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APPROVALS DATE tD/stG.COMMENTS OWNER BUILDER DELCARATION
<br />I hcr.by ifilrn und.r ,cn,hy.r p.rjury rhd I m.rcnl,l lmm (h. (bntmcros Lians La* for rlE folhwins ..apn (S.c 70ll 5
<br />Businc$ and Pma.$ion Codc)r Any Ciry or Counry which rcquircs ! lclmir lo co.srru.t, allcr. imPovc. dcmlish or m|nir any
<br />ntudlr.. Itrior lo irs n\ua@- al{ eqlter ihe aptlic l lor such pcrn b nb , sigNd .ldcmnl thal tE or shc is licen*d lruruanl
<br />to rh. Eovisbns ofrtr Conkacktrt Licctr$d t w (Ch.rrfi 9. Commncine uirh Salion ?mO of Divi\io.I orrhc Busifts and
<br />Profcsi.ns Codc) o. thar hcorlhc n dcnlr rhcrctrcd lnd lhclJlsh for rnc sllclcd cx.tr1p'ion. Antvi.l0rionofScction?0ll.5byany
<br />npllicrnrrbrrpci,niriuhFBrh.,mlica.'roacivil!.nakyornornrrcrhanlivchudrcddoll.K(5500).
<br />l. rs ouncr of lh. ropcny. or nry cmtloyes wil h wrecs rs th.ir slc .omFn$tion. sill do ltx {ork and rhc {turuc n nn
<br />inlcndcd or oltcrcd lor e[ (SN 7(xl. Brsims\ and Pronsi,)ls Codc Thc Conrnckr's l-i...\. tie docs nor npply n) an oamr ol
<br />rhc pnDcdy who hurils or innmv.s rh(]@tr. rBl rtr' d,Es \u(n w)ll( hnnflfor hcnclfor rhmr8h hit or hcro*n cnu'hycN.
<br />pmvnhd rhr {rch irnlrnncm s ra mt inrctrd.d or oflaed fttr srlc lI hoBcrr. rhc llildin8 o. in{mvcmnr k $ld wirhin onc ,c
<br />ofconpLrkr. rh. Owo.r BuitLr will hr\r rh. bnnicn ofpftrlinE rid hc or \hc dil fln buill or impnrvc ln. pm,Ely lor lhc purpo* ol
<br />Lnsowncrorrhcpn,rnt.intur.lu\ivuly.o ha.tniS wirh lic.n$d.uftnct,6 h con{rud rtE tojcct (S$ 7O4{. Bt\in.s
<br />lnd l,Irilshn G)dc: lhc Conrrrols Lir.n\c Lrtr dms ft, lpply k' an.$ncr olpropcny wh,, huilds or nnrrovcs rh..co..
<br />r d sho .onkad\ntr \u.h l]n,ads *nh r Co.rackn( r licrn{d puhurtrr r.rhcContdois Liccnsc tiw).
<br />uaatrEBs-coutErs rIoN
<br />DriclAnrua!
<br />I hrrrh!rffinnutrLlcr ltmlryof pcruryoncof rh.lalk,*i'i8dc.ldnnnn
<br />I hrvc ond will mai' iin wor*.ra comr.ns,rion insunftc, ,s rcqund by sariotr l7m ol thc Lahor Codc. lor lhc pcrtomncc ol
<br />rhc sorl lnr shich rhn Ennir i\ trsud] l\lrsulkcr n in\uroncc.rricr tu ,sliry nu,nbcr sc
<br />| 11,.:t r4-I
<br />I
<br />-l
<br />ccnify rhar in rhe p.rlarruEc ofrh. $ork for whih rhi\ p.rmir i\ i$u.d. I \hrll nor cmploy rtry P.rwr i. any nlnncr
<br />{r dsb h..oif, \ubjc.r blh. * cn.on[ctrsnli,rn hssorc liltari!. ld l8ncih0l il lshould hc(r,m suh]rd rorlF
<br />w.rkc^.o.rr^-n\dn,nfovi\bn\ufS..rnrlT0Ootrh.LhtrCodc,lsh.U.lonhwith.ondy*ithrh.$poyision\
<br />1lARNINc: I,iilurc hr ccurc Borkcn conpcnq(ior is trfl!trr!|. rn,l shrll \uhiccr rD ond.)r b fi idrl Ntrlkr\ d,ul
<br />civil incs ur ro onc hundrcd rhousnd dol ). in addnion ro rhc con or.otrIfnrarion. dnm8cs d: t.ovidd ior rh.
<br />Se.ri,in l(176ol rl[ lxhtrC,xlc ini.rcd rnli
<br />,A.. Gr..rnn\.<-r_-"_{I+ls
<br />DEIIASAIIOJ
<br />I herchy ulfirm undcr pculry of ri..j!ry rnar I rnr licen{d uodcr 0ovnion ofChstt{ 9 (comntminS rirh SNrhn 7u)O) olDivisn,n l
<br />of rh- Busirrss d Pmicssions Codc- xl nry lkcn$ is in lullrbrcc{ cfi(i
<br />ro\srt1W0etW evYdq-
<br />I h.cby arm under F,Eliy or Jxrlry lh.r rh.rc k r oNrudb. r:ndin8 l8wy for thc Ierfolrrwc of rhc ert 16r whkh rhk Fmi b
<br />nslcd(Sec. 3097.Civ C ).
<br />AIPITCANLITEOAAAI]AN
<br />I lrNby lnim !.dcr pcnllry.lr.rrury onc of rhc rollowing d(ltrnrn,n1.
<br />Dcnmlition PermirlAstEnos N.tilicarion F{dc.al Rcsuhlions lTnt 40. Pan6)
<br />-Rcquircd
<br />Lcncr of Norificalion
<br />_l.cniry rhar rhc fcdcrrl r.grhrbns Rlrding n\b(no\ rcnxrd ff. n r rprlr.hL k,rhi\ proFcl
<br />-lccnifyrharlhuvercodthklpplicsrion0.dshrcrharrhc.lnvcinrb,mdionhcorcdllg@16.o,ply*nho0CnyundCoutrr}onlinin.c\ ind SIrrc Liw\ Nhr aurhfia rcprdrnhrivcs ofrhitairya*l Counryro cnrcr upotr rhc
<br />rhtrc ktr,i, cri pr.t]cnylilr lr
<br />,\ppliMnl o. ,\pctrl Signnl 14(€\".,",?/7frf'
<br />Site-Work
<br />Underoround v,'qy'k s-:trPrtz+ lb
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Salety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Bonding / Groundinq / UFER ?/eilrc tL.66 9>ft?-Dfutc Z,ra-,tr
<br />Translormers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Soffit Rouoh
<br />Ceilings (T-Bar Rough)
<br />It/eter Release
<br />Rough
<br />Servrce Meter
<br />FINAL 4lqrh0 itrtttr rrta--tf),,."
<br />Notes, Remarks, Etc
<br />ELECTRICAL.INSPECTOR RECORD
<br />Under Slab / Floor
<br />I r[.rc'nni u.dcrSNri.
<br />-B
<br />&P.C f(trrhilr.ai r.
<br />Dol. Osner
<br />I h!!c a sill nuinrain , Ccrt irrdrc ol c(,n{.r r. sdlf I nsurc rr uort.d .dnD.nsat bn. as lnvided ror bySalion 3700 oflhc
<br />La&r Gnc. nrrhc pr oimme ol I hc *o* for which rhc pcirnil is irsuc
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