|
ELECTRICAL-INSPECTOR RECORD
<br />r)\\\I,tR ttl t)r R t)l,t r \lr \ ()\
<br />I hcicb! afllr'n u Mcr |fntrlry .f ltrjry lhnr I .n cx.nu lmn rh. Cotrh.k{s Licc.\c tjw ttr rhc l'ollo+ ing rca\on ( Scc ?0.1 1
<br />Bu\incs( afrl Prolcrsion Ctrlc): Any Cirt or Connt, whicn rcqutcs ! Fnnir to mnntucr. rlrcr im!turc. dc.mlnh o! Ep(r lny
<br />itucrur.. prir ro irs h\urc, nl$ i.qxir.s rhc applicanr for slch Fmir ro ilc , sismd { cnr rhol hc or shc h licctrBd ptrruni
<br />ro rhc pmvisbns ollhc Conlmclq s Liccnscd Lnw (Chatrcr 9. Comnemirs wirh Scction 7(x,o or Dirhk,n I orrtu susn'c$ .nd t
<br />Pflnt$innsCodc)ortholhcor\hc kci.mfl rhcr.lrumund thchrsh lor rh. ulhgcd cxcnprhn Any vnndi.tr ofS&1ion ?0.11 5hylny
<br />.ttli.j!foratr6n\lhjehrhc.npli.rmbicivilp.nahyofioimodrhatrl,Lchutrdrcddollan(S5lrO).
<br />-1.
<br />!r owncr oi rnc pm[rnt- or my cnplolecs silh *aacs as thcn ob conu.nllln,n. *ill do rhc *or* ukl rrr {ulm i\ hr
<br />inrcnlsl or olird ft, slc (Sa ?0.1.1. Bu\inc\\ and Prcfusio.s C,xlc l h. C.ntd.rols Li.cnsc Ltrw docs nol lpply lo ai osrcr oi
<br />rhc tnrlE y who boilds or nqru$ rhcmn. flrd who dNl su.h wyk hnnscll or hescla or rhml8h hn or hcr .en c tpkJtc.s,
<br />pn,vidcd rhar soch nnlR,knr h mfr inr.tuLd orofiircd for {ft ll h){ cvcr. ilr huildi'rt or iqm*tNtrr i\soldwihinom )e!t
<br />olcondcrion. rhc osncr Buildcr sill hrw rtc hlrdcn of prcvinr rhd hc or shc did frn s{ild or i'n rot rhc pbpcny nn tu Nrriosc ol
<br />l. ff owmrolrh. pnncny. adcrclusiv.lt contadins sirh licen*d conrrbF ro $nstud rh. nmjccr (S(. 7044- 8u\incs
<br />a,n Eois\ion Codc ThcConlrucrois Liccn\c lf,lw d@s n.lr,'plyr. rno*.cr orpn,pcnr$ho buildr or nnProvcs rhcrcon.
<br />rtrd who.$nrrhf.isuchpmjeBwirhrcbntm.k(oli.ctrsdt'lrunnrlnrhccontrrcrolsLiccnrcl!e).
<br />I rmcr.mnr undcr Sc.rion
<br />Dit.
<br />tr.( 1, \R,r I l()N
<br />Poli(yNumhcr-Erfnc\:
<br />I..nifyrhrrnrrltrrcrloi,rutrcc.fthc*orkforwhi(hrhNltrr rir i! is{rcd.I shrllnol.nrployrn, p.^.n in a ynlitrcr
<br />n)r\lohcsnnc\uijdrorhcworkcrs'con,pcf\rrionlns\olCrliinir.rn{lurrrhrrirl\lx,ul,lbrc.rc{rbJ..lr,rhc
<br />so ctr conrpctrrrriqrpmvision!ols(rnnr:l7d)ofrh.Iihrcodc.lshrll,r(,nhsnhconrd,\irhrhorpr)!ist'n!
<br />civil liNs up (r onc hundrcd thousi(l dotlan ($l{X).UXr. in dditio ro rhc cosr olcnmpcnsarion. drhrgcs ai f)vidcd n, lk
<br />S.cri .1076 ollh.l.ntry ( odc. inrcrc( rDd rnon,cy\ ttcs
<br />I'PCLASAIIO!
<br />I hreb, afllrm nnder rrn,lt, or p.rjury rh.r I rm liftn{i u.d.r ptuvision ofCh,/q 9 (ommncins silh Sccrion 7(xlor orDivi\bn:l
<br />of in. Busincsotrd PBlcssions Codc.0 m] liccnsc h in lirll rbrc lnd cflccr
<br />Licr r. Ntrtr xr
<br />taNirxucllaNrdDlNlilt tt:
<br />I hrtubyrfiir u c' Fnaltyol trrluiyrhd rh.rchtr c.n{tu.rion hM Fq.ncylorrhcFrronunccollic$orkrorwhi.hrhi\Frnrilis
<br />hcued ( sN. 1097. civ. c.)
<br />Le.dcisN.m:-
<br />d.ttllcrlNfDtrCl. .BAIION
<br />IlrRh)nnh,utrJcrlrnnhyol trrluryo .ol rlrtulkr\ltrgdc.h i(rr
<br />Irctrx)liri()n P.nnir\ A\lr\(* Norili.rrnnr tu\lcnl RcBrhrn r (l irlc to. Pir6)
<br />Rcqun.,l lrn.r of Norifi .rrkll
<br />,nltritrc.\ rD,l Srd.l.r{! ahriog b 6uil,lir!..'p'o\.n1xrtrr:,'l rltr\cir! trl(ittrtrrvrr.frr trfitrrlr
<br />ibok n$ri.md pn,Fny for insticctn pur
<br />.\ntrli(anr or /\r€nl Sitnnn'R
<br />APPROVALS COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lite Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor /a
<br />Bonding / Groundinq / UFER lo-zr*..lK \,lU-tc)
<br />Transformers
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Solfit Rough
<br />Ceilings (T-Bar Rouoh)
<br />Itrleter Release
<br />Rough
<br />Service lvleter N'"'l'lg \ -tt/ttl
<br />&uYmFINALil/a/il n7L-
<br />Notes, Remarks, Etc
<br />A
<br />201
<br />I hd.hy rlli.rrf(lcr D.filrr_.l l,crt yf trcol !h. n,l[nroe,l..l.tr,'l,trir
<br />tr !r Cixlc. l(r rlic N'n nr (rc oi rhe \rrk l{tr \hr.h rlir Nrn ( iN cd
<br />rh. q,r k ln' \rh.h rhll t^-nnir i! isncll [1y\so'k.'s ..n,J[ \]1i,nr i']urun.c.xnirr x,kltr)
<br />'cy
<br />iunrld n'.
<br />I.dify ihar rhc fcd.rd rclul.rions rcSrding ashcsros rcnrvrl rc Dor lPllicablc ro thn pojer
<br />-l
<br />ccnilyrhil I tuvc rcad rht applicarion et narcrharrhcatn$ intoin i,nh.omi I trgrd lo conply wnh ull City and Counry
<br />DATE I rD/SrG.
<br />I
<br />=
|