|
ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE tD/stG.COMMENTS OWNER AUILDER DEI,CAR TION
<br />I hcrehy lfrrn undcr Dcnrlly r)t l)criury rhal I a'n €kcnrnl fmn lhc Coirrx.td Li..r* Ijw ior rhc lollowin8 rman (S.c,70115
<br />ausincss and Pnr'c$i0 Cdc): Any Ciry o! Counry shich rcqrtds . pcnhir l. onnrud. alrcr. nnpmlc. demolhh ,r Eput nny
<br />{tucrur.. Irior b n\ hsuancc, rlso r.quircs rhc rprli.mr for \x.h Frn t to filco si8tred slolemnl rhlr hcorshc t liccn\.d lrAranr
<br />ro rhc povisionr olrhe Conrracr.is l-i.cnrcd l,a* lchaprc,9- Conftn.ine wirh sc.ti.n 7u)o of Divktun I ol rhc lJusinc\s lnd
<br />PofcssnrnlC.rlc)orrh h. orsh. iscxcmpt rh.rcimmundrhcbrsh lor lh. lcgcd cxcnl'llio.. Anyviohrt,nofsccrionTtlll.5hynny
<br />lp,rliconrlor.pcr.ritsubjcckrhclpplicrntroocivilpcnaltyofnornsrcihanfivdhxndrcddollan($s00)
<br />_1, rs nwn.rofrh.IFn ny..r nry.nDlortcs !irh *.!cs * rhcn $t .oflrpc.salion. willdo l,r wort 0.d rh. {turm i\ frn
<br />inr.nd.d or on'.rcd ror *lc (Sc.7(l14. Buiincss 0trd Prnfcsiois Codc: llrc Conr,acrois l,iccnr l-aw dd\ not,prly b anowncr oI
<br />rhc preIl(ny who builds or illpn$cs rhcol ald sho drs such enrk hnn*lt.r h.srlfor rhmuEh his or hcr o$n cnrployccs,
<br />lnolidcd I har su.h iDloEEnk !E tror inrc.dcd .r ofraEd lor sb lf. now$s, rhc huikling or inqrmt'ftnr is $kl qirhin orc ]{*
<br />ol conDlcl io.. rhc Owmr Buik6 will hrvc Ihc budcn .f omviu lhd h. or stu dxl [, huild or imprct th. ,sFiy ror rhc purFs ol
<br />-1.
<br />!s ovnq ol rhc tmncny- a,ncrchtrivclycorlra.rins *ilh liccnscd conrmcds h con{tu.r
<br />'h! Fn+.1 lsc.. 7(]4,l. Bu\inu$
<br />a' ADIL\siin Codc. Thc Conk&ktr r L(ens. lj* d(r\ nor nprly ro mo*mr olpmpcny sho nuits.r nnpn,lcs rhcrc.tr.
<br />and sho conrfl.k lor such rmJccls *nh a ConrE.i{tr( s) liccnscd p!^unr hrh.Contn tofs Liccnsc tjs)
<br />-l
<br />anrc\cDpr utrdc!Sc.li{,
<br />Ihle ()*ncrl
<br />IlltstrlBsl:orllliNsrrlo!
<br />DITCLTIAAII0N
<br />I hcr.hyrlltnruf,lcrt.ulrroftctury.ncolrhclalk'wi',g cch'Jrbn\
<br />I hrv. lnd w ill tuinrrin n Ccniltdc .f c( {nl b Scll] ln\uro f(tr *orkcN .onDctrsurnnr. as nn)vnlcJ tur l,y S*non ]lm .f rhc
<br />l-lbor Co{lc. ir rhc tcrformocc ofrhc work r(trwhkh rhcI.rnrir i\ i\sucd
<br />I hrvc rnd willnrinhi,r work$l .onf.nsalion instrrnce.0s rcquircdiySsri,'n:17(x).frhcl-lborc.dc.lnrhcpcrfoirmnceot
<br />lh. work ror*hi.h'ht pcnnit is tscd. Myworkch conrFns0lion insurmcc coricr and Fricy nr,nb.i m:
<br />CsnEr.-
<br />Policy Numb.r:-Eirioi
<br />_l..nily rhrr in rhc rtrlonfl'N. of rl.( No'k tur shi.h rhn t(rinir is i\trcd. I drill mr cDlrol itry pcr$n in lny nunrur
<br />$ rrr) 1....f, {rhl..rri rhc\orkcs'..nrFn\rri(r lrs\olCrlila,rii. rnlagrerlrr ill \hould hc.oat \rhjccr tJrlr
<br />wo*cr{.onDcrsrriotrl'rnisiotrcolSc.liotr:lr(xroihcl.ntnr(tnlc.l\hrll-fonhsirh.onrtl!trirhrhoscJriovisi,!r(
<br />IVARNINC: Frihc nr *cutu workc's .onrrri\ ri{fr ro\rrr!. i\ urhqrul. r sh ll \nrjccr nn cnrpl.Jcr t, criminnl |i(n hic\ rnd
<br />cilil finc\uIk'onchu rdJ rhotrsrM olla^ (Sl(r,(l()), i', r,ldiriotr k,rhc.o{ ol'.onrpcnslrion. drnB8.\ r\ pmlnfud ntr rhc
<br />Sccri{r 1076or rhc lntmrCodc. inrcrc{ md r orruy'! lrcs
<br />Qnz+-ctz
<br /><'-q12//3 1,."t
<br />I hcrchy affiirnundcr p.naltyolll.rjuly rh l am liccnsl undcr proehion of Chlprer 9 ( com,mn.in8 wnh sclbn 7000) or Oivhio. l
<br />or lhc Busincscand Prorcsions cdc. ud myli.cnsc is in rull n,rce ofrlc[c.l fi6#7
<br />?/t4rs *LY_
<br />I h.rchydrnnnundcrFnrlryofp.rjurylhri rhnc ha.onstruc1ion htrdinsoscncyforlhepcrtontu.cc orrhcqork r wnich rhn Fnni n
<br />hsued(Sc.. 109'7-Civ C )
<br />AIIIICANLI,}ECI.AAA.IIQN
<br />Ih.rt'yrrfimu crFnahyolrcrjuryoncolrhefollo$in8d(laruiioi\:
<br />DctrDlii.nPcflnils.Asl[sIosNnri6c.lio. ftdcnl Rcsur'lions('rirt,l0. Prn6)
<br />Rcquncd Lctrcr oi Notifi cdi(trr
<br />-l.cdi,yrMrrh.lcn.rilrcgukri{n}
<br />r.grdi',g n\}f,{o\r.'novxlrr. Nrnt)tlkrhlc m iln: frojc(r
<br />l.cniryrhnr Ihrrc rr rh'\ rflililri{ md{dcrharrh.rtvtrtrlnnDidrh.otrccl.Ir8rel.conlllysirhrllCiryrdCounry
<br />aurhorizc EDrNntarivcs .f rhis Ciryand Counry ro.nr.. ufrl
<br />2/A_ D6'c %L8
<br />ru? Fffitt€/(
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Li ght Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Bonding / Groundinq / UFER
<br />Translormers
<br />Torqueing
<br />Sub-Panels
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit),a.(8 . raL
<br />Walls (Flough)lo-''q
<br />Ceilinos (Hard & Soflit Rouqh
<br />Ceilinqs (T-Bar Rouqh)/0-/7 -/O illot"-z\ lr., gaQu)
<br />lVleter Release
<br />Rough te-t?-/a Ott"L
<br />Service Ir,4eter
<br />FINAL t -/(-/? t l)eG+,(99
<br />Notes, Remarks, Etc
<br />Under Slab / Floor
<br />Air Conditioners
<br />6
<br />kndn s A,]drcs(
<br />-
<br />t
|