|
ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE COMMENTSID/SIG,
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Life Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Building
<br />Under Slab / Floor
<br />Bondinq / Groundinq / 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)
<br />Ceilinos (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rough)
<br />Rough t
<br />Service Meter
<br />.?n/2.//=,
<br />FINAL \,)
<br />Notes, Remarks, Elc l- t
<br />OWNER BUILDOII DELCARATION
<br />I hcrcby nllrm undcrycnrlry oi rcrjurt rhnr I ad exemo lioh rhc C.ntack's Li.cnsc tjq fot lnc followins rcd\,. (se.7011.5
<br />Busi.c$ ad Pnfcs\ion Code): Aiy Ciry or G{nty whi.h r.qxncs n Fnril lo connnd. alrcr. inrptuh, d.nblnh or mpdn any
<br />{ocrrrc. pri,r ro irs hslan e, aho nrtuirs lhc +pli.i.t fo. such pcrmn ro fik ! sisEd drr.mnr rhtr thor sh. k liccnrcd puruanl
<br />to th. pmvhions ollhc ConrEckn\ l,icensdd li{ (Chtrrrcr 9, cofr r.tr.itrg with Seclion 7000 ol Dilhion I ol $. BusnBs lnd
<br />Pnntssiors Codc) or tharh. or sh. is cxcmrr thcr.from aM rhc hash lor rhe all€scd dc'nplion AnyviolrlionofScclion?03l5byuny
<br />arplicani lor ! lcnnil subjcls rhc lpplicut ro u .i!il Fnah y or nor tut $e 6!c hundrcd dollars ls50o)
<br />l. as awncr orrhc l(,pc,ly. or nrycmployecs qilh wascs us lhcn n'b.o.llrns,rnnr. willdt thc $'ork uftl lhc dNre i(
<br />'hinlctrdcd or ofrc,cd ior snL (S(.70r4. Busircs &d Pror.$ii,F C.dc Th. Cont..l.ls t,iccnsc t u doe\ nor +plyr. M ownc! or
<br />rhc topcny sk, hoildr or iirpmvcs rlrmn. orn wh. dN qch Mlt iirtrsclfor hsrclforrhftu8h his.r hcr osn.nrrby..l.
<br />afl,vidcd rhal such impmwtuaG m not inr.nddl oroltatd fu slc.Il tk)rcEr. rhc ttriHins or i.rpovcmnr h cru wirhin{nc rr
<br />of.orphrion, rhc Own rBuildcrwilltuE thc ttr cnof[ovinSlhal lEor\hcdkl n.r buildorimprorc dc !'mFny fo! rlt !uq-{.f
<br />l.asosrE olrhcDrcpcny.anrcrch\iv.lycotrrrdih!wirhlic..scd.otrtrcktrsrocon(rucirhcP(+crisd( 7(xJ. Bu\tr.$
<br />nid Pmfdri,n Codc:'l'hc Cont..kn s Liccnsc l,0r'docs nor rptrl,lo !nowDcrofptu!. yqh. huildso! imPnntsrhcr.o'l
<br />rnd who conlmcts ir such rnjcc( NirhaGn racrodn liccn\cdlursur lolhc Q,ntracr{tr r L,icc.\d l-aw)
<br />;,'"47/'fiF Z!
<br />I hcrchy lll-rrm Dndcr pcnrl'y 6r rcrjury orc or rhc lollo*i.B dNhrarions
<br />-l
<br />havc ond lillminrain a Ccain.dt ofconrc.r rosclalnlurcfor sorkcr'corpcicdri.n. d\ tr.vided lbrbyS(lionl']ff)ofrhe
<br />L.hor Codc, for rhc ,l.rftnroce ofrhc work ror whkh thc ,.m'il i( issucd
<br />lhrlr rftl willnsinrrin sorkcrs .onr|Ensaltr iNuraR-c.0s rcquircd hySccri,r:17(X)ofihc Lahor Codc. Ior rne IErnrmrn( uf
<br />rhc wo lnrwhi.hihis p.nnil is issucd. My worker' mmncnsal ion insurlncc cdir tu tbli.y.u rncr m:
<br />t ftdily ihrr in rhc lfrforrnr'f,r olrhc work ir $hich this f..rnit is is\ucd, I \hrll ior cnlploy ntr] !cMn in trny mankr
<br />so 0r io tironE sutrjcd b rhc wo*c^' co'nF.rrrion lrws or Cilrrornir. ind .!rcc lhd il'I sLuld hc(,nr suhi(r to rhc
<br />workctr'(nnDensarionnrvilionsofS.di.ilT(X)ofrhctihrC.dc.lshrll.Lnhsirhcotrglr*irhrh.sc|)nrvisior\..
<br />IIARNIN(; lj ilur. k, {.tr'c \f'lu\' irnj)c0\tri( .1 tul- \hall suhiNr jn cnrnloycr nr ai'niml rrrrlri.s rnd
<br />.ivil lincs u, t, otk hundrd lhousrnd dolhrs ($lul-U1o,7'of.omFnsrlion. doroBcs o\ tmlid.d for rhc
<br />:1076 "arhc t-h, codc- tr crcnq/e/lf l1
<br />DICLABA.I(I!
<br />I hcrcby oflnmundcr pcnohy 6r p.rrrt lhar I o'n li..nrsl und.r povhiotr ofChatrcr 9lconmncins wirh sc.tion 7000) ofDivision l
<br />of thc Burincss and Pmfcssions Codc. ltd my liccnE is in flll foc aJri cfiNl.
<br />coNsrf,urll(r t[NDlNctcErLr
<br />Ihcrcbyrf6.rnundcrFtrrltyofpcruyrhrrrht..i\!6n{.rhnk ine tr8crc! for rhc Friormln.c ofrhc sork for shich rht lErnil is
<br />n\ftd rs.r :1097. Civ. C.r
<br />APILICANLDIiCIAaA.IIO!
<br />I h.E'by trflim undcr rc,8lty olFrjury one orrhc lolloains d6hrarn,n\:
<br />D.mlirion lcroirs Asb.sbsNorific io. Fcd$trl Rcau hrb.s (l itlc ,lo, l'n6 )
<br />-Requircd
<br />L!fl.r or Nolilielion
<br />-l
<br />.cniry rhst llE f.ncrd rc8llarioB Egading alb€sk* Emvrl e re' ,m,licablc lo lhis pmjecr.
<br />_l ccarfy rhlr I havc Etrd rhE,ppli{arion qE {trle rhor rhc 0lnvc inaornurion t corer.l eSrs roomdywnh !U Cityand Conni,
<br />n,d nancc, and sr,tr Ljs i rhrngr+rdtn8 .oNrrufo1 8d h.rcbv luthona rcpr(nr&v.. ol rhF c y and c/ounr)
<br />rro
<br />cn e, ull.n rhr
<br />:;::::T;::*\WilUl/J_: ^"4k/np.m,,cDm.{pr,n,,: / hl c kae [ " Za ( q ?q.
<br />i-
<br />7ZKlTl
<br />I
<br />i?t
<br />Communicatrons Cable
<br />lvleter Release
<br />,,
<br />t-
|