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ELECTRICAL-INSPECTOH RECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUII,DER DELCA'UTION <br />I hc.chy amrn xnd.r Fh0lry oi p€rjury rhar I d cxcntr rmm rhc ConlructoN l-icc.{ tjw ror lhc iollowin8 '.dv,n <br />( s.. ?0r l 5 <br />Busin.ss aM Prolcssion Codc): Any Cny or C.unry which rcqutcs s Fmi ro consldct. !hr. intn)vc. dcmlhn or r.Tat anv <br />(rucrurc, prior io ih hsuarcr. aho rcquiEs lhe lppli.anr ror su.h r.nnil lo filc0 sis,ed na!.ftnr rhd hcorsnc ia lic.6\cd puilu!trr <br />k, rh. pmvisions of rhe ConlEddar Lionscn L.w (Chq,tcr 9. Commtuidg wirh Scdiotr 7m0 ot Division I ol th. Br\i'Es ud <br />Ptuicsions Codc)orlhar bc o, \hc k cxcmpt lhcrclrcn lnd lhc hlsis lnr rhc 0llcgcd cremPrion Any violdionofSsri.nT0:ll5hvanv <br />oppliqnrln!lcrnirsxbj..rsrh..pllicantl.acivilFnalryorMrlmrclhlnfivchudrcddolldr($500) <br />L ds osmrollhcl},olxny. ormycmploy(s sithwrscsrs lhct sk ompcnqrion. silldo rhc wort ,rld 'tr stuturc is nor <br />i cBlql or olfcrcd r.r slc (Se.7()4,1. tiuriNs and Pfl,lcssion! O)dc: Thc (l'nimctr'\ Li..Ds. tiw docs ml ryply k,0n osrcr ol <br />rhc pmndy whot lds or t ptuws rhtrcn. dd who dcs sh wo* hnnclr ot hcrclf or lhmleh hk .r h.r own empbv.c\. <br />prolidrd tharsuch n\rovcmnh m nn inrc cdorofi.tri f.,$L ll. ho$crcl rhc btikiin8 o.nnpmtrEnlG$kl within.trc r(rr <br />ot orq,kri,n. rlt Ormr Bu :hl *ill have ll)c hrdcn of pn,in! rhd hc or sh. did r hild or infroE rhc nmtcny nr r puryo* of <br />-1. <br />ss o{ftr or rhu pnlE y. rm gclu\ittly conkncrinS wirh li.cn{d conlructns kr c.tr{ru.l llt Pr(+cr (Scc 7(}4:l. Auqn$\ <br />.rd lnrlcshn Codc: Thc Conkrkr\ Liccn$ h* doc\ nor 3t)ply ro r owncroiproPcnysho boildsor nnptowsrhcr.oi. <br />Dnd who co n(h lor such pnjcch wirh r Corhcnn() licc.scd pusMm ro rh. coNadoi \ Liccn\c I rq ) <br />_l sndx.nDt und$ Sccl <br />1YORXFR\' (l( )l\l PltNS,{',l l( !N <br />DIIIAXAIIAN <br />I hcrchy ain'n undcr r.,lryof Frjuryonc orrhc r(rk'win8 d..Lrarn'ns <br />-lhavca <br />will ntrinrrin a Ccnific corconscnrt,sclr-I$urulotwo ql .onrP.nsdlion. 0r prcvidcdnrbvsc.ln,nl7(xlofrhe <br />bhor Code.lor thc pcrformft. oflhc aolk fotwhich rhc Pcm,ir k k\Nti. <br />I hrvc,nd will moimlia vorkcra comF.ns ion nrurrrce. as rcqdirt b! Se..l ioo 17(x) oa rhc Llbor adc. f.r lh. PcrfomrNc of <br />rh. worr lor pnich lnh ncrmir i\ iriucd Mywotkcs compcnsrrion insurir_o.rnicr adPolky nu thd arc <br />o \.I.ln <br />-l.cnifr <br />rh r in rhc pcrioflnrncc oirhc work for whhh lhis l)croiir i\ i\so.d.l1hrll nor cnDloy liy plNn tn trny manncr <br />$ N h h.roff {hrer lo rhc w(,.in( .onp.nerion lnws .f Cnlifonir. rid .Prcc lh{l il I sh'ult h..onE n'bj.tt lo rtE <br />woik.s omr.nsdn,n nrovnn)ns ofS..rion l?0O ol rhc l,alFr Code,l rhrll. fodhwithcomply sirh rkr{ Pmvisions <br />WARNIN(;: Failurc ro scurc workcr' .onpcn{ri .ov.td8c is unlowtul. rnd n l subicl an corlo)$ ro criminll ,)enrlrie\ uid <br />civil nn.r up b on. hundrcd rhousaid dolld( ($l0l),I)00), in addirio. k rhc coi ofconPensalion, d,m8cs as Providcd ror rlt <br />Scdion -lo7ar olrhc trh, Codc. inlcrc{ trid dionky s f.os'7-t.tL <br />I hcrcby.trr uxlcr pcnally ot Frjury rh3l l 0D liccnsd under Pmltio. or chafct 9 (commncing s h sction ?Oio) 'r Divi\io' 1 <br />or rhc Bnsincs and Pmfc$ions Cod.. md nryliccns h infull forceafticlrccr' <br />13 \\9.eq'.r <br />1-:-.1'"la c l.r:"r- <br />CONSTRI](:TIoN LI-NDTNG A(:FN(IY <br />Iherchyrrfirnurdcrpcallyolrrrjrrrrharrhcrci(ocotr*rucrhtrlcndinssrtNyntrlh.Dc orro.corrhcwo.krhrwhichrhtFiinnLs <br />issucd (Scc. :1097, Civ. C ) <br />AITUCANI.DICI.AXAII!}N <br />I h.E$y afiln, undcr p.nlxt of tf,rju,y onc nfrhc n,lb*ins d..t*r'io.s <br />Dcmlirion Pcflnils-Ashcs(os Norificnriotr Fcdcral Rcgul0lioN ('Iirl.10. Prr6) <br />-Rcq!ircd <br />Lelrcr oi Notifi.dirr <br />I.cdrfyrhd Ih. lialcrul rcxuhrnnr\ mgarUin8 *hcnos rcnnvrl Jrc nor rypli($b h lhi\F)rc.r <br />l.cnifylhlr I hrvc rc J this{nlictlion $rr.rhd rhcak'vc inlilrm i,trr i\comcr' lxrrLi rocomnly wirh rllciryrtrd C.unr, <br />fthn Ciynid Coumy b cnlcr upon lhconlirurrc\ dStxr. tj*srclrrinsro hu <br />$.vc nr ioncd pnpcny f(n insr..riotr <br />Atpli..nl or Ar€nl sto!rrrc <br />.b"^'U l*'- <br />1-L\9., <br />Site-Work <br />Underground <br />Pole Bases <br />Liqht Standards <br />Spas, Pool, Fountains <br />Siqns (monument) <br />Life Safety /Low Voltage <br />Fire Alarm / Dampers <br />Buildinq <br />[Jnder Slab / Floor <br />Bondinq / Groundinq / UFER <br />Translormers <br />Torqueinq <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rouoh) <br />Ceilinos (Hard & Soflit Rouoh <br />Ceilinqs (T-Bar Rouqh) <br />It/eter Release <br />Rouqh <br />Service lt/leter <br />FINAL $/5/16 5\6U <br />Notes, Remarks, Etc <br />Communications Cable <br />lxtr4cr.\.1.1'r- <br />T <br />I <br />=