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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARAT'ION
<br />I h.rchy ,rfiro undo FnNlry ol pcriury lhar I an.rcmpl f$n rh. Conrrto6 Ltcn$ lj* tor lhc lnuowing e{*n lscc Tonl 5
<br />Bxsnr\\ akl Pii'rcsion Co{c) Any Cily or County qhi.h rllunc! ! Fmil r. condrucl- .lr{, improvc. dcnmlkh or tPtn rny
<br />strucrurc. prior ro ns tsu0ne, also Equncs thc appliclnl lor such [Ermn lo fiLa ri8n.d sarcnf,nr {d h.ot shc n lictnscd ,rursmt
<br />r. rhc rovisi{'ns orrh. Conrra.t, s Li.cn*d ljw (Chipr.r 9, com rminS wirh Sccriotr ?dI) oi Division:l ofrh. Busi'1c* rnd
<br />Pmlcssiotrs Codc)orthrl h.or sh. h cxcnrpl rhercfionond rhchosh ior lhc rllegcd crcnDrbn. Aryvi,,l.lidiors(lko70ll 5by$y
<br />+tlicrnr tor a p.mir subjc.G rI[ trptlicad ro acivilpc.rnyordor trr,.rhM livc hu rcd dolla^ ($5UO)
<br />_1. us o*rcr ol rhc pr.Fny. or nry c lphtrc\ *nh wagcr r\ rhcn {,tu smp.nsalion, will do ltE wolk and lhc irtura n nor
<br />i .frLJ or ofrcdd f.r slc (Sd 7(X4, Busik$ atrd Pmf.$i,n* Codd: Tlc Co.tiadoi\ Liccnsc li* dtrs.or aptly lo nnowmr of
<br />rhcpFltcny wlr builds or inDrers rnc@n- and who d.Es u.h $. hi'nsclr or hcr{lr o. rhtuu8h his or hc. own cryloycc{.
<br />pn,lidcd rh r ru.h inpr,Eftnr\ rrc nor id.d.{ or olicild tr $k. Il hJw.va. rhs huildi.3 or iryn,wnrnr is v,U wirhinoE Jar
<br />ofco.rkri'n. rhc Owmr Buitdr villhrw tlr budcn of FJV'r! rhar h.d rhc dd mr hulrd or in{'mvc rhc Impcrly nn lhc !u'FN ol
<br />t.
<br />I
<br />downcr uf rhc pft ,Pcnt. nrrcr.lusivclycoN ru.r rh. I)'{,iccriscc 7(!-,1. Bu\irrc\s
<br />Pnrlir\i Codc: lhcCotrrrrlor\ l,i.cn\c l-,wd.cs J, who buildsor improvcs lhcrcon.
<br />Prur.t wirh r conta(tr(
<br />B
<br />Tlriq
<br />7
<br />lhrvc dd will tuinrrin n Ccn ili.arc ofConrcnr r,Sclal,htrrc tu qorkc^ ciDrt'ctrsrlnr, rs f)vidcd l'orbrSNrn,n:l7U).frh.
<br />L xtr ('Glc. ti,lhc rqntrmncc ofrhd *orl lor whkh rhc r.rmir i\ issucd
<br />I hav. rnd willnrintrin qorkcrl conDos3iion insurch-c.0s rcqutcn by Sd t,n :l7m oi rlt titxtr Codc. for rhc pcrionunce of
<br />rhc wo,k for which tht pcrmir is nsed. My workss comp.trs0l ion iNu!0rcc c icr and Flicy ounhj m:
<br />I.cdrfyrhnrhrhcrcrloflniNcolrhcNorklirwhlchrhirJrrtrrir is l\{,cl. I shxll tror .mnl.! rtry n.ho in.rfmrrncr
<br />n, nrn)hccom \uhl.crh rl( s.rkc's c.n,pcr\ ri.nhu\of(rlil,rtrix. tr igto\ rrd il I durl(l rf,.onrc n,hi.t b rhc
<br />so,[.^ .onlncn\rri{mpn,!nioi].l Sc.ri( 17(x)of rhc Lrlrtr I sharl.fo hwiihcornly,nhrnoenrolhion\
<br />*:ylt*'[
<br />*orlc^ onFnsition co 1.y.. to diflinal!.n!ltics !nd
<br />dnmScs rs rovAcd for lnc
<br />ff nuo,,*.,
<br />l hcrcby ifiirnu cr pcnlhy.llcrjurylhrrI anr lienql u nrrn!i ! qnh Sc.ridr 7(xXJ)ol l)i\i\iqr.l
<br />CQNEIBU(: )IiIE!DI!!iAAE!(I
<br />I ncrc$y glfifln nftlcr pcnllryol'rrjurylhar rhcrc n,F,ndru.lion b.dinE rsdn.y tor rhc l.rrormancc olrhcworkfor whthrhis Isn n
<br />issucd (Scc.109?, Civ. C.)
<br />AIIIICANLDLELAXAIION
<br />I lmt'ydfirnnndo pctrtrhy oifcrjry oN olth. follo*ins dc.l0r.lionr
<br />DcdDlirn,n Pcrnrir* sh.sos Norilicrlir Ircdcnl RcEnhrirfs iTillc]0. I'fi6)
<br />Rcqtrtcd t1trcr.f Nsnll..ti({r
<br />I ccdilyrh rhc fcdcmlrcauhlnnN
<br />--l.crrilyrhnr
<br />I lu'vc .crd rhnrtfli.rr on coft.r I n!'.ct,(rnrtl!sir 'lx:e[inordi Ncs!n Srarc lisa rclnrintr,6uild
<br />Jh^( trrnrioncd troNny lhr in\nc i
<br />Applionr trr AAenr \iAnnlure K T
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lile Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding / Grounding / UFEB
<br />Translormers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Rool Top Equipmenl
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walis (Rough)
<br />Ceilings (Hard & Soffit Rouqh
<br />Ceilinqs (T-Bar Rouoh)
<br />lvleter Release
<br />Rouoh
<br />Service ltileter
<br />FINAL flabM t vu
<br />Notes, Remarks, Etc.t Ul
<br />I hcrchy rlltn utrd.r Fnahyorrcrtrry uN.frhc tr'llo*ire
<br />of rhc Busincs and PmfcsiorECodc. ad nyliccnsc n m fulllbrcc fltcid.
<br />l-i.c's. ( lx\\ I r..n\. Nuf$cr
<br />l)arc (onlrucii'r
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