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ELECTRICAL-INSPECTOR RECOHD
<br />COMMENTSDATEID/SIG.APPHOVALS
<br />Site-Work
<br />Under round
<br />Pole Bases
<br />S as, Pool Fountains
<br />S NS monument
<br />Life Saf /Low Volta
<br />Fire Alarm / Dam ers
<br />Communications Cable
<br />Under Slab / Floor
<br />Bondin / Groundin / UFER
<br />Transformers
<br />To ueln
<br />Sub-Panels
<br />Air Conditioners
<br />Boof T E ut menl
<br />Facto Wired Unit
<br />Walls Conduil
<br />Walls Rou h
<br />Ceilin Hard & Soffit Rou hS
<br />Ceilin T-Bar Ros h
<br />lvleter Release
<br />Rou h
<br />Service l/eler
<br />FINAL
<br />OWNEN BU!LDER DELCARATION
<br />I hcrcby afUrn undcr pcntrlty of perjnry rhtr I 0n.x.ry,r froh rhc ConlmcloE Liccn* Li* fot rh. rollowins ramn (S" 7011 5
<br />Busincs ,tut Pmfcssion Cde): any Cily or Counr, shkh rcqunc\ ! Fnir ro onslrud. altcr' nnpole denslish nr rcPn anv
<br />{flcturc. priorlo irs issunncc. {lso rcquircs rh.,rPli.sl lor suc! Fnnil to filc a \irtrcd ndcmar lhar h'or shc ir liccnscd rurs'nl
<br />lo rhc rovhions of rhe Contrtdd s Lkcn*d Il{ (ChapM 9. Conmc(in8 with Se.tn 7filo of Divhion I ol lhc Busin'$ d'd
<br />Pmlcssions Codc) or rhnl hc or shc h ciempr rh.rlnom and rh. haris lot lhe BllcscJ cr.mPtion An, vidlnlionofs6riJnT03l5 bv onv
<br />apllicanr for aFrnir subj(ls rh. utplic!.t ro acivillcnaltyornot mrclhoi nvc hundrcd.lollds (Sstu).
<br />-t.
<br />,s owrcr ol lhc pr.Fny. or n1y cq,lo,t$ wilh w,8cs !s lhcir $L comlcn\at ion. will do rwtrk lxl lhc $udm is mt
<br />;rM&l .r offs€d rm salc rss.?044. Busincs atrd Pn'fcstnr Codc Th. Conlr rois Liccnsc I iw d@s not lpllv b an owlEr ol
<br />rhc pn,rE ry *ln t{ilds or inpmq lbc@n. dld vho des sxh Bor} hif,sclfor hcr.lfo. rhough hh or hcr owncnPlny'cs'
<br />prn"ia.a ri,r .,"r' iDpdcmnh m nor inlcnlcd or olTmd ror sslc ll h,scw. lh. hoildinS or in{,lNrtrl i* sold wnhin one ,tr
<br />; comflclh., rhc O*mt Buildcr will hzk rtr burdcn of pnvin! rh,r tE or shc dil sr build or inw'k rhc pmlEq r'r dE IDrrRr of
<br />l. rs o*n.r ol rhc lot'cny- am erctusn cly conl.rcring wnh li.cnscd conrracttrs ro d,nnrud rh. Pn*ct ( S( 7044 Btr'imsi
<br />md PirrLxsbnCo{lcihtcotrr0crofsLiccnscl-awdocsnoroPplytoanowncrofPrt,r.avwhobuildsorimPtovcsrhcrd'n'
<br />0nd who co hds for such pmj.cG wirh a Conhclo(r) li.ch\L{ punuanr u rhc Conlracroi\ Liccn( tjs)
<br />-l
<br />!mexcn9r undcr Sdi(_.8 &PC fnrhisr.i$r
<br />ita8trEIILlaIIlIXSAIQN
<br />DECLABAIII)!
<br />I hcrcby,lfi rrundcr ll.nalryortEriuryonc.lihc rdlowi.S dcch.r'ion\
<br />-th.!eatdwillmsinrain!ccnificsicolconsentlos.lflnsulclor*orkc^.cofPcisllion.asPmvidcdf(*bysNtion]17{x)ofthcbnor Codc, for lh. Idaormmc or !h. wort lor whth llE p6nil h issu.t
<br />-l
<br />hav. ,rl will mai rin sortcs cotr{Enssrion ibsuENc, as rcquiBd by Sd ion l70o ot thc L!ho' Code. lor lhe p'trormmc oi
<br />rh. *ork for whi.h rhh Frmil is isnrcd My wo*cs' .omlcosalbo insurmc can r ut Plkv nunb'r m:
<br />Poli.yNumhcr:-
<br />-Erptcs4I ccnify rlrar in rhc pctl'onnircc.frhc work l'or *hi.h rhi\ p.Irnir is issucd. I shall nor cryloy atr, Pciso' in aiy lnMncr
<br />$ ,s k, tr(rR shjccr ro rhc s.rkcn'.ompcnsar i{ ldss olcalil'orni!. r l iEnclhal irI\hould tr.onE \rhjcd rolhc
<br />sorlcr( coNfctrsil ion povistuns ol Sdn,n .l7O() uf rh. tjtxtr (:odc. I shrll fl)nhNilI co'nlly qith rhosc F)visions
<br />WARNINC rrilulc lo {tue $o.kcrl.omFn\nrion.ovcmec i\ unltrwlirl..nd shsll suhj.(r trn empk'ycr io si'ninll p'Mlrts rnd
<br />.ivil ll cs rp k, om hurlrcd rh.u\trnd d.llrr\ ($l X)O). ir rddirn nr rhc co{ .l ronncn\rrirnr. dxrm8cs r\ P(rvidcd fLtr rhc
<br />SNrion 30?6 ofrhc Lrbor C!d.. inleE{ dd,lr
<br />DIII.IIBAIION
<br />I hercby zffirn uMcr lcnllryottrrjury rhar I am li.cn\.{ undcr Provi\ion .r chaplq 9l.ommncins {irh S*rion ?dx)) orDirkio' '1
<br />.i rhc Busincs,nd Pnntsions Cdd.. nM,ny liccnse is in rull lnre andcffrd _,,
<br />Licens.Clasrr-
<br />l.).t.:
<br />cONs'I RU(:T()N LI"NDIN(: AcllNcl
<br />lhcdhyalltmucrFnallylp.rju.ylhallhdch!.on(DclionlcndnlS!!cn.ylorlhc!.onBnccollhcsortld*hichlhhle.nlilis
<br />issucd (Sa lO9?. Civ C ).
<br />landcfs Na.E,
<br />-
<br />ATTLTCANfDECI.ASAIIQN
<br />I hcNty afid undcr prnllly.lpcriry.nc oI lhc rollo{in! dNlrntionr
<br />Dc!fr,liriotr Pennils Ash.nos Nolificarion FedcnlRegul0ln,ni (-l irlcd0, Prn6,
<br />R$utrcd Lcnq nr r*i'norDn
<br />-l
<br />ccniayrhar rhc rl{c ral rcgular ions ESordins lsttsros rcmvalarc nor llplicrblc lo rhh F)jcc1
<br />-l
<br />cc,lily fiar I havc @d rhn applictl ion ,nd (atc lhai rh. tbow inforror ion i4.oret llsre to c'nPlv with'll cnvand Colnry
<br />-odinlnccs;nd srilc kss reldid io buildins conslru.ri r. ,ld hcrobv sorlbrtc rcPrc$nl&riv.s oflhn Cnv{od Counlv lo cnrcr upon lh'
<br />atnrvc mnrn,ncd pfl,r.d, tu n
<br />Afl,li.anl or AEent SilEln
<br />z/4.fr )
<br />Liqht Standards
<br />Buildinq
<br />7/L.//4 SI\€(
<br />Notes, Remarks, Etc.
<br />trndcr'r AJ,l,cs
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<br />D.l.:
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