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ELECTRICAL-INSPECTOR RECOBD
<br />APPROVALS DATE ID/SIG.COMMENTS OWN'R B(]II,DF]R DEI-CARA'NON
<br />I hrrchy arirn nndcr pcnalry (,fFrjury rhar l ,n.rcnu fn,n rhc Contr.cl,,F LiNns !trs i(tr rh. folk,winB rcnson (Scc.7o.1l.5
<br />ausincss rkl Profcsin C,tc): Any Cily or Counry Bhich rcquircs a ncnnir k, L1nNru.i. Dlrcr. nnnrelc. dcmolth or rcNn rny
<br />{ocrrtrc. prirr to irs isuocc. rko dqun s rh. +dicrm ntr \khlxrnir ro fiL i siSnL{ slllcrmnt rhlr tcor \hc i\ Iiehcd punurnt
<br />h rhc trcvisotrs or lhc Conlrnctols l,iccn*d Lo* (Chaflcr 9. Commcrcin! wirh s..tn ?ffx) oroivision:l ol thc ll0\irrus and
<br />ProfcsionsCodc)orlhrr hcorshe i\ercmpl lhcrcfronand rtc hlsn fo, rhc alL8.d crcmrrion AnyvidnriotrolS..ri,!70.r15hyany
<br />rppiicntrr for ! pcrmir sublcch rhc amli.rnr b a.ivilpcnalryornor fr,crhrtr Iivc htrMrcd d.ll0r ($5(x))
<br />-1,
<br />rs oqncr oi lhc !ro0eny. ,, nry cmplores sirh wlEcs rs rhcir nik L$nP.Nd n,r, will do rtE wk md rlt nturu. is tror
<br />i. Lrl .!olrcrcd ft qklsd.7oll. Aurircssond ft.fcssins Co,c: l tE Conrrackr'r License hwdNsRn oaplyroonosmrol
<br />rhc pDpcny *ho hilds.r imFoves rh.tun. d sho des nkh uo* hinscll or hcrsclf or rhrough his .r h& oqtr cmPloyccs.
<br />,rovid.{ lhrr such impnrvcntnlsmmr inlcnL{l or oftEn t)r sb.lt how.kr. rhc hu ilding or iry)rcttntnl ir sld wnhin onc y.tr
<br />orcompbri{nrrhcOwncrBuild.rwillhrRIhcbudcnofpm rg rhd lr or shc did nor tuikl or inpr)vc thc F,pdy for rhc rutlx,E ol
<br />l. !\osmrofrhc prot dy. nmcxclusivclyconr.crins wirh liccnscd confu.tFt conntud rhr tn+.r (s$. 7t)4.1. Bu\i"cs
<br />.rd Fnlsshtr Codc: ThcO)nlract, s l,i.ctrsc t-r*docs nor lprltr, anowncrorl]'opcnrwho huilds or ]ifn,vds rh.tco.,
<br />and sho co acr\ nr su.h,tuj.\ts sirh r conrm.lo(s ) lic.nql purulnr kr rhc Conkrcrtr s Li..n$ tj$)
<br />-l
<br />Me&mpt lndcr Ssr
<br />w()RXERS C( )Nt Pt-NSA',! l()N
<br />Dlirl .8AUA!
<br />I hcrebyniirmutucr!!uillyol pcrjurroncof rhr rall,Ni',Ad.clnrrrirtrrs
<br />I h0vc ann will minlnin a Cenifica'c or Consnr ro Sell lnsurc iq solkc$ oqxnsarion,0( pmvidcd lor hyS(rion]Tmorrh.
<br />ljtx, Codc, fff r hc ,.rronmtuc of (hc sork ior which rhc ,cmril is hn'cd
<br />-lhalc
<br />lnd rillmainrain worl.rr rofrprisarnr in\!rrnc.. ar rcqrn.d hyS$liof 3?Orol'l,rc L!6.r Codc. rar rhc |)cr li'Irmncc ol
<br />th. *ork r'or which rhn pcrnir i\ is\rdd M y *orkc6 ..'np.i$r i('n insunrc cn cr rnd lr)licy nu'nhc, uc:
<br />l.cdily rhlr nr rhc r.rloflmtre ollhc uork lir $hi.h lhn p.nnn i\ iskd, I shnll n.r cn{lo} iny n 6.n in any nrnncr
<br />s, a\ n, hc.om rubrccr ro rhc *ork.^ co rNns.liotr lrws ol Calibnrin. rnd 0Srce rhxl if I \h,rld bcdntu {bicd b thc
<br />workc,\, dnnpctrsrlbn pn'ri\n,ns of Scd ion l7(Xl of rh. t ft)r Cclc, I {r11. t,nh\ ilh omnl) *irh rhok phlhnnN.
<br />WARNINC: Flilurc r, rcxr s.rkcr co.rD.n\nrion corcmac ir utriiwtul. anJ shrll \ubFcr m cmphrtr lo aininalF.llrics rnd
<br />cilil linc\ trp io oR hundrcd rhousdnd dollns (Slm.uD), nr nddilion lo thc cosr ot conrpc \aln r, ddnugcs .s Providcd tq rh.
<br />Sccri()n.1076 ofrh. bhtrCrxlc. inrcrcn n arlonry's ltcs
<br />9-t.{ -t6
<br />^pprionr
<br />DEII.AIAIIIIN
<br />I hcnby orftn undcr p.Mlryofp.rjury rhul I an liccrsd utrd., ptr'lision.rCh+lcr9 (.onnmNirB wilh Scclion 7IrO0) orDivhnrn 3
<br />or rhc B inc* lnd Pn)rcssions Codc. nd my liccnsc h ir tull lbre nnd cllal.
<br />t.
<br />q €-L&
<br />IANEIX.IJEUA I,X,OINC.AIiENJ
<br />Ihcmhyillirnu.dcrp..illrolpcrjUryrhrrrhdhi\rro{.rionIdin8r8cn.j_IorlhcPcrbnnoDceofrhe*orkr{r\hichrhis|Eraiih
<br />r\sucdlsN :1097. ( iv c )
<br />AIIIICAIfDECIAAAIION
<br />I lrrhy t'fllm ullc.r pctrrhyofperiury onc ollhc rollowins dalsarn'ns:
<br />t).noliri.n P.r6irs sh.sos Notiic io.Icdcrdl RcSuloliotrs (Tillc 40. Pnn6)
<br />_R.qut d lrrrf .f N.xfi.rtiotr
<br />I.cnifyrharrhc fcdcralrc[nl i(n]s rcgudnr8 sstr{os rcnoul trrc nor lnlli.rhlctu rhis pr.lc0r
<br />l.cnitithdl I hNc rcid lhhrptlicalionan<l{xrerhar lhcxh,rc int{xmtrrion n.om.r lrELtroouplywirhrllCirynfrrCoutrry
<br />onlinan.cs lnd sr . tiws claring ro huibnE con{ dnrn,a hc'chyaurh.rizc rcDrc{nl ivesofrhisCiryrndcounryroctrrquFinlt*
<br />fi)vc nEnri,nrcd 0ropcny lor ir
<br />/t00lir nl orAaetrlSiEnslure
<br />vlA L1+<
<br />*," 943-lt
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lile Salety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communicalions Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bondinq i Groundino / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)4lt4 18T 'n -.-, ,k D)
<br />Ceilinqs (Hard & Soffit Rouqh U \ /L
<br />Ceilings (T-Bar Rough)It r It Tw l^r#)il;r.z)
<br />l\4eter Release I J\\,
<br />Rough
<br />Service ltrleter
<br />FINAL INI '-*D)
<br />Notes, Remarks, Etc.l- r ru\l(la
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