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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Lioht Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Salety /Low Vollaqe x
<br />Fire Alarm / Dampers
<br />Building
<br />Under Slab / Floor
<br />Bonding i Grounding / UFER
<br />Transformers
<br />Torqueinq
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Solfit Rouqh
<br />Ceilings (T-Bar Fouoh)
<br />Ivleler Release
<br />Rough lo lits t uq|e)5l1\ f,+@..1 -"t .,-p..^rt
<br />Service lt/eter t
<br />FINAL '*tt*<tr/.",I)
<br />Notes, Remarks, Etc.U\
<br />OWNER AUILDER DELCABATION
<br />I hcrchy amrnr und* ri.nahy or r.rjnry rhar I m cxcnl)l fmnr rhc ContacloN Liccns tiw lor lhc follo$ins rcrsn {s( 7O:l l 5 '
<br />Businc$ ad Pmtussion C.dc): Aiy Cilt or County which r{unca a pcmn ro onslrucl. alrci impbv., d.mlish o. rpair m}
<br />struclrc. prior ro ns issuancc. nko rcquncs rlE applica for such lEnnir ro filc a sisn d sralcft.r rhnr h or she is liccn$'d pum t
<br />ro thc Fovisioni ofrhc Conr,acror's Lien$d Llw (Ch!prc,9. CoMctrin8 wirh Sccli.nr/dro oaDivi\ion I ofthc Aurinc$,nJ
<br />Pfurcssion{ Code) or thar ltor sh. is.r.mpl lh.r.from lId lh. brsis for lhc llks.d cxcnq,rhtr. Any viohrion or sdthn 70:l Ls hy rnl.
<br />lptli.ant lor a p.mir subj(ls rh. lpnlicanr lo a civil !.nahy of mr mrc rhln fivc hu.drcd dollds ($5m)
<br />I. rs .wmr oi rhc pmlInt, or my cmployes wilh wrScs as lhcir eh ompcnsol io!. *ill do lhc wrk dnil tlx sMtm is nor
<br />inlcn& or o[alcd for slc (Sa.7Ol4. Business and PDfc$ions Codc: The Conrdols l-hcns tiw des iol amly lo an o{n( or
<br />rhc tnrEny who hoildro, irlierc3 lhcmn. dd who d* skh Mrt himsclfor nccclfor lhouBhtis or lrcr owncnployNs,
<br />providcd rhar .uch intmkmnts m mr i cdt d oi uflc,.d fttr sL. Il hoscw, r buildiry or inpmrc'rcnl is sh *nhin .ft ,t!
<br />.f.on krirn. rtr O{rcr Boildd will how th. tnrdcn ot proving rhd lr or \hc did mr hdld or in{,orc lh. tmFny ftr rlE I{rlsr of
<br />I I:1. nwNolrhc pmllciy. !m e\.lu\ilelyconrrr.rms wirh liccnsed conta.nJn ro.onstru.i rhr pojccr (SN.7044. Alsincs
<br />-ffi]'ofcsrn corlu Thc cobkacrois Lrccnec Lrw docs Dot aplly ro sno*ncr of propcny wio htildr oi improvcs rhcrcon.
<br />lnd who onlmcrs for such nhl.ca wirh a Conracr6(, lic..*d puisunnr hlh.ConlEdols Li.ens t wl.
<br />/
<br />a+z"J8
<br />DM.lllrlllQri
<br />I hcrchy ailifln uDdcr pcrlryotp.4uryonc ofrhc laibwin! dcclxrrrnnn
<br />-l
<br />havc arnsill minraitr !Cerrificarcofc6n{nr toSel{ lnsure nn sorkc .om$ns,tn,n.as providcd Ior h, Sccrion :17(ll ol rhe
<br />L.horCodc. tbrrhcp.rfonnonccof rhcsork for*hichlhcFrmil is nsucd
<br />Ihav.andsill'minrain*orkcrJ.o rp.n.rrion i'rrr.kc. A rcqurcd hyScclion l70O ol i,rc l,anorCodc. nlrhcNrlornraNcol
<br />ihc *ork ntr whi.h rhi\rdn,ir i\ ir\uL{ Myqorkcs .o D.ns[ion ir{rrNc caricr all{l Fli.y nlmhcr m:
<br />l.rnily rhit rh, IfrfonErmc oitlr wo* fn uhiuh rhn Fiinil is isucd.I\hrlln.rc'npk,y Diy tc'ion in itry nrnncr
<br />$ rt,hcdnrr $l,jd hihc sorkd(co rr.ns,ion hw\ of Calir(riir, rtrd rsr.rhrrilI sho klbcconr rubjccr brlt
<br />worlcr\ coq)cnurn)n p'.vhion\ ofsc.rn STm of rhc l-iln C.dc. l dnll. lbnhwir h coarply s'ir h rhos F)!isionr..
<br />WAkNINGT F0ilurc to {curc vorlcN compcnyrliqr covcrirc is unh*lnl. a \hrll sohi.r m onpk,tcr ro aimiml peulics and
<br />civil nrcs ut ro otrc hund,cd Ihousund dolh6 (S10O.ul0). fi .dd rn rhc co{ or.oiBisarnn, dnn B.( a\ povidcd lor rh.
<br />S.(rio :10?6 ot rhc ljbor Cric. i'rrcr.\r,
<br />z/z4zctrI
<br />I 1[r.6y rilirN undcr t^'nrlry ol Icrjry rhnr I rm li.ctrwt pn,vtnr o{Chifl.r 9(.o.nxncing wilh Scclion 7fiX)) ofDni\n,n ]
<br />CANIBIJSUANIENDAJi.A!;EN!:T
<br />I icrchy llfirm uoder Fcnalry of l.rjxry rhd rherc i* N .on$tudkJn Lndi.g a8cmy for rh. tal'onDmc or rhc $o* for whhh lhh lf,rnh is
<br />issucd (Scc 3097. Civ C.).
<br />ATPfIIANLDEII.IINAIION
<br />I hot$y ,mnn undcr p.Nxy ol !.rjury ok or lhc rollo*i.B delratio.s
<br />Dcnblilion Pcrmils-AstEsros Nolificalion Fcdtnl Resllalt,nr (Tnt 40, Pd6)
<br />-Rcquncd
<br />Lcrrcr oI Norifi cation
<br />JLt uairt t a * t aoa ngul,tiors cs.iding asb.nbs rtuval ec nor ,pplicahlc ro rhis prcrNr
<br />ordirrtrccs jtrd srrc tjwrrcLrin3ro huildinS rucriinr. ld hcrchy aurhorizc rcpr.\c arnt\ofrhisCiry0ndCountvr,rc.lcrup.nrhc
<br />nhovc rcitokd fslcdy nr inspccrlon
<br />Appli(rnl or Asc.t S*nnxrrc ?/4/.,/a
<br />Communications Cable
<br />Sub-Panels
<br />PolicyNlmbcr: Erpircsr
<br />-
<br />of rhc Busin.sand PbfcsFions Codc, and nrylic.tr* h in lull lore ad crrc.r.
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