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ELECTRICAL-INSPECTOR RECORD
<br />DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underoround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Vollage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding / Groundinq / UFER
<br />Translormers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soflit Rouqh
<br />Ceilinos (T-Bar Rouqh)
<br />Meter Release tl /)
<br />wt vt I I U al,
<br />Rough w/1
<br />Service lvleler
<br />Notes, Remarks, Etc.
<br />OWNER BUILI}ER DET,CARAIION
<br />I hcrchy aiirnr rnlcqrnrlrr .f p.rjuiy lhrr I @ e\cntr froh rh. Contd.ttra Li.cnsc tiv ror rhc followiry rco$n (Ss ?031.5
<br />Ausiucss 0nd Proicssion Cclc) A.y Ciry or Counry which rcqutcs a !c.mn ro consrrucr- lltcr, inDDw, dcnolhh or rcprk ,ny
<br />srruc.urc. prhr k) irs tsu cc. sls rcqut rrhc applicanr nn{.t Froir r. fik i rigmd natmnt rhd lEor shc h licensd pulsa
<br />lo lh. tmlisions oI llE Conracl.trt Licensed L.w {Chaplcr 9. CommcminB sirh Sccrion 70{D ol Divisi,n I orrhc au\in.ss and
<br />Pn,t sionsCodc)orlhar ncorshc tcxcnDr rhcrclronund rhch{xis fitr rncdllcgcd dknllion Any viohtionofSstion?0:ll5 hy rny
<br />,-rrtrtrrnr n{ . p..n'ir .ut'r.rr\,h. {pl'.rnr ro 0.'v'll. Ar) d n r 'n{crhin lrvc hundrcd dnll0hi!1rrt,,
<br />AA t\
<br />Ili/s olner,lrhcrmFrly. nIrJ cm!l")..\$ h(,a.,u'rhcn {lc cnrTcl{rtr'n. w,l J rh.}urlnxlrtr{dumhnil
<br />I,M"d.d * "fi-"d r". *h lsm 7or4, au$ft\. Jn'i Pn,rcsions Codc: Thc Contdor's Li.en* hw des nol atply ro an o*ncr ol
<br />rhc pmFrly whJ buikh or inyrors thcmn. ald who des such *\rk hnnscllor hc^clfo, throuEh ht or hcr oq..mtloycc\.
<br />f)vidcd rh"r {ch impotnxnk m , inrcnd.{l or ooerd for salc. lt hoscwr, lhc hoilding or i'.pa,v.!tunr is sld *irhir om }td
<br />oi compbrhn. rhc o*rc! Buildc, *ill hnw th. tnrdcn oI provin8 rnd be or rt. dil rcr 6uild or i'n oE k rrerdy aor rh. l[tlhic.r
<br />l. r\oqncr.irhe non dy. amcxclu\im1, c.nrra.rinE wirh li..n\en cotrkxct,^ t' con(tucr rht tn'ic.r (S(. 70,1-1, Bu.ir'c$
<br />nnd Pnifcs\inr Codcr Thc Cotrta.rofs L(ctrsc Lnw d.c\ tror rttly k) rtr nwncr olpmpcny who bnil& or i,ll|rnrMs thcr.oi.
<br />nnd who conk&(ntr ru.h tn,jccr\wnhrConrrrcr.(r) li.cn\cd
<br />li?1"v
<br />I halc a willnrinrrii*orkcrJ.omFtrsrrionirsuian..,r\rcqutdhySc.riotr3r(XrollhctiborCodc.ffflhcpcrtuirtbn.cof
<br />rhc wo'k r{tr shich rhisFrnrir is irsucil Myworkc^ .o Fcn\ n ,nsur .c crfticr {xlNlicynun$cr tuc:
<br />A,,kr, *, . *" *uo,'*nLc orrhc worl ror which rhn rem,ir n isiucd. I slEll nor cnploy nny pc^.n h {ny m..ne,
<br />{f,V,ir"'..* -r,r..i. 'r'"
<br />$orkc^.onryn,r,un rau i or c;rirornia. d +Nrhrr ial sn;h h..onE subFr rorhc
<br />workc^.onrNnsritunnft,vkionsofS(tiotr3700oflhcLIbrC.dc.Ishall.bnhwilhcomplywilhliosIrovisions.
<br />WARNIN(;] lj0rlurc lo surc rortes compcnsdi.n covcrr8c is unla$tu|- rnd shau suhjccr an cnrpl.rtt t, oininrl Fmlri*.nd
<br />:*$M#nolhn (Slm.(xrr. h trddirion TfiW-
<br />I hchbyalftnun<ld Fndhyorp.rjury rhd I a li.cn*l und.r rovisio; oi Chrplcr 9 (commmins eirh Seri,n 7fix)) or Divhion l
<br />!f lhc Ausinc$and PmfessioniCode. rfll nylt.nsc n in tullrorcc dnd.ffftr
<br />i..n{ Nunhcr
<br />-CONIIBUCII(}{.LEIDINGIIiENII
<br />I hcreby,flir{ lndcr Fnalr, orp.rjury rhd lhec ktr mnnrucli)n hndine +emt for ln€ pcra.rut. orrhc work ror which thh lEmll h
<br />nsucd (Scc. 309?. Civ. C.).
<br />AITLS:ANLDESABAIIS,N
<br />I ,E$y !fimr.dcr penrlry.ipcrjxry om orrhc r.Uowins d(brdrions:
<br />Itmolirion Pcrmils-Asl,csros Norificario. Frdcrul Rcsuhrioos (TirL 40. Pd6)
<br />-Rcquircn
<br />lrtrcr of NclifEarion
<br />rions agaidine Lqb.jros rmval arc nol applic lc lo rhls preJccl
<br />icorion lnd srordhor thc trtrvc infornmrion n corccr I ogd ro..mply wilh all Cil y snd Counly
<br />n l.en4(rhrr thr rcdcmlrcsuld
<br />4,,k(**.tr*.*1,*',t
<br />,hovc ft.r t,ncd flop.dy ror inspccr
<br />Appll.r orA{.nlSlgmlum:
<br />Pemire Mn.tpnn0:N ItA
<br />"^'il;i[
<br />I
<br />APPROVALS
<br />FINAL
<br />I hcdby amrm undcr !.Mlly or r.rjury oft orlhc rouowhg dc.ldrioncl
<br />I hDvc aid will mimain d C.n ia*ar. or Con*.r kr Sclf l ninrc for sorkcis ..'nFtrsd ion. N Imvilcd tor by Sel ion :l7l)o ol lho
<br />ljb$ Codc. for rhc perfonturcc oi rh. {orL for wli{n rhc Fnnir k issurd.
<br />I
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