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ELECTRICAL.INSPECTOR RECOHD <br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCANATION <br />, h.r.by sffrn und.r p.nally of pcrjurr rhsr I m cxcrpt imm rhc ConrrucroN l-ic.ns. tiw r.r ih. rolbwinS rcabn (Sc.70315 <br />Business md Profc$ion Codc): Any Ciry or Counry *hth requiEr . rrnnt ro onrl cl. 1116. in{,ovc, d€mlisn or eFn any <br />d .rxd, prior lo ik ksx,.cc. sls r.quncs lh. sprlicanl for such r.rmit io filcosisned (aremnr rhar heorshc is li.cnscd puruanr <br />r. rhc pm$ions oi rlrc Conts.roas Li.c.!.d bw (chaflc, 9. Cnmmncin8 *ilh Secrbn 7000 of Oivision I ol rhc Busincar and <br />Prcrcssions codc) or thrt hcnshc tcxcm lh€rcfromlndrhchosn tulh. allcgcd cxcmrrion Ant vbl.lio.ofsNlionT0ll 5l,yan, <br />appliclnrfor!pc.nrir n'brccl! rh. artli.rnl b d civil Ftulr, or nor nbr. rh8n fivc hundrcd doll0r ($5OO). <br />fflr[-a,'*, *,* n-^nr. ornr]cnrlo]rcs - h '08cs rs rhcn soh sntc.sdj"n- wirl do rrt sdk ond rhc stutm is nn <br />lnIcndd o!.,Icd ror elc rS( 7r rl4. Busincs ad Prnfessions Codc: Th Gn ,u.tors Liccne tj* do.s nor lpnly lo t. owmr ot <br />rhc p6pe'1y *h6 tniur or inqnv.s rh.mn. aJrl who dds skh *.* hingll or hcMlf or thmu8n nt or her.wn .n{,loy.cs. <br />rmvidc'r thai su.h imnmvcnE s N nor idc ol or oftcBl ror slc. ,( howctq rhc huitti4 or inirowftnr is sld wilhh orc )ttr <br />oiconFktiotr. rhc Owmr Buildc Bill harc IIE t!dc. oI tmvins lhlt tE or shc dil mr bdu or inprclr thc p$t dy r.t rhc lurtnc or <br />I..sowmr oflhc pn,pcny. !mcxclusivelyconrrlinE silh licc.scd conrrrcbn k,..nnrud rh. Pn)jcd 1S(. ?(x,4. Busin$r <br />i PnrfssionCodc: Thc Conlrrkr's Licosc lf,* doc\ nor aprly k, M oNnc orpiopciry *no huilds or nnpn,les rh.r.oi. <br />.nd who.onh.Btaisu.htrcj.dswirh0ftnrm.e,(\)li(flscdpuruullorh.Conrruckr'\t-iccn€tjw) <br />-" +L <br />I hcrcby allirr und.r pcuhyorp.rjurtonc oarhc f.lh{ ing d(lxr <br />l havc Md sill roinrain , C.n ifrdc of ct)nsnr kJ Sclf.ln\urc f(r qorkcB .onDrnsiri{'n. ,\ pmvidcJ tur by SN! ion l7(D .I rhc <br />l2txrr Colc- ior rhc tsn,rome ufrh. woik lnrwhi.hrh.l.rn is is{ucd <br />I h!!. ,tuI * l n[inrain $oikcrl confctrs ion insurm.c. as rcquncd hy Scclion .]Tm of rh. lrh.t Codc. for lhc I'crntrromc of <br />rh.workr(trehichrhhp.rnirisnsudlMyworkcr'snrlcnsalionnNur.ncccrnierarldrnicyou'nl'crdc: <br />4+#--iffi <br />*nrkcn'omtEnsario.provi\ionsotSc.rion.l?00ofrhclrhtr(ixl..l\hrll.fodhrirhconrplrsirhrhoctroeti{,n\ <br />WARNING: r,i[r. t, ecur. workcs .onDcnsdion covcrrtc is urla*lL']. rtrJ shrll sohjccr rn cill)l,,ycr ro criDirrl pcmhi.s md <br />.i!il finds up k, one huMrcd rhousn.d dollss (Slm-Un). in rddirt'n t, rhc.oi of.omFn\rr'on. dlnE8es as !rc\nld lor rhc <br />::,l4ib1$. : <br />I hcEhyrlltmun,tr nctrrlryoltujur!rlrar I int lkctr{d provisio. ol Chtrt'lcr q (conrm.cinE * <br />.l rhc ll'rin.s <br />"nd <br />Pronsion\ Co c uJ m! lic.nsc is i', rollfomcrndcirc.r <br />LienK Numtcr: <br />-CQNEIB!!:UQNIENDINCAGENCI <br />I hcrby afliirn und.r Fnrltyorpcrjury rhar rhcrc is i mnslrudion tndins ?scncy li)r rhc Frr.ilrhn.c ofrhc work lor which riis Fmi n <br />hsucd{S( lll97-Civ C) <br />t ndcls Namc:- <br />A.TTLICANLDICLAXABTN <br />Itr{hy llmundcr pcnall! orpcrjuiy onc olrhc lollowins dccl!!!rions <br />D.molnn,n Pcrfrirs Ash.sos Nori,i.ariotr Fcdcr0l RcBUhrnnu (rilb40. t' 6) <br />Rcquiro{l l.crrrr ol Noriliori,rt <br />lffid;;ffii <br />rcsllalions Esordins rsbcslos rcmvoluc ool afflicahlc ro rhi! projul. <br />n arpli.ation Md rlarc lhnr rhe {bore inr.mri,n is comcl I !8rr lo otr{,ly unh a Cny ind Counly <br />nt-rc rflrioncd pmp.nyLr inrpccrion <br />,\ppliunl trrAxr t SiAtrtrl r. <br />^w"::Tblis- <br />Site-Work <br />Underground <br />Pole Bases <br />Liqht Standards <br />Spas, Pool, Founlains <br />Siqns (monument) <br />Lile Safety /Low Voltaqe <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bondinq / Groundinq / UFER <br />Translormers <br />Torqueing <br />Air Conditioners <br />Flool Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rouqh) <br />Ceilinqs (Hard & Soffit Rouqh <br />Ceilings (T-Bar Rough) <br />N/eter Release <br />Rough <br />Service lt/eter lt l <br />FINAL <br />Notes Remarks Etc. <br />iq <br />t ndcis Addrcsr: <br />- <br />Sub-Panels