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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Pool FountainsSS
<br />Si gns (monument)
<br />1-ife Safety /Low Voltage
<br />Fire Alarm / Dam pers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bondi / Groundi i UFER
<br />Sub-Panels
<br />Air Conditioners
<br />mentEU
<br />Facto Wired Unil
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rouoh
<br />Ceilings (T-Bar Rough)
<br />Ivleter Release
<br />Rough
<br />Service [t/]eter
<br />,,ildJt? I -'lllrt l-
<br />c$-,r
<br />Notes, Remarks Etc-7 {; Cov.! ltl CUJ t
<br />OWNEf, BUILDER DELCARATION
<br />I hercby alfinD ufld.r p.nalry or p.rjury lh,r I d cx€mpl fmm th. Conr.clor' Lic..€ tj* f(s rh. tollbvins ra$. (Scc.7oll.J
<br />Businc$ lul Prcfcssion Codr) Any Ciry., C.nnry which rcauncs . f6mir io constdct. all.r. iq)ft,vc. d.mlich q. rFir any .
<br />slructurc, Fi,r b n. issoarc- als rcquncs rh. amlk,fl fo. strch F,mir lo nh { siBD.n nlkmnr thai tE or shc b ti..nsd pnmani
<br />ro rh. pmvhions of rlE Conhc'or's t-iccnsd k{ (Chlprcr 9. Co'nmcNins wilh Sucrion 7000 of Division I of rh€ Blsine$ lnd ,
<br />hofcssions Cnlc) o. rhar h.qshc L\cicmpt thcrcfrom alld th. bask tn rh. rlhscd cicn{,rion. An,viol ionofsarinr?03t.5bymy
<br />dp,'licunt for r pcrnril subleca thc applicinr lo acililpenaltyofnol m.dhin fivc hundrcd dollrs t$51()).
<br />l. a\ own.r or rhc lrIl'|rny. or my cDploy..s wirh wrsc\ 6 thcn $b comFnsurion. will do lhc work Md ih. stmtm k mr
<br />inrc c<l .rolIcrcd rn elclSN 7l)44- Busitrcs r Pr.t ssbns Co<lc: Tl.c Conracror's Liccnsc Llv docs not artty ro anown$or
<br />rhc F)r. y *b lDilds or in{mvcs lhcNn. ind who doe\ such work hiNc ll or hcrslf or rhoueh his or hcr own cnllorccs.
<br />tn,vidcd rhar such inpnrkm.n d n inh'dcd orofrcBl f.r sL.Il h)wcqcr rhc buitling or in{,nrrcm is $ttwirhinotu }rd
<br />ur.omplciion. lhc Ovncr Burlld will havc rhe hordcn ol prcviry rhlr hr or sh. did nor build or ir{mrc ric F)peny ior rh. purF,s of
<br />l. i\osftrolrhc ropcny, omcx.lusivcl, contkrn,s $ith li.ctrsed contrrlo.sl. onsrfld rhr ttuFd (scc ?Or4, Btrlncs
<br />urxl PnrtssiDC.dcrTh.Comractor'rLiccnscLredocsnorapltrkrano*ncrottrop! yqho huitdsor imrmvcs rh.ron.
<br />nd sho conrnErs lbr suchl,micr wirh r Co.rscror(I liansd Durcur r. rhc c.trkrcr, r l-icctrs trw)
<br />I an'crc.rt, u.drrSart,n_.3 & l!C tarrhhrcrsn
<br />D.lq o*ner:
<br />wonxrqsiir)i, piniATiil[
<br />DICLANAIAN
<br />I herby ofiiflnundc. pcnalryofFrjoryonc ofthe following dc.lxari('ns
<br />Ih.vcmduillnBinllina('cnias colcotrririosclllnsurcrbrrorkcn conrrcn io..,s ttuvid.dnnbrS..ri('n:]7(xroiltrl-dx, Codc. Ior lhc !.lfon,Ekd orrhc*ork forwhich lhcFirnir is i\sucd
<br />y'n*","0 *r,,,ro, **[cs'conllrncdbn rn\umtuc- &s requrci by serion ]7{n orrhc bt(, Cod., iorlhc p$t lmancc otrhc*okrdshrhrhnFmir.i\$edMy*orkcFom[Icn$hnn,n\uromccdridodFtrynu'nhcr..
<br />69 L}
<br />-lccnilyrharinrhcr.rlarmi.c.trhc$orklorrhi.hrhispcrn
<br />n i\socd.I \Mll nor cmployonyncrsotr ir rny Drtrrc.
<br />$ * r, hcdmrc shrd lo rhc worlcs c.mr.nsari,,n ltrw\ ofcfllifortri(.nd lsN d irI should b.&m subjcd rorhc
<br />wortcr' .oft cn\dlion provision\ oI seriotr r?00 or rh. uhr co{c. I shall. bnn*nh onpty wirh rho* Frvision\
<br />W,iRNINGT l,iiluE b s.urc wrkcr ompcneii(in.ovctus.hjd !n eflIloycr to nnninal Fn,kics,ndcivil fincs up to otrc huftlr.d rhon{id dol[6 (Sloo.ux).onrpcnsrliqr. d!m{!cs is nrovidL\l fd rlr
<br />:::::":-';:'rt6[i;l
<br />I hcEhyaiirmundcr pctr.lry.rr.rruryrhrr I am liccns.(Mc, pn,v(hn of Chrflcr 9 ( commcncinE wirh Ssrirn 7(n0) oI Division :l
<br />oi rhc Busirc\r dd P0li\\ion\C.dc. r l nrv lic.n{c n i'r,ullrrm. anrlctii.r
<br />o ,,,,*,/11/x)67?
<br />I hcEby !,Irm undcr trMlly of prjury rhd thse i a mn(Ecti.rn
<br />nsucd (Se. 109?. Civ, C.).
<br />a&n.y tur rh. nsrff'umc ofric $ort aorwhichthhn nnir k
<br />APPI ICANI DECI dRATI0N
<br />I hotby altm unds Fnnxy of F.rjury ooe of the iolloqinB deh.rl ionsl
<br />DcflElilio. Pcrnn!Asbcsros Norificlrion F.dchl R.gul ions {Tnb 40. Pan6)
<br />_R.gxircd lrtrf ol llolifEtin
<br />-l
<br />.enif, rhal fi. tcdctul rceulxrionr rcaslina ashstos ertulal sc .or lnplicabL ro rhis projd
<br />l.d,lvrhrr I hrvcrcadrhirl .rd sarc rhlr rhc !tn!c inlo,mr ion n con cr I aere k, ompl, ! ith !U Cirr rnd Counry
<br />rrdirrncr\ ind Srarc ltrws relr(irB r (ulhorizcrcprcsc itcs olthh C
<br />ah,vc nrnriomd l,oplny ror ins
<br />PNL
<br />Applicrnl or Agenl SiSmlnE
<br />P.dile Eme ( prinl ):c/A
<br />.';J;/;',-'.
<br />Lioht Standards
<br />Transformers
<br />Torqueinq
<br />Roof Top
<br />Walls (Conduit)
<br />FINAL f2
<br />Lc cls Addr.ii
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