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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE COMMENTS <br />Site-Work <br />Underqround <br />Pole Bases <br />Liqht Slandards <br />Spas, Pool, Fountains <br />Siqns (monument) <br />Life Safety /Low Voltaqe <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <br />Bondinq / Groundinq / UFER <br />Transformers <br />Torqueinq <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Bouqh) <br />Ceilinqs (Hard & Soflit Rouoh <br />Ceilinqs (T-Bar Rouqh) <br />Rouqh <br />Service [/eter <br />H/[/k (t\61F|NAL tlfri> <br />Notes, Remarks, Etc <br />o\\'NIiR trt tl,lrl,R Ll,:1,( .\R \ I 11)\ <br />I hcrch, lrfin uhdcr pcnolly {)t pcrjnry rh,( I .m cxcnPt lmm lnc c.nrrcloN Liccn( Liw lot thc folhsi'4 Msotr (Sec.70.ll.5 <br />Buri..s and Profcsion C.dc): Any Cily or Counry ufith rcquncs a pcnnil ro connrucl. allc.. imnrovc d.mlnh or rplt anv <br />idcrurc. ri,l ro ils h\!!h... rlso rcquncs rhc lpllic!.r for \xch Frnit lo filc n riencd s{rcm.r thsr he or shc is liccn{d Pu^uin! <br />ro rhc ptovirion\ or dE CofllEclof! Li.o.sd ljw (ChaPIcr 9. Condcn.inS wilh Stcrion ?uD of Divhion.! .rrh' aurnrr nd <br />ProL$n,nscodc)orlnarlEor\h.iscxcmptrh.rclrcnandrhcbasislorlhcaltscdcxcnPrion.Anrviolarionofscctiotr?O3l5bvinv1 <br />,pplicanrlbrararmirsnbic.hthc.mlicaorroacirilFnallrornolmorelhainvchundrcddolhd(5500). <br />I. as owncr of thc ItrolEnr. or my c,nPloles uilh wa8.s ar rhir $h cnmncnsar ion. will d. lh. 'ok ard rlt imtur is nor <br />inlcndcn orolltcdfors0lc(SerO44.Brsincsn.dB'ofc$ionsC.dcrThccontd.rolsLicenEliwdo.!notofdvror'o8 $or <br />rhc pmr.n, who hilds or nnF)vcs trson. ond wtn dB sh fr,* hntrsclf or ncr*lf or lhmu8h his or h.r own cmplovccs- <br />providcd lhal such iqnowmnk oc mr inlcndcn ot ofercd loi {L li horcver. rhc btrilding or ii{,rotmnr ir sld within om J@ <br />;r co'nddi,r. rhc owncr Buildcr sill htrk rh. ttrtrd.n or omvins rhd tE or \hc dil *n hoih ot nryok rt* pmFnv n)r rhc Nrr$* of <br />L nsowns.lrhc poFdy. ncxclusilc,yconrrucring wnh lic.trrcd conrllctnro onslrucr llE lroicr (Scc 7Ol4. Bu\i'cqt <br />lnd Pmfdrix Cod.: Thc Conlrlcroas l-iccn\c Lrw does nol t,,Ply ro anowncr of,noFnv wh. builds or improlB rhuon. <br />a.d wno conrrlck r.r such tmjrcts wilh a ContDcro(9 ln.n*d I'uNsnr ro rhc Conrrbis Liccne Li*). <br />I exc'npr unddS6lion-, B. & P.C lorlhirEasn <br />]UlErEItE(OllrENlArlllN <br />DICIAIAIIQN <br />I hcrchy ainm undcr pcnaxyol|Erjuyonc orlh. r.lk,$irA d€lamrions: <br />-l <br />hrlc and wiu minhin a CenilEarc orcotrelll ro Sclf-lnurc for work 6 conlenslrion .s lmlidcd lor b, Sdion l'7{norlhc <br />tib.r Codc. lor rhc !c,fo@c ol thc work for which lh. p.rmil is hsucd <br />I halc nnd srllm.inrrin *nrkcr\'comPcnsati.n insu!!ncc. as r.quncd hySecrion:17fl)of <br />rhc work forwiichrhis pcmit is issucd My workcrs .otrtFns.riotr insurancccrdicr *n p.li': <br />rhc t{hor C.dc, ,q rhc pcrlbrm&mc of <br />&H.l 4oP'v@tut <br />l.cnilyrhal inihc pcrfornuNcolrhc work ior shichthi\ Pciinit is issuctt l fiill nor cnrployrn,!.4otr itr 0nvnEtrtut <br />$ ^ b s.cu!f, subjNr ro rhc workr( coqrnsar iotr liws of Cllirdni,, md !8rcc rhtrr il I shou ld lEconrc subjfti r. thc <br />*ork.6 co'nFns.rion pnlnioB ors..xon 37(xr ollhe Lltxn C.dc,I shrll. thnhsirhonDly airh rho{ Povhiotrs. <br />IVARNING: hilurc r. *.urc workcr' conpensdri.n .ovcrasc is unhwfxl ,nd shall suhjccr an .mll.vtr to criarindl r.mtics 0rd <br />ci(il lirN\ up lo onc hundrcd rhous(nd dollan l$lu).un), in h Ih. cos ofconlrcnsarn,i. d mgcs r\ nrovilcd tir lhc <br />:::WI;:ffi n,,,, <br />DICI.AIAIX]N <br />I hcrcby ilfirn undd l.nrlrr of tcriu.y rhnr I m li.ctrs.d und.t pmvisb. of Chqtrct 9 (comtun in8 qnh Sclhn 7000) of Division 3 <br />ot rhc Busine$ and Ptur.sn,ff Codc. a mr liccn\c is in tull lnre ond cflc.r. <br />z-?-l <br />u""6 .*,^^* fu. <br />COM:IBUSIIQNIDNDINIiSGEIII <br />I hcEt y affirfr xndd Fnalry ol Frjury rh,r dcru n a connruclion lcndinS oscncv lor rlt !frrornuncc ol rhc *ork lo! which rhi\ Fmir ir <br />ksucd(56. :109?. Civ. C.). <br />bndcrsNomc <br />- <br />lftLICANfIl[lI4lBAI]AN <br />I trR't y aiim undcr Pctrrlly ol P.tjury oN ofrhc lnllowirg dcchrari{,ns <br />rlc'noliri.n Pcnnirs Asl,c{os Norifi.dion ,rcdcr!l RcEUl ionllTillc r0.l'jan6) <br />-RequiEn <br />L.ltd of Ndifgli- <br />I cenify thar rlE f.dcEl r.Buhlions Eseding rsb. os Emvrl oE n r ,lplic{blc ro ltis pmjccr. <br />-l <br />arlil, rhlt I havc rcad this lprlicarion !d stal. lhor lhc sbtc inrdrfrlhtr is cotr*r' I aSrs lo omplv sirh aI Cnv lnd Counrv <br />odinutuc.;.d Sl{lc Llws Ehlhg lo buildin! consrruclion. !d h.i.by t!fiori* Eltc*.ldiws of this Cilv ,rd Counlv b cnld lFn Itt <br />rt{*. nrtrrtri rtlf'of.d, nr frApplic!nr or,\Hdl SiAtriltr t o.|P -r"r"Dl4oe&4a_ <br />ID/SIG. <br />Under Slab / Floor <br />Sub-Panels <br />Ivleter Release <br />Lo t4aao- <br />I