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APPROVALS DATE ID/SIG.COMMENTS ()1'NI:R BUII,DgR DELCARATION
<br />I haby lIIm undd pqEl] of parury rnr I d dolpr fto6 fi. Coflrrro6 Lkog trB aor llE folloeb{ ren (Sc.7oll 5
<br />BsiB ad ProlBbn Co&): Aly Cry or Codt *hEh r.qui6 . Fhr ro (tarucl. rir, uqrovt dstulilt or re.r &y
<br />fic'ue Fnr to "r i!s@cc. .lh rcqo,6 tlE rpplier for uch pdnn lo f k r.tfl.d lrdom! rhr lE m iE . li.ar.d FllM
<br />ro rh. FosioB of rh Conndoa! I-t.B.d L.s (Chrpr6 9, Com.mins wilh S.(ion 7000 of Divi3io, I oa thc Lluircs 6d
<br />PmfshN Co&) c rn r lE or $. i amlr rlE froh !d llE tG! lor tlE.lh.d qditr6n. any riohion of Sali,n ?011.5 by ey
<br />rr?licor for r pqnn $billr th. @licd to r ciril lqdrt .l mt !m. th.r fiu. hudlcd doll,6 (1500)
<br />- l. s o*n6 ofrh. FoFny, 6r my oplorG wilh *!96 s lhcir $1. .onp6s.Ibn, will &' lh. wort &d *E ni.re i! ml
<br />inod.d d ofi6.d fo, {L {s6 7044. BuiK md FroadioN Cod.r TIE codrsloir l,to& hw dG @l ndy io d ol}c oa
<br />rh. F!'Fty *tn hiil,s or d+.€ tlE@ !n *hi &s $cn $o* hiEll o. lEslf o. llmugt hn d lE orn nnpk lG.
<br />prov'd.d lh.r ruch !rp.!!sE ! e mr i.'rqd.d d otk lor r]. l[ ho*@. dE hildi,t d r4.w.Er ir sld wilin om )r
<br />ofcontldiotr th. O$tr6 Boir:16 pill hlE rhc hnt n ofF$viry lhd h. or CE did tur UiU d idrpmv. $. F!Ft, 6r UE F(pos of
<br />l. a 0*6 olrhc FotErt. m.rcl*iv.l, .o,ndru *.ih liGE d rodrdoR ro odruct tlE rnj6t 156 7044, &8!B
<br />Dd tbftslbn Cod. Th. conltaclor! Lic.N. L,* do6 nol q,ply to e ovod of propaty *ho build! or inprovd $4m.,
<br />u! vho codrncl' for $ch roj.d! wirh ! Cod*161, lio!.d Ftre!! t. tlE Cortulolr Li.w L.s)
<br />I h .rmpl urd6 Salbn B & P (' rorlhB r@'n
<br />llEriEest(olr.8Ed5alla!
<br />aEclJaarra!
<br />I ha.hy amm und6 Fnsht of rrjury on. of rh. aollo*in! d.(hritioN:
<br />I h!v. sl srll mj .in . Cdifxd. of CoMr ro Sdf-lte fot wld omFurF.. ! Forlt d 6r by Ii:rbtr 1 7m of E
<br />L.&tr Code fn rh. Ffolrm. of lh. eut for $ttn llE Fi'l it 6u.d.
<br />VAfh... &d *,u nai.,raD *0r!6 co(F@rnrn ilMec. s r.qunal by setiotr r7m orthc tabot cod.. ror rhc pqforlle. or
<br />rlr wrt for *t h rbi! ,non n is,.d My wdtd' NoF!.i,n iMe. cir .n Flty numtq e:
<br />,.',".'- qvwv lCAn Zvvt(,tn
<br />',.,,,,,,,,,,,", -w(Etr4V OIU ' ,.,,..tl / r I Z0Lo
<br />I cdi&lhd h !h. pcrfom!trcc of lh. so'l for sh(h tht Fnn i! i$udL I sh.ll mr mplo, xy F$n in &ylmE
<br />e &rro b..om. sbjdr ro rh. *0lt6 .ompddion Lws of caliaomi.. ed.sEthsr ifI $ould b..oo. subj{rt ro rh.
<br />e.rt6' comFslrion FoviirN olsclion l7m of lh. L.tor C.de I {ull. lonh*ith Nmply *hn lhr FDrbnB
<br />WARNING: lj.'lur. ro su. *0116'comp.n$lon ovqoar $ uola$lul, ed th.llsubj.d tn mployd tr siminal FMhis trd
<br />rilil fin6 up h orc huhdr.n lhour4d dol
<br />sdrn 1076 ol rlE L.bor ( o&, id6d ..d
<br />h dinion lo rh. .on ai
<br />-t tt,
<br />I hqcly rlrtu untc Frh) ofFju.y rhr I m li$El u,id olclrfla c (mffiins sith Sction r00o) olDrBioo l
<br />of lh. BBinB od PerdtN Cod., &rl ny hc.N is ir full forcc ai cft6r
<br />Or" I
<br />.,* ' cto
<br />llu lz"z
<br />qT7<r?
<br />VtVtv^'t- *laQ-
<br />CONiIAUCIIAd.LfTDIdG.ACE (I
<br />I t@by anm u.!d pa6hydlpnjury rh rha. i! ! odtudion k dinA rgfl, for lhc p6tomd.. of thr srk tor ri,ch rha Fnn !
<br />&!.d (56 109?, Civ C.)IfrL.r Nm.
<br />attucANflEct a8Arlar
<br />I lEdy atrm und6 pa.hy of Fjury otu of lh. followi4 d6b.rbB:
<br />D.mohiof, P@ir!-Arb6ror Nori6c.r ion lj.d6.l R.3uhtioN ( l irl.40. Par6)
<br />i.quild tnrq of tlotftrih
<br />I cdiry thal rh. f.dsll rcsuldioN r.sEdins otEros rflrvEl m nor .prliabL lo thi! pmlal
<br />yfi-,ry r* , *" * ,no .lpli.dhn sd 3r. rhi rlE lton
<br />'naont'iFn
<br />. corr.cr io d'mply f, hh .ll Cty.,n Coody
<br />\6 oarhB (_ir, od Counryro 6rd upon th.
<br />t I r.- /t.r-o
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough
<br />Service Meter
<br />FINAL
<br />Notes, Remarks, Etc
<br />ELECTRICAL-INSPECTOR RECORD
<br />oddn.d ed Srar. tr*! Ehrrg to
<br />ahovc frdrion d pmldy for
<br />Under Slab / Floor
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