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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE tD/srG.COMMENTS OWNER BUILDEN DELCANATON
<br />I hcrcby ofinm undcr pcnllry or llerjlr, rhd I d creqr an,o thu conlmcrou Liccnse LIu for rhc t{,llosirg r.is. (S.c 70:r l 5
<br />Busincsi and Profesio. C.d.): Any Cily or County whah rcquns ! Fm b con{fl.r, allcr. in{,rovc, &mlish or alan any
<br />{flcrurc, prior r. irs L$urn.c. aho rcquncs ric lpplicanr ior such,lcn b nba ligncd st,lcmnl rhd hcorshc is liccnscd NNn.r
<br />r{, rhc pmvilion\ of ih G,nrftdor's Liccnscd Ijs lchrprcr 9. Commncins wilh Sccrion 7mO of Dithio. .1 ol lh. Busincss 0nd
<br />Pn,fcs\bn\ Cddr)orrhar h.orsh. ir.rcnfl incrciiomand lnc hosn for rhc allcscd .rc mfl ion. Anyviol ionofs6lhnT0.ll5br..,
<br />,pt'li.rfl loru pcrmn suhF.h rhc lptlicrnr to Bcivilpcnrlryolll.x mr. rhad riv. hundrcd dollus($500)
<br />-1.
<br />!r .*n.r of rh. l,()trriy. or my .Dpl()yccs wirh wrgcs 5s lheir q,L (nq--n\ar ion, sill do rhc *ork ,nd llE (rrw is nor
<br />inrcnd.n or orlcrL{ lor slc (Sa 7044, Bosinc\s snd Pmr.sin,ns CdL: Thc conrracxtr\ ,-icen* L.u docs rer lprly ro rnosnLr.l
<br />rhc pNlcny who bxit\ m impmB rlrmn. rJxi wh. des suh mrt hnnselfor hc6clfo. rlmuEh hia or h.r owtrc,nploy.cs.
<br />/ovidcd rhor strch iqrorcm s orc not intond or otlcrcd tor s(lc !i howcver, rtr huilCing or imlrorclEnr is sold wilhin onc Jtrr
<br />of.onpLrirn. rh. O*ftr auiUcr w hareIIEhtrdenofpovirgrharhcorshcdilmrt ild or imPtuv. rh.Imtdy lor rhc,)urlns.f
<br />-1.
<br />is opNr ol rh. pnpcn y. am eiclusilcly conrracrins $irh licn{d c.tur.ro6 ro .onslDcl ttE ,tmjccl (Sa 7044. Businc*
<br />md Pnrs\n. Codc: Tnc Contrcror's Li.ctrsc L!{ des nol nplly k, on opncr nl proPcn, wh. buildt or inpmvcs ficrcon.
<br />and pho conlmcls foi such nri*clr wirh ! 6.rBdon, liccnscd pursuan' ro rh. Conro.l.ls Licen* L.8).
<br />-lamc\.nrnrundcr
<br />sc.ri,,n-. a & Pc lnrrhnt r{trr
<br />Iral€ ()rn.r:
<br />WORXFR$ L'lI,VPI:iI.SATION
<br />DECI,Af,AIIO!
<br />I hcrchy am.nrlndcr tcnalry or l.rjuiy onc orrh. rollowinC delearnns
<br />-l
<br />h.vc n Bill minllin a CcniaEarc oa Con{nr ro Sclf l nsurc r.r work.K .ompc.sul ion. os 0ovidcd lor hy SNrion l?fi1 or rhc
<br />lrbr cod.. Lr th. lfrronmncc olrhc *ork for which lhc r.mit k n\ucd
<br />_lhave rnd *illnDinrrin sorlc^ ro rf.isdrir{ nhurutr... ns rcquicd byS.dio 37(x)ol rh.l]h.r(ndc. lnrrhc !'ctlornuncc.i
<br />rhc *ork ni $hirhrh'\ pdnnir i\ ssu.{ My *orke.s conrl{- \rrio. irsura.cc.rdcr rd F,li.ynun$$m
<br />ax,,i,1
<br />-l
<br />ccdiiyrhd inrhr l,e ornERcofrhcwortlorwhichrhk|Ernriisnsuql.lshrlln.rc.lPloyonrlc6oninonymanner
<br />$ $ b bcorc {hjcct to thc r(rtcr' .nnrp.!s{ nnr h*\ of Cnlift ni,. ind r8rcc rh ifI snouu hccom \uhjccr hrh.
<br />wulknr.onrpcnsdnrnpmviri{,nsorS.crioo37(x).rrh.lf,}.rCodc,lihrll.f.nhwirhcomPlywilhrho*povnn,n!
<br />WARNINC: Failurc ro ccurc $orkcr' conpcnsrrn,n covcagc i\ tnhqrul, d shall subicr an cnl']o]cr lo .n inal ,.nrlri$ and
<br />.ivil lilrs nn h orc hondcd lhousnd dollo\ (Sllr).fir)r. in addirn,n tu rhc .o( ol conrPcnsrion. datugcs !\ pmvidcd for rhc
<br />s(rnnr:rl)76olrhc l.!tu (id.. i'ncrcn rrlrrtnncy r h
<br />IIECI,AMIION
<br />I hcreby ainrm unds Foalry or p.aury lhn I m liccnsd undtr {'rclirion of Chapr.r 9 (etmruin8 with Sc.lbn 7000) trf Divisinn 3
<br />of $. Busi.es md Prcfsssion! C.d.. !.d ny lkq* i! in tull ford and cll6r
<br />a-T
<br />CONS'IRIJCT'IoN I FNI}IN(; (:ENCY
<br />I hcrchy .flnm undcr Fruhy ol Pcrjlry rhd lhdt t,Qrnetu.rirn Lndin8 !8cmynnlhc pctformtc orrhc work i whichlhistrmit i\
<br />hrucd 1se. r09?.civ c )
<br />L.trdcls Addrc$:
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<br />AISLLCAN:LDETUBAIIQN
<br />I hcEby rnim undc, p.nrlry orFrlury onc ofrhc iollowing d(liralions:
<br />Dcrmlirion P.irnik-Astrc(os Norilica'i6n F.&,nl Rcgularions (Tnlc.O. P.n6)
<br />Rcquncd l.rlcrot Norifi cali,!
<br />_l.cnilyrhrrihc fc crrlrcguhrions rcBidirS ashsl.l rcnn,val ric noi itpli.rhlc ro$is PmJc.t
<br />l.cnilyrhd lhNc rc rhis applicrrionatrd drrcrhxrrhcrbrc inf,mx i({ 1s.or..l I rarcc loconrdyrirhrllcnyiM c.urry
<br />y rurhtuc rcprccnlatilcs oflhis Cny dd coxnry'o en'd up.n tlEoiltrrrct J Strrc ftras rc]f,linE t, huiklin!.oni rtn,n-
<br />Jh{. rflh, I'iincn} .' 'n.r$! nr N1rrtti- ,
<br />^ppliclnror^B?nrstxnoru( )(
<br />\)<\,f{
<br />ftmilennNlpnnt):
<br />I
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Life Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Buildang
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinos (Hard & Soflit Rouqh
<br />Ceilings (T-Bar Bouqh)
<br />Rough
<br />Service lvleler
<br />{/rt/lt ,z .yen t1.^+41
<br />Noles, Remarks, Etc
<br />Communications Cable
<br />Ivleter Release
<br />FINAL
<br />tindcr'\ N/m
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