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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE COMMENTS OWNEI BUILDER DEI-CA RATION
<br />I hcrcby llfim utrdcr pcmlly oa ncriury that I arn cx.nDr rmnr rhc Conrr.doE Liccnsc Law lor $c followinx E!$n (Se..?011.5
<br />Busi'r.\s and Pturcsion Codc)r Any Ciry or Cohry which rcqunc\ r n€rmit lo con(ruct. ulls. improvc. dcmolth or rclan .ny
<br />slructurc. fliorto ns hsuancc,oko rcqunccth. dttli.0nr for such lcrmn tu fih r sigftd {arc'rcnr rhrt h.or shc k li.cnkd pu*udnr
<br />t{, rhc pi(,rkinnr of lh. Conltucl{n\ l-iccnsed ljq (Ch{ q 9. Colnmemin8 $irh Scclion 70(10 of Division I ofrhc Busine$ ond
<br />Pmlcssions Codc) or rh h. .r th. i\ ckmpr rh.hk.d lnd rk t asis tr rlc alLsed ercnnrion Any vklaraonofserionT0ll5 bynny
<br />applicrnrrorrpcrmir\uhjarlhc.mli.anlroaci!ilt'cmllrolnormtrcrh.trfivehunnrcddollaG(S5t1o)
<br />-1,rsowncrolrhcpmpcny.rrrycnrtloydssi[wagcsrirh.nvftconlFn\nlnrn,willdorh.w.rk
<br />nd rhc stulu i\ nur
<br />inrendcd o. oncrcd nn sb (Ss 7044. Busims trtrd PftnasioDs C.dc:1lf cnntnclols Li.cnsc Low docs nor ollly ro anowncr ol
<br />rhc tn{Edy wlh buildsor in{tur$ rh.Nn, dd wlr, drxs such krl hnns.lfor h.rscltor rhtuu8h his or h* ostr.mploy.cs.
<br />p&,vidcd rh *o.h impn,lc'tunh e 6r intcndcn or otTcrcd lill sb ll now.wr, rhc hliklirg or tnDmtmnr ii v,*l wirhin oft )rir
<br />ororohrion. rhcOsner Buit& Nill hlw ilE hudcn ofroving lh.r tE or shc dt mr t ll o, itrllm$ thc tmIriy fo, rlt purFr ol
<br />I. aro*mrol rl,cpnptny. !trl.rclusivcly.onrr.rring *ir[ ]iccrscdcoMndorsrocon(rucr rlrc pF.rccrrScc 7(]4:1.3u!n.$
<br />rd Pn,fcs\i Cd. lhcCotrk.rr'\Li.ctrscLra(l()c\norrpplt,nrMori$ofpi()lfnywhoburldsornnpo\esthcrcotr.
<br />.trd sho.onrrd\nn\uchtnrl.cr\sirhr(i,nkrcnnh)li.cosclftr^urnrhrhccontJcttr\t.i..n\cLis)
<br />_lircxcnrfr undn Scdnfi ,B &PC i{thisr.Nn,
<br />l)ar. (hrn..
<br />rvot( 0Rs' c(,ilr taNsAl'toN
<br />]2EILA.BII]!]N
<br />I h('(ht rllnn utrJ.r prnrLr!olpcrjr\ ond olrl[,,,]1,\\ ir! dc.lxrirk!r\
<br />ry'tl,.,.r, . r l , .
<br />| , i . r . .
<br />, . , ,
<br />.. . .r ),. ).,1 .:" shi. "!, t,, ir . i.\.r.,
<br />I nrvc utul will nuinrain s,orkcri compcnsatn insurnNc. as rc(
<br />rhc so'r ro' {hich rhi.$,mtr ,\,}u"d M) tror[c6' c.mFn\Jri.n
<br />cJn(, -< \-q{4\ ersr''.a
<br />tuircd hyS.clion li(nol rhcljborG)dc. forlhe pcrlo rnccoi
<br />inslmNccaFicra Flicy nunrher !rc:
<br />.T C.
<br />-lccniryrhd
<br />irrhcltcrh Mtrc(ofrhc work fd $h'.h rhnr.nnir il s{icd. I \hrll tror ctrlployrnypcron nr.ry Nr.trcr
<br />\' r ro bc(,ft shj.d ro rhc *orkcr( .on,!.nsrr ion hws ol Calil.ni( and igEc rhrr ii I rhoukl bccon{ suhFi ro rhc
<br />*orkcrJ conll.i\irnDpnvGionsolS(rionl7(X)olrhclitbr(:odc.l\hrl-lbnh$irhcon, ysihrtoelro\hion\
<br />ll,\RNlN{; lJ L . i, !,.tr'. \,' l,r\
<br />*a"\,1,r"*
<br />orr,,rh,
<br />1l n'htccr nn cnrrloyc! ro .rnninrl pcmlrics Nd
<br />ol'conlrctr\ilion. dtrmr8es as p.avAcd fir thc
<br />Y::ri'\aT R
<br />I hcrchyrllir.rutr .rN,rlryoI|criLtryrhr I d r li.ctrwltrndcr]rn,r iorCh trcrq(contrnon ingLVirhS.rri, 7000rol Dnr!otr:l
<br />Psfc*tfiCl c. dkl nry licrn\. i\ in lullturrtr cftqr
<br />G
<br />,*" \\C \\
<br />II.IIIIEUqU()NIENDIIG.ACEIII
<br />I hcrcby amrm undcr lEnrlry oi pcrjMy lhd lh.r is . on(ocrbn knding d8.fty ror lhc p.rf.,mmc or lh€ wo* lor wnich lhn lErmn n
<br />ksucd (se. 1097. civ. c.).
<br />, AITLII;ANLITESAAAIION
<br />I hcnt4oltimuMcrFnaxyoll'crjuryoncolrh.nni,wingdccl srn,ns
<br />Dcmoliriotr Pfimirs^ib.sos Notifi.ari.n F.dcral RcE!larions (1 itlc 40, Parto
<br />-Rcqunc{
<br />LcttcrolNolifi. iotr
<br />I c.dilyrh rhc fed.ralrcllhrtuns rcBardiq rsbenos rcnbvrt lrc oor llDlEabh r. rtris nrorcct
<br />r=licn ily lhnl I tuvc rcad rhis .fflicrri u (rrcrh rhcnh,vc irforturi( n.od..r.I rgi..io.o'ntlywirhrllC yandC.rtrri
<br />rzc rcprcstr! rc\ ofrhis Cny.nd
<br />,.t":l
<br />nrr oi. n (lh.!rhyxtrrhor rrtl
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Si NS monument
<br />Life Salety /Low Voltaqe
<br />Fire Alarm / Dam pers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Groundinq / UFER
<br />Transformers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouoh)
<br />Ceilings (Hard & Soffit Rouoh
<br />Ceilings (T-Bar Rouoh)
<br />l\4eter Release
<br />,A
<br />Rou gh 5-2-l{xl{tta
<br />Service [t/]eter /Y
<br />FINAL ra-n-v YtlrN
<br />Notes Remarks, Etc.w
<br />IDiSIG.
<br />onlirrn.cs rtr(l Srnlc I$s rclrlng
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