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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG. <br />Site-Work <br />Underqround 6 Sb*'( <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Lafe Safety /Low Voltage <br />Fire Alarm / Dampers <br />Communicalions Cable <br />Buildinq <br />Uqde,r $lab / Floor I <br />on / Groundin / UFEB q s \)l41"tt{D A P*ar'*k7- <br />T"ranslormers H <br />Torquerno ,{661 Lk*Y $*\ <br />Sub-Panels <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduil) <br />Walls (Rough) <br />Ceilinqs (Hard & Soffit Rouoh <br />Ceilings (T-Bar Rough) <br />Ivleler !eleasq(-Konl looll 6t 9 ,r0tlt(0) <br />Rough <br />Service [v]eter <br />FINAL -.{\ <A.,J1Jt) <br />Notes, Remarks, Etc. <br />OWNER BT'TLI'ER DEI,CARATION <br />I hcrcby rfifln undcr pcmhy ol Frjury lhd I m cxcmnl liorn lhe C.ntracl.n Liccns.l-!w nr rhc iollo*ing rco$n (S.c 70ll5 <br />Busnrs ond Prcf.sn,n Codc): Any Cily or Counl] 'hich rcquircs ! rarmir to (nno.t. alrcr. imPmv.. &nnlhh or rcpli an, <br />srrucrurc, prioro irs hsu,me. rl$ rcqui.cs rhr appli.snr lff ru.h Frmn ro filc. siBftd (nkmnt rhol hcorstc is liccn{.1 t@aor <br />lo Ihc prolisi.ns ol thc Conlrocrols Licenrcd L!* (Cfiaplcr 9. Conmcmins wirh S.crion 7fix) or Divhion I ol lhc Busincs and <br />Profcssions Code)orrhlr hcor\hc hcxcn0r rhcrcfrcdnnd rhc barir nn$c alL8cdcrcmplion Anyviololionoiscdn,nTnll ihydn, <br />applica fi, rFrmir \lbicch rhc rrtlicdnr ro acivillcnrlryornd mftlh liue huRlrcd dollars ($500) <br />l..s owncr olllr t,otrny. or my cmllolEs *ilh snscs or rhcn v't crnnpcisarioo. *illdo rh. work end th. snrlw h not <br />intcrtu orolTcrcd lor slc (S( 7(14t. Borituss &d Pmf.sn,h. Codc Thc Cotrha.tor's Liccns l-lw docs not anply io ( owncr o{ <br />'h. tmr.ny sk) ttrilds or inqxovcs lhcsr ntu who docs such w(nfi himsellor hcr*ltorrtmuEhnh or h.r.*n cmdoyccs. <br />providcd rhor sucn iDpmrcnEnrs N B, inrendcd n ofcrcd lor ek ll to*cti rlt hrilring or nr{mEmd n bld uiihin onc )tu <br />of.omphliotr. rhc Oqrcr Bui[cr willhor lh. ttrdctr of amvir8 rhlr hc or st di] r, huild or impmvc thc Impc^y for th. nuQos. of <br />_l, aso*ncroirncnmp.ny, ncxclu\ilclt.onta.lirgwilhlicctrrdcontrrio$roconslrucilhcprnccl(Sc.7Or4,Buenc$ <br />0 ProlissirCodc: lhc Conl.rcrols l-iccnsc Lor docs trol.rply ro an o*ncr ofponerry sho builds or imDtovcs thcrc.tr. <br />and wto.omffhtrrnchtojcckwi(hrG)nrh.bi{)lkcn*dNisuanrk,rhrcdmclolsLicc.scL,w) <br />-l <br />a6.&npr u.d.r Sdio <br />I!IBtrE8g.1I!}IIIENIA.IION <br />DICLAXAIII.}N <br />I hcrcbyllfir unncrpcnalryornsJuryo.cofrhcrolbwingd..hflrtnrr <br />-l <br />havc ud $ill roinrain a C.d ili.,r. dr Cons. r. sclf lnsur. ror workctr ompcnsrion. !s provid€d for by Ssrion l7m or rh. <br />t2txn Codc, lor ln. p.dbnMrcc oi rhc $ork for wnich th. pcrmil is hs!.rl <br />I hrlc.nd willnri rin *orkcrs .ompcns.rion ,nsurnicc. ns rcquncd by Sccrion]T0O ollhc Libor Cod., f.i rhc Pc{ormM.c of <br />rhc work f(tr shi.h rhis p.rnrir is issuql NlyBorkcs compcnslioD in\urrrcc.ldicr xl F,li.y nunrhcr d. <br />I ccnilyrtur hrhc Frl'onMnccoflhc wort forwhichlni\ pcDir i\ is\ <br />h xt' h.tum uhFd k, rhc sorkc^ coilNnsari, l w\ofcrlinmfl.r <br />$orkr.i cofln.n\ari(mnnivi\ tr\ olsccri(r ]71)0olrlr Lrlttr c-df.I <br />workcis' conrpctrrtrrion covcragc lors to oimiml rEuhis uod <br />d.m8cs is pn'vidcd lor rhc <br />2 <br />Dcnrlry olt.rjury rhir I !9 ({nnmnri.r with Sccltnt 7fiX)) ofDivision.l <br />.f rhc Busi'rcs\ r d PnnassnN and nry lte.sc is in full n{cc tu! cfld <br />16c+ <br />fld nn hndin8 iscrcy rr rt pcrhmncc or rh. *ork ftr ahich rhn tcrnr n <br />hsucd (sa. 309?, ci!. c. ) <br />LndclsNarc <br />-AITLICANLP&ELd,EAIIAN <br />I tmby {ilinn undcr Fn.lly olpc.jury o.e of lhc folk,wiis dcclararii,ns: <br />Rcntrn.d l.rh.f M ift.xrrn, <br />n,n irrorlyr I trlrnhconrrlyeilhdl <br />horiz. r.|nr{ rrtld ol rhir Ciry ond <br />drv rha J:?'?/6 <br />COMMENTS <br />Air Conditioners Einnc\ <br />7