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