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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS <br />Site-Work <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 />Buildins <br />Under Slab / Floor <br />Bonding / Grounding / UFER <br />Transformers <br />Torqueing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rouqh) <br />Ceilinqs (Hard & Soffit Rouoh <br />Ceilings (T-Bar RouOh) <br />It/eter Release <br />Rouqh <br />Service Meter <br />*ltffi /tt>FINAL cfltr/ta <br />Notes, Remarks, Etc <br />OWNER BU I LDER DEL(:A RATION <br />I h6.hy ofir,n unds p.ftlty oi p€rjury lhd I e .tcmB fto,n lh. Conltlclo6' t-i.ense ttw fot rh. followi4 rc&n(S.!.7031.5 <br />Busin6s md Prclsion Cod.) An, cny or cou,ry whi.h ratut6 . p6f,n to .on$tucr. ahd. inprov., d€bolish orftPair My <br />srrucnr.. rior lo ils issudc.. also ratutG lh. applicmt tor strch IEmit lo file ! si8n.d salddl thal h. or sh. i, licm.d puEuMt <br />ro lh. DrovisioB of $c Contncloit Liccn*d Law {Chafls 9, Codtoe.ci.8 wilh Sation 7000 of Divisiod I oflhc A*iness sd <br />Prulshns C.d.) o. rhnt tE or shc n srcmfl rhdefiod &d rh. bsB for ihc all.gcd €rmplion. any violatiof, oas6tion 7031 5 bv anv <br />applicanllorapqmilsubjstslhctppli.dtloacivilp..altyofnol,norclhofivehundrddollds{i500) <br />l. d own6 oathc prop€rly, or ny cmplot6 wnh sag6 d rhcir el. coDpostion, will d. ihe won( ad fi€ eB-l@ 6 mr <br />inrs'dcd or oiI€r€d tor sl. (Se.7o44, Busin$ sd PrcfsioN Cod.: Tlt Contnclois Licd. Llp do6 .ol appl, to e oM6 ol <br />rh. prDpdiy whr hrilds or nnFD6 tng@q ad who d(6 such $otk hims.lt or hqFlf or lh{urh hi! or hd own .mployc6. <br />provid.d rhar such improE .ds e mr iddd.d or ordal fo. ek Il h.vdq. lhc tliBins or inprcwmt i5 sld vilhin on. td <br />of.ompkxion. th. O\qr B{ilds will ha!. lllc hntar oaprolits th, lE ot sh. did ,ol tlild or i'qmve rhc pmFry for lhc purIDE or <br />-1, <br />6 oMs oarhc propdry, @.rclusiv.ly co.traclins with liccBcd co.rr&toEro consrud rh. Fojc.1(s( 7044, B6in6 <br />Md Pilfsim codc: Thc Conldcroas l-icc.s. Law do6 nol appl, to sn orvnd olprordy *hd brilds or improv6 lh6on, <br />and *ho conlGds lor sn h !rcje.ls wilh a Conl6clo(s) liccEd pudMr ro fi. Contrecror's Lic€e Ii*) <br />-l <br />dcr.mpr u.d6scrion-. R &PC lor(hisrNfl <br />WOiXERS'COMPENSATION <br />DECIASAIIO! <br />I hocby al6m uid6 p.o,lty oapsju.y oE oflh. follovins delar ioB <br />-! <br />havc ardvill @iflah a califical.ofco,mt lo scl m@ lor wort.6 on]pcnsotion, 6 pmvidcd fo, by Selion 3700 o llhc <br />L.bor Cade for lhc Ddlo,l@c. olrh. worl aor wnich lh. F,tril ir issu.d. <br />:f'trrv. md { 'll mainhin work.B' compcNat rcn 'B@nc.. s Equn.d by sdtion lToo of lhe ttbor cod., tur lh. dfor@c. of <br />KA isu.d. My wo*dr coniposaion iEr cc cMiq ald rFlicy ounbd rel <br />c Da i.'tef <br />""rrrn"**@ <br />I c.artyrhar rnlh. Dfllomdc. ofrh. sork for qhrch rhB pdrn{ E suol I + <br />6t <br />.ll nor orloyanypcuon in tnyn'dnd <br />$ 6 ro b.com. suhldr ro rn€ woli6' omrE$arion laws orc{lilonia, and sere lhal il I should b..on subjal Io th€ <br />$rk6.omr.salionpmaisioGolsrcxon3700ofrhctrilrCol(Ishdl.fonh*ithconplywilhrli,epovisions.. <br />WARNINC: Failurc lo seure vorkm' comp€nslion covmAc tul. Md sh"ll subjsl dployo ro riminol psuli6 dd <br />ro lhe cosl of comp.Nrion, d@gd a Fovid.d for Ihcrho6 d dollds ($100.0(10). <br />('.\lc inr6d and adomey s <br />L <br />I hqeby amro undd pe.ahy of p.rjury lhat I m licsE d und- Forision of Chsptd 9 (commocins wirh Saiion ?000) of Dtisiod l <br />oi rhc Buin* dd EoadsioG aod., and my lic.E is in full forc. dd .ftdt <br />o .?{ <br />I hdby allhn bdd Frlly of p€rjuy rha lld. i5 a .onnNdion loding as6cy lor lhc pdfomec. of thc \ro* for "tich rhis pqmn i! <br />i.sucd (sc 1097. Ci!. C.). <br />afllratrLDllcLdEallax <br />I hdtby 6frn undd pdalry of ptrjory one of lh€ lo llowinB d*ltd ions <br />Donolirion Pqrnirs'Asb6ros Norifi.ri io. Fcdd0l Rqulal ions lTillc ,10, Pan6) <br />-i.quncd <br />l4116 oa Norin.arion <br />I cdifylhal th. fcdmlrcsulalioN r.rdins 4bslos rc'noval dc not applicablc lo lhis pnjd <br />l.elifylhal I h!v€r€adrhisapplicarion hc abov. infomalion is cod.(1 I agrd ro onply trnh.llCnrod Counly <br />ordinance d SIarc l,ws Elatins ro i!6 otlhis Cnyad Cou.ryto drs tlon thc <br />ab!. n.m6.ed piopdy for i <br />Applicrnl or ,\A6t Sigmlurc:"""'1t/4* <br />I <br />L.nJd r Add* <br />-