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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE tD/stG.COMMENTS OWNER BUTT,DER DELCNRATTON
<br />I hcrcby aflnn undcr F.ahy ol rcrjury 'hol
<br />I m cx.mpr rmm (h. Conra.rou Licens tjw lor ihc iollosin8 rc.bn ls.c ?03 1 s
<br />Businc$ axl Pnlcssion C.d.): Any Cir, or C.unly rhich rcquircs 0 lErmir lo onsldct. ohs. imlmvc, dcmlth or tFn any
<br />ntodu,c- lrior ro irs issu!rce. ako rcqlnes rhc alplic0nr rbr such F mi ro fiE a sismd sraremnr rhar lE or sh. is ltco*d puElahr
<br />to thc Eovisbns ofdr Co.kEbls Liccnsd t{w (Ch.pr.r 9, C.frmBin8 *nh Scclion 7om of Divhn'n I or rhc Blsincs and
<br />Pn,fcsn,.r Co{tc) or ihar hc o, shr k cx.nfl rheElod lod thc h.sis lor rhc dkS.d .r.nplioo AnyviolrrionorSc.rhnTOll.5byany
<br />q,rlican' lor a ,,cntrjl subjNls th. amlicanl ro ! .ivil pcni lry or nor mE rhe fiv. hundrcd dollas (5500).
<br />l. N o*n( of rh. pnrFdy. or fry cnflortr\ *irh wrgc\ o1 rh. ir ulc roop.ns i.n. *ill do rh. wtrk dxl rhc {mrm G tur
<br />i .ndd or orIcrcd lor $lc (Sa.?044. BusilEs nnd Profcssbnr Codcr Thc Conlnctols Liccnsc tiu doc\ nol lpply lo rn osncror
<br />rh.pol{ny who huilds or inlptr,va rh.u,n. md who .lms such s& hinsclf.r hd*.lf.r rhR'xgh hi* .r hci ow cnrrbyccs.
<br />Dori{l.rl thur such imlotemnr !rc ml i, cndcd or ollarcd f.r qrlc ll howcE rhc tdildir8 or impmvemd G nnd sirhin one rcr
<br />ofconrrbtnh. fi. Owncr Auitlf sill hivc rh. burdcn of pn'ving rhd hc or shc did tur build or i4)ov. rhc pm!.ny lor llE pu{n* of
<br />l. N .wncr of rhc !mp.dy. a'n cx.lurivcly .onracli'ig *irh licei{d .ontrcro( ro drNdd rlk p$i\l (Sc. 70&. suiim$
<br />trnl lhtssirr Codcr Thc Conlracitr \ t.iccnse t,oq d@s tror ilply to an owncr olpmpcny *ho 6uild\ or nnnnvcs rhcrN.,
<br />rnd who .d.rrck for such pn c.k w h r Cl,nrn.hn r lkrtr*d puhuMr ro rhc Conlr..rols Licctrsc L!w).
<br />I omcxcmpt und.. Sdr B & I'.C furhi\ rc.son.
<br />lu.BlilBs:louflNiiarraN
<br />DESASIIIQN
<br />I hcrcht rtft'n trtrdcr lcnalrlofr.rj!.ronc ol rhc f{n[)qira d..lxrrnnr
<br />lhrvc arxl willnDinrain dC.nificarcofC.n\. bS.ll ln\trrci(reork.A..mp.ns0ooi.ns pmvidcdlorbySalion3T0Oolrhc
<br />Illi, Cqlc- t)r lhc pcrlonuncc orrhc wo ntshichrhcn rmi is n{td
<br />I hrvc rtrd will nrinriin vorkcri .onrlrcN.rtu ir\urnmc. i1 tuqtrircd byScclhn.l7l)O.ithc ljhorC.dc. nr rhc pcrtortun( of
<br />tltr n is issucd. My workLrs conn n$oun iniurM.c.Mid ffil,Flicynumh.r m
<br />D . \.\
<br />I.cnrfyrh hrhcpcrlo Mtr.coirhc wo.k ld whi.h rhir!.nnir is nsucd.Ishallnol cnrphyany pcron inlny 'nannc'y, rs r,, hcconE subjci h rnc *orkcn conrncnsarior h$\ ofcrlilorni( ind Jgrk rhar if l \k'uu t (,,t \ubt cr k' rhr
<br />$orkc6 c.nrtcnsriion pmvtioas ors(ln,n.l70(Jollhc l,hn Corc.l\hrll. nrnh$irh co'npl! sirh rh{ rn,vi{t'is
<br />WARNIN(;: Faihrc k, {.u. sorkcB conrNnsdj'nr .o!.rr[c i\ unlrwtul. .nd \hdl suhjcd .n cnUnDer ro riminal FBltis and
<br />.lvil fin.c up r. ond hundrcd lhousrnd dol[n l$l{D.lXt,
<br />SNrion 1076.rrhc libr C.dc. ir cn( and anorNv.s l.cs
<br />), in addirion ro rhc cosl ofconrF
<br />rr,r", ll llt t r 1n 10
<br />^rruN ll{uto
<br />DIiCIAMTON
<br />I hcahy rr6nnundc. !.nrltyofpcrjurylhar I rn liccn*d undcr rmvnion olChaptcr 9 (comnEncins wirh Sccrion 7$o) orDivhn,n l
<br />of rh. Busin.ssmd Pmfcssions codc,.nd my li.cns. is in fullforN d cflc.r
<br />I ,zo1.l qcL
<br />AITLICANI.IIECI.AEAIION
<br />I hd.'bynmmrnd.r r.n lry ofFrjury onc ofrhc rolk,winE dLrlnr io.\:
<br />Dcnlniio Fermils-Asbcnos Nolificlrn'n Fcdcrol Rc8ulntions (Tnb.10, P.rr6)
<br />-Rcquncd
<br />tdl!r ol Norifi cii,n
<br />l.cniltrl rhcrcdcmlrcAuldi.ns rcE dir8rsh,no\ rc n)vxl r. hr rltli.rhlc lolhn nrojccl
<br />E-rrd,ri rhr I )bL. rcJd ths afrEar
<br />.rdinJn!cr rn,l S,rr. lr$\ rLrinE r. bu
<br />abov. mnrioncdpmpcny lor iost .rion
<br />i(rrtrd {irr Ih rlt rh'!.)comrly*nh all Cnrxnd Counry
<br />lhn Cnyand Counly ro cnrcr lpon rne
<br />ADplic!nr or ,1genl Signalurcl .- l
<br />-Paq;ll. L.4
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Founlains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding i Groundinq / UFER
<br />Transformers
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilinqs (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rough)
<br />Rough b/(L//6 ,t\€{
<br />Service lvleter
<br />FINAL f//tttq rASg
<br />Notes, Remarks, Etc
<br />Ivleter Release
<br />V^*^ra
<br />calglaugu!)NrENltlliclc[Nct
<br />I h.Ehy alftrm undcr rrn.hy of p.rjlry iha' thcrc k a onsldcrb. lcndin8 a8ercy tor rhc Frformme ol llrc *orl itr *hi.h rhir p.mk ii
<br />trucd (S(. ]m7. Ci!. C.)
<br />l{nlcr\ Ndmc
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