh rhos 0rorhn,nr. <br />WARNIN(; rriLrc n, scLR sorktiJ.onD.nsdiotr.uv$agc is utrlnstul. (nd shull \ubicr rn coTloycr ro dirin,l Fn.hics ind <br />.iv I llN\ , I n, .nc hundr. rltuu\r do <br />Sr(ri(nr 1076 olrlt l-rhtrCodr. trn.tun nll(l <br />in addirion n) thc co( ofconrpeiern,n, drmecr as p.ovidcd ior rhc <br />I hcrcby dfinnund.r pcnally.l rcrjury thlr I ail pmlinoh olCh,lrs 9lcommrcinS sith Sccrion 7fil0) ofDivFn,n:l <br />of rh. Busincss.nd Profcsions Codc. ui my liccnsc h in <br />D?{ii1-t <br />I hcEby dtumundcr pcnrlry of pcrjury $d I <br />issucd(s( 109?. civ c.). <br />Lnding r*ctr.y fu rh. terlir.nrarrc oIrh. *ork fitr sh{h rhis tEhnn n <br />A.P.&IIANLDEII,AS{IION <br />Iltnlryaflimudcr Dcn,lryorpcrrury om of lhc following dchrtrlions: <br />Dcmlirion Pemirs Asbcsros Norilicarion Fcdcal Regulalbns (Tirlc40. Pan6) <br />-Rcrloircd <br />lrn€r of Norifrdion <br />I agm ro .omply wirh all Cily rnd Counl, <br />divd\ ofrhis Ciry rnd Counryto cnrq uJnn llE <br />5 <br />l"!.,n <br />Pole Bases <br />&aurlaz <br />I <br />^,.clzl{