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ELECTRICAL.INSPECTOR HECORD
<br />APPBOVALS DATE IDiSIG.COMMENTS (,WNER BUILDER DI1LCANATloN
<br />I h.rcby afftn lnder Fnlhy {,4 pcrjrry rhlr I m cxcn[l fmm lh. Conla.lom Liccn$ t2w for thc lollosin8 relsn {Scc1]11.5
<br />Susincsr and Proac$ion CloL) Any Cily .r Coumt *hich rcqut r d FrnJr ro .on ru.r. ulrci n$i(,v.. d.mlish or 6rtrn ahy
<br />srruclurc. prnrr lo ik ksmncc. ol$ rcquncs rhe amlica fd such Fmn to 6lc o si8tun stlrcmnt lh.l hc or shc i liensd plr$ior
<br />lo lh. t ovisions orrh Conlra.ror's Lienscd tls lchatrcr 9. Co6n ehg wirh sc.rion 7000 or Divisio.I of lhc Businc$ and
<br />Pmfcssions Codc) or lhal h.orshc ncxcnpl thcrcfon Md rh. b.si. forrh.alkSen.x.rtrplion. AnyviolllionorSElionT0ll.5byany
<br />t,hl'ra,.'on'nirruh,c(hlh('pnltan'ln!cnrllcmky,,lnormurcrhanlirchunJrdd,,llarrt500r., I
<br />/ [ [y' * .**, .r t'" p6ny. o, fly cmrroymc w h wrs.s sq rhcn sb .ompcnsdn,n. wir do rhc sm* and rhc srnf,rw h mr
<br />inralldcl orofrcrcd rnr ql. (Se.?0.4. BusUN(.nd Pror'.sions Codcr Th. Co ractol s Licc.sc L{w docs nol lPply lo !n os rc! of
<br />rhc DFrr.ny who blilds or impmtr tlrcmn. md who dc such wlk nimsclfor hcrcll orlhmush th or hcr o*n eq'loy.es.
<br />[ovnhd thnl su.h impbvmnb e frn inrcnded or oficrcd fo. slc lt howcrci rh. buildins.r impmwmnt h eU sithin onc ,!r
<br />oi ompLrbn. rh. Oqmr AuiBd will h,w rhc burdo of pIoviru rh.l h! or shc did mr t{iE or irlmvc tnc p6Fny ror lh. purl[s of
<br />L arownerotrhc nmpcrrr- am eiclusivcl, conrradins *irh liccnsd conrrrn'nro conrrdcr rlr proj..r (S.c.7(M4, susims
<br />a PnrfsstunQ)dcr Thc Conta.ktr s Li..ns. tlw doer not ryply tr on o*.cr oftrn)p€dy*ho huild{.r i'nrrJv.s rhcrcon.
<br />and who co rscrs tu such rojccrs rith ! Conrrucxtr(9 |i..tr{d pururnr r, rhc ConrNtut Li..nrc trw).
<br />u,\lo,
<br />I hcrcby rlTnm undcr Ptmlryofp.rjury oi. ofrhc iirllowinE dcc
<br />-l
<br />lrvc mlwill DinrdirrCcflifi.rrcofcon\cnrk,Sclflnsrr.lorsorkcn cofrprn\atioi.,\ pmidcd f hyS.{rion]7m orrhc
<br />LrttrC.dc, fdrlr p.rfo.runc.ofrhc wo.l for shich rhcI.nnn is islucd
<br />_l ha"c and will man ain workcs compcnsrlion iasurlncc. rs r.quircd b, SN'io.lTtD ollhc bhor c!dc,lor lhc pcrfornBmc oi
<br />rhc *o for *hich rhis l,crmil is t$.n. Myeorkds oqrNdion insu.arcccnicr rnd lolty numb.rdc:
<br />P,'li' r NFhu' r\nrm":
<br />,Y\1,,',,--","^^."*""".,",. " "","' +r, u\ro hccnm suhJ..r r. rh. $rA.r omp.nqr'.n lrs\,'r Ctrlil^m'o. rftl sem. rhrt ir I s
<br />*orkcr{ .onrFnsoriofl t'rolhions ol Scdion llfi) of r hc Lrlbr c(dc. l shall. f.nhsith conDly wirh rhor pmekio
<br />[i#ri1ui*
<br />con,r^-n\rti,n! co\lragc i! ufh*lnl. rnd n !L {'$lccr tr cnlnoFr r) cf,inn.l Nnrlric\ rtul
<br />dollan (Sl(x).(Xx)). iI rJdirnn] io rhc co( ol ronr,xi\rri'nr. dxtrrg.\ r\ ptuvnl.d hr rh.
<br />I hcrct'y arfirm undcr pcnilry.iperjuly rhar I !m liccnetl xnder pmvt r)l..nnrEmi'rg sirh Scrrion 7(XI)) .l t)ivi\nn, :l
<br />of lhc Busircss md Profc$iorN Codc. d trryliccnsc is in rull nrrcc arxl cffc.r
<br />!a!I1BUETIoNTDNDINC-dg!!CI
<br />:\\!cd (s( 3(D7. Civ C )
<br />ArtlrcaNfllll^ts^ItoN
<br />llf,rl$taflnn,undcr pcnrlry orFrjrry om.l ihc f{nbwi'ig dcclxrxrn,n\
<br />Ilcnxjlirirnr l,.mir\ Astj$ros NorilicrrioD l.cdcril R.Strhrirrj\ (1irl..tr). Prnarr
<br />-R.qtrircl
<br />hlrcroiNolilic!ri('n
<br />I..difyrhxrrhc lcJrrulrcguhrnnx togmli'rB \b.no\tunn'! lrr.norrfpli. lchrhhlx,jc.r
<br />-.l.cnirirhdllhNcrcnJrhnippli.ntn,n
<br />klr.rrcthrl r ibvc irhnll(i, r i\c.rrccl l.Ereb..mnlrwilhallCirvandC.unl,
<br />ordi.ao.cs llrd Slltc ljws rcldin-q ro buildin8 rucrior dhcrcbyau'horizc
<br />ft'vc mnliomd pruFny tur insFclion
<br />Applironl or ,\,lcnl Sknnlur
<br />A b
<br />:"lrl;/r "
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Life Salety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Building
<br />Under Slab / Floor
<br />Bonding / Groundino / UFER
<br />To rquerng
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Eqctory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilinos (Hard & Soffit Rouoh
<br />Ce ilings (T-Bar Rough)
<br />Meter Release
<br />Rough
<br />Service lvleter A
<br />FINAL I 1>U3rl x
<br />Notes Remarks, Etc.
<br />Communications Cable
<br />Transformers
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