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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS ID/SIG.COMMENTS OWNTTR BUtI,DER DEI-CARATION
<br />I h*chy rmrm undcr pc.oll! ol rrj!ry ih, I an cx.ml, rmnr rhc Cotrt.croF Licen* l,rs nr rhc ft,ln,wirrB icnsn {Scc 70ll 5
<br />Busircss rftl Profc$ion Cndc): Aiy Ciry or Counry which rcqun s 0 [Ermir lo on{ruci. tr|rfi, nrymvc, dcm'lish ,tr rcP'n r'y
<br />srrucrurc, piux, irr i$u4.d. o rcqnncs lhcaPplicnnt tor such ncnnir ro lilcasigncd nnl.nt lhalheorshc i\ li..nscd N(nmr
<br />to rh. ptuvhions of lhc Conrrocrq \ Liccnsed l-aw (Ch prcr 9. CunrmcEin! wilh Secrn,i 7(lxl of Divi\ion .1 or rhc Busine* rid
<br />Prnt$ion! Cod.) .r thar trorshc tcxcryt lhcrcliorrtrdlhc bo\i\ turrhc allcg.d crcmrrio. Any violsrionolSc.rbnT0ll5 bynry
<br />rmli..nr for.t rmir bjedslh. Ttlicrnr to tcieilrcnrlryofnor nbt rhin fivc hu.drcddolltu\ ($50t))
<br />L i\ owmr or rhc Iolcny. or my cm,,loyccs wirh wascs rhct {,lc .omFnsdion, rill do lhc w(n k drl rtr (fr1urc i! nor
<br />intcMol or oflcrcd tur slc {Sa 7044, Busines\ nn'l Prorcssions Codc: 1 tu Conlracl.is l-iccfk l ls des nol opplr ro an ownd of
<br />rhe pFncdy who btilds or imnrov.s thcistr. and who (lms su$ 'ork hinr.ll or hcisclfor rhouAh hn o. htr owncntPloyccs.
<br />provid.d rhdr such impmvcmnl\ arc m, iirc lsl d otlircd for $lc lt hoBcEr. riE h{iuinS or inr8rcnrnr is s'ld q iihin .It y..tr
<br />ofconlpbrhn, rh. Osftr Buikls *illtflvc lh. hurd.n.l prcrins rtlt hc or dt dil mt boil] or irrttovc rhc PmFny ior th. put[nt ot
<br />I..sowncrolrhcpropcrly-"mcxclurivclyco.tscringwirhli.cnscdmnlrrr'Fn'on{ddrh.Frojc.l(Scc ?lx'l Btr5itus
<br />aid Pmlc\\ion Cudcr Thc Conrrrctor's Liccnse Llw docs norryply t, nn owncr offropcnywho brildr.r imrrovcs rhcrcon-
<br />lnd *ho.ontErsforsuchptulcchwnh,ctIlth.ttr(s)licctrscdpusu n b rhc cd{i,.rors Lacnsc L!w)
<br />Dii^id.d lnr hr_ s(r. l7lx)olrln'
<br />trlhr Con.. ktrrlr NrfonMn.c ol
<br />/'
<br />I hcrch) rl,nnr undc' pcnJlry ',rpcrjdry'.ic
<br />' DticltBAuax
<br />of thc LlbwlH! dcchrdri(iN:
<br />-l
<br />hrv.n qillmainrainrCcniturrcorconsc0lr' sclr.lnsurc for sorlcr'comp.ns nr. rs
<br />htrtr C.dc.lbrlhc lrcrfornEnccol'lh. *ttrk for whichrh. fr rir is issucd.
<br />,l hrvcrnd *ill mnn rin w.rkrs' cnnDc.s.lion rnrumrcc. is tcqut d fiySccrion l70Ool rhc
<br />rhc qo lor uhici lhh Frmir i\ i$ucJ. My workcr{ .onfctrsatn'n iNuru..c crnicr tukl Flicy n
<br />Icrnifyrhrrnrrhc|{rLnrnDccoirhcsorkn)rwhichrhi\p.mirisn{Nl,Irhalln.rcmpl,)yanyFcho. rnyn nrcr
<br />s mrobccom sut'jcd hft so'koJ.onrlcnsnri(,r hqs or Calilbrnir. uRlaStucrlrr il I shoulJ h.conE rhicd b rl'c
<br />$orkcn conrl,cn\arionpn)!i\ioi*orScctiuD 37mofllt trborCodc,l rhrll. lnnhsnh.oD y Birh rhosc Provi\nnN
<br />WARNING: Frlurc ro {.urc worlrcrl
<br />rivil linc\ uf t,.n hundrcd rhouslnd
<br />comNnxorin covcra8 n lnh*rul. d slull suhjccr atr cnDby.i t, nimiul pcmllic\ rnd
<br />doll \isl )-fiX)). jn 3ddirnni ru rh..on oi.orltn\rrn,f,, da.';:::'i1l[ru17
<br />I hcrcl,y ailtnr !ql( pcnalry ul p.rjury thal I anr lietr*al und€r prcvirion or Chlrrd 9 lco nmnc i,rs *irh SFr i,n 7flx)) ol Dilision I
<br />ol rhc Busircss and Prcfesn,B Codc, arn my liccn\. is in lill for.r aRl cllsr
<br />(:oNSTNUCT!oN I TNDING AC9N(]Y
<br />I hcrchydfirnrunds p.nalryotp.rjuryfial lhcrc isrconsrru.liotr bndinsrr. !lorrhPcrto.motrccorrhe*orknrwhi.hthkJEnnilt(sucdlsc. l0)7. Civ. (: )
<br />Lndcr's Addrcsi
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<br />AIILISANLDEII.ABAIION
<br />I [nby dtirnr undcr pctralry.rrcrjury otrc olrhc folkrtrirS dcclflrtions:
<br />Dcnrlirion Pc nirrAsbcsros Norificlrion Fcd*ul R.ruh'nJns arith 40, Pn 6)
<br />R.quncd ktt.r of Norifi c!,t n /,,-
<br />l.cflrlirhrllhcledcrulrcsulari.n\R!rd'nsa\If,(o\rcntr.lrr.rrqrdicrhlcx,rhi\pn)iccr
<br />orlimn.c\ n Srrrc I rssruLrii! ro btrrld U.oNni.li,D. n lrcrch)_ nrho't.'.1 ymdCourryt, ctrrcr uBr rhr
<br />^,rlPQtS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Life Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Buildinq
<br />Under Slab / Floor
<br />Bondinq / Groundino / UFER /o-/ -/8 J)- [.nr+-w )
<br />Transformers
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Solfit Rouqh
<br />Ceilinos (T-Bar Rouqh)
<br />[/eter Release
<br />Rough
<br />FINAL /04-/g J"/"JrtGr'
<br />Notes, Remarks, Etc
<br />DATE
<br />Communications Cable
<br />Service l\ileter
<br />il$vc nrfliurL'd J'loNny lbr
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