|
APPROVALS DATE COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lile Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding i Groundinq / UFER
<br />Translormers
<br />Torqueing
<br />Sub-Panels
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rouoh
<br />Ceilings (T-Bar Rouoh)
<br />It/eter Release
<br />Rough i[/$Q g-27.19 x 4tA
<br />Service Meter l
<br />FINAL K-n-ly
<br />Remarks, Etc 1.,-v
<br />OWN[R AUILDAR DELCARA ION
<br />I hertby rmrm lndcr penalry (,f pcrjuly rhrr I dr q.rnr tom rhe G)nrrrkK l-iccn\e l-aw ror rhc rolbwing rc,$. (sN 70ll 5
<br />Bu\rn.!{ Md P'ol.s'nn Cd.r An) C y^r..u y $hkh 'cqutrr\ r a.rn1 rnlP.o\c. \tcnn i.h u rcnrn en)
<br />nruduE. rio.ro irs hsulmc. il$ rcrruiEs rhc apdkanr for su.h Ernir h filca si8ned sralcmnr rhar hc6r *hc ( li..trsd ru{urtri
<br />lo lhc pmvnions of rhc Conr0ctols Li.cnrcd Law lchnplcr 9, Connncncin8 wilh Scclion ?O0O oI Diri\n,n 3 orlhc Burin.r\ rnd
<br />Profcssions Codcrnr rhlt hcorshe iscicnfl rhcrcliomlnd rhe hlsh fo, rnc allcgcd crc,ll,rn,n Any vhhln,iofSflion?0315 by trny
<br />lmli.ad rr n l)erdir sxhjNh rhc aprlicanl b , civil pcnahy ot nor mrc rhan fivc hundmd dollds (S50O).
<br />-1,
<br />!s owrcr o,lhc t'otEny. o! my empk,yccs Birh wraes 0s lhcn sik crnrpcNllion. sill do rhc work ul rh. st ruru is nor
<br />imcfrhd or oilcrcd ror sle (S( 7044. Bo\in.\r ond Pn'fcrsnnN C,xlc:-lhc G'nta.r.r'. I -tcmc law docs hor,rDly to an o$rcrol
<br />th. tmFdy vho hilds or inqroB rhNn..nd wlN dms such uo* hi'nrcllor h.sclfor throuBh his o! hcr osncmployees.
<br />pn,vidcd rtu such inpmv.nrnG E nol inlcd.d or ofltEd for sh. lt howcrcr. rhc trildiry or illqmlcm n soB wnhin "nc }tr
<br />.tcomthrion,llE O*ncr lluildc. willhaE rhc bwlcn ol pmvirt rh{l hc or shc dil mt hoild or hlmE rtc F)p.ry for rh. purIl)s of
<br />l. d\owtrcrorrhr pRrrcny. rn.x.tu\nrly.oikr.rins*irh lic.ns.d .oitrdor\ t) .on{nr.r rh. pmj.d (Ss 7O!. B$incs
<br />aftl hitcsion Codc lhc Conrrlclols l-i.cnsc Lrw docs nol.pFlyro M o$n.r ol nr.pcrty who builds or inprorcs rh.rcoi.
<br />rnd who conrhcrs frr s!.h pu..t wirh i Conkacro(t liccnsd pu^Mnr Io rh. cl,nh.tr's l-i.en€ L2e)
<br />-l
<br />rncxcnrDl u cr Sc.lhn a &PC larriisrcrn .
<br />Dnle: ()Bn.r:
<br />]Laa6E8El0Mf[NldIQX
<br />DLCLA&$A!
<br />I lrrcbyrfliflnxnddpc lllry.f Frjur!on..frlrfollowin!dc.l ori{Jn\:
<br />Ih.rt. llill'tuinr nrccdifi.drorcon\.nlbsclaln\rrcli,wdrkcN'corpctrniotr..spn)vidcdf(trbys(rion:1700.lrlr
<br />I-rhn Codc. i(n ihc Frformrncc ot rhc trork tr*hichrhe p.nnir is is{'cd
<br />lhlveandwillm .l,in worlcrl c.nlll.nsntion innrrncc. rs lcqutcd ny Sccl ion ll7ll() oi rhe Ltbor Cods nn rhc l.rronun.c or
<br />rhc w.lk tuwhich(hn pnnit is Gsuct Mysorkcn co,npctrsliotr insurancc crdicr !d policy nunrbs uc:
<br />Poli.yNun$cr: Expncs:
<br />-
<br />Icc ify rh! in rhc |Brli,rnrnccofrhc sort lir *hichrhis n nnil i\ h$rcd.1s,hllnor cnll)],'y"n] Fr\.n inrnytnnnmr
<br />ro rslo lr.onr $b.,..r ro rhc workcr cornctrsdhr lrws ol Cnlilimir. itul alrcc rh.r iil should h€om subFr ro rbc
<br />workc.J com,cnsarbnlrovniotrsofScclio lTmolrhc Lrtrtr C'(xlc.l $ril.lonhrnhcon{'lywilhihor prorisi'n\
<br />WARNING railurc ro murc workcrJ conFnkriotr .okns. is unlr{ful. Md shall sunc.l an cnrtloFr lo crimiBl lrnalr d
<br />civil fincs uI k' .nc hundrcd lhousand ($lur.tx)o). in iddirnn nr rh. cr( oI c,inn. Jrnusr\ r\ piorid.J lnr rhc
<br />sc.rn'n t076 ur rhc Lrh,
<br />,,,",6 /zet/r g
<br />I lrN$y rflnn,undcr poirh, ul r.rtu
<br />DIC'"AMIION
<br />u dcr pnrvi\n,n fChrtrd9(co mf,rcirE sirh Sccr i{'n 7{DO) of l)ivninn .l
<br />G 4{z s9 4
<br />",,",42q/!s
<br />I hcrcby aotm trDd$ Fnahy oi rcriury
<br />i\su.d (S.. 1097, Ci! C )
<br />nrrifi lcrdir! rg.tr.y ttr rh. pcrl;nnincc.l rh. $o'I f,tr shi.h rhn lttuir i\
<br />APPLI(]ANT DE(]I \RTtTmN
<br />I llnt y !fim undfi p.n,lry orp.riuryonc of'tu rullowin! J.rlahrn,ns:
<br />Dctrmlitnn Pcrmirs AslEsros Norifi.lnin Fcdcrll Rcsullrionr(tirlc (). Pana,
<br />R.quircd trtrc' ol Norifi uri.n
<br />ngrcc honll)ly wirh nllCiry rl]d Counry
<br />nc\ oflhi\ CiryriJ Coutriyk,crrd uBr rlf
<br />E /.94'
<br />ELECTRICAL-INSPECTOR RECORD
<br />ID/SIG.
<br />Air Conditioners
<br />\ taJu
<br />Notes,
<br />ol rhc Ru\i'rs anJ P rsii,n\Code. rnd nrr li.cnr k ir ltlllbr.c rndcllNr
<br />t--f
|