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APPROVALS DATE COMMENTS
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lile Sarety /Low Voltaqe
<br />Fire Alarm i Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Groundinq / UFER
<br />Transformers
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilinos (Hard & Solfit Rouoh
<br />Ceilings (T-Bar Rough)
<br />Ivleter Release
<br />Hough
<br />Service lt/eter L
<br />FINAL ,/?a/1 "7/)
<br />Notes, Remarks, Etc.r/ r/'- l\\) t -
<br />OWNER AUILDER DELCARA TON
<br />I h.rchy rmrm unner p€ulry of F jury rhdr I m q.mpr ton rh. Contr.clon Liccisc kw ror rhc rollowinS rclsoi ( Ss.701 1.5
<br />Busincss Md Profcsion Codc): Any Cny or Coutrry whi.h rcqutcs a Fnnil ro c.nntud. drd. imFrovc. dcmlnh nr rcnnn any
<br />srru€ture. Irior ro irs isslanc.- ako rcquir.! rh. rp/i.d fo. such pcmnl ki filc ! silkd {nr.mf,l thtl lE or shc i\ liccn*d Punu !
<br />to rhc rovisions ol lhc Conlructols LicenEd Llw lchlpler 9. Co m.ncin! sith Scclion TOlXl ol Dirhn,n I ofrlE Busnr$ ond
<br />Profc$ions Codc) or rhat nc or shc ir cxcmtrrhcrcrmm rnd lhc basil lor rhc 0llcsed cicnPrion Any viol.'ionofScclion?0:11.5 by 3iy
<br />npnlic!trr tur apc.nrir iubj(hlhc lmlics lo acivilpcnallrolnot m,rcfi nr. hundrcd dolles ($5001
<br />-1.asowncrotrhcpropcny.ornycnplo)rc\wirhwnScsasthcnsb.omDcn\srion.willJorhcwork.
<br />rhcslmr@i\ n
<br />inrcnd.rl or ofrcrcd ror slc (se.7044. Businc$ .nd ftofc$ions C(lc l hc Cotrt..ror s Lkcn{ LIr doc\ nor lPlly tu nn oskr oi
<br />rhc pml)cny who hu ilds or inDovcs ilhr1, Md who d,B such $olt hnnsclf ot hcr*ll or rhn gh ht or h.r own cnnt,yccs,
<br />l(,lidcd rhrr such nnfrwnrnh !rc ftrl irtcn lcd orofer.n hr ets la h.*e*r. rhc hrildi.e ur irr{rxlmnt is hU $irhinon. far
<br />o, on{kiiu. rhc Ownd Build.r will h.\r lrE hordctr oi prcviry lhnl hc or \hr dil i.r huild or iNpmrc rhc ,rmldy Int lhc Puqxxc ofv
<br />)C,. *.**,nr*
<br />^,.nr.
<br />amcrchsnclycnnracrins pirh liccnid.ontm oF r. connrua rhc polst (se.7o+1. Busincssumd hof65rn Codc.Ihc Crnrmroic Liccn{ Low docs nor.pplylo anowne! olproFny }ho builds ot improvcslhcrcon
<br />snd who onlmctsfor such pmrcts wirt ! Connero(s) lt.oed pu*uanl to lh. Cotrtractor's l-iln* Lau)
<br />I rmcxcml)r uNlcr Scdion-. B
<br />','",9^ 27-/f
<br />I h.rcby alrtr undcr pcMltyofp€aJu.yonc ofrlrc f.Uowing deldolionil
<br />-l
<br />hovc und will nDi' ainrC.nificolcofcotrsnlroSclllnurclorsorkdl ..mt'.nsari.. as !ru{idcd ftt bysccrirn 3?00 otlh.
<br />Ijbo! Gde, lor ihc pdrormre or rh. work for whth lh. I,cmil ir issucn
<br />, hdvc trnd willmiinrrin so cri .ohpcnrarion inslratc, &r r.qut d by Sc(rion l'700 6f rhc t$.r Codc. for tlE !'crforEN of
<br />lhc lork foruhich thh pcn r Lr iqiEd M, *orkcB mmF.sario. insuron.c cnicr and Flky nu'nhn *
<br />CrE.r-
<br />Pol'cyNurhcr
<br />-f
<br />\ni'.
<br />XI mn'lr rhr rhcr.r,nrmnccol'thcrorllq trhichtnnF"nr n hsucd.I \hnllTr/.o\. r" t'ccnnr.ut'rco r, rt,c *orI.F' rcn{,.nsiron |.tr\ or ( rlrr.mE.,rd JE're rh.r I
<br />c.rlloy lnr Ii.rY,n if rDy [0mr
<br />should h.\onE sullcr ro i,L
<br />wo,k€G' codrcniario. pmririons of Sdr ion lr00 oa lh. t tIr Codc, I rlEll tunhsith conDly wilh lhoE pnlnionr.
<br />wlrurrxci ltitrr" t or. *,trkctr .onpensariotr .ov.age is unlouftil. snd shsll subr.lr an cmdoFr lo djni.al Fmxi.s oxl
<br />civil fincs !I) ro om hundrcd (hou{nd dols ($loo.mo). i. addition lo rhc cdr or conp.nsolion. drmges sr pr6rid.d lor ihc
<br />Sdnn l0Toorlhc l!h.r Cudc, nrcEd ond rtrormy s lccs*'"i'dtl-tf ^,,,@
<br />I hcrcb, arn6!.der p.naxyorl. juryfial I .!n liens{ undcr ,'mv isio n of Chapl$ 9 (comnEncins with Sccri.o 7m0) ofDivision 3
<br />of thc tslsimssand Preicssions Codc. tid myl,c.np k in 6illfora ird clfsl.
<br />CONSTRT]CTION I FNDIN(; A(;ENCY
<br />I hftby rmrnundcr Foaltyoipcrjury rhbr rfisc h r c.nnrudi.n htrdinS.rency lor lhc pnformncc ol rhc qork lor *hich rhil Frnrir h
<br />t\tcd (Sc. .11)97. Civ C.)
<br />a.tfucArfD[g,aa r!]N
<br />I IER'by lltimr undcr n nalry of pqjuty onc or rhc folbwnr8 delrrl ions
<br />Ddn'lirion P.rnir*Asbcstos Nolificolnrn Fcdcral Rcglhn,ns (Tirlc.t0, P.n6)
<br />-R.q!ird
<br />rxn.rorNolifi .dion
<br />-lccnifyrhar
<br />rh.lcdcralrcsxlrrio.s rcaffding osE(slo\ rcnrr3l arc lor atpli. lchrhisIn]cCI
<br />X*:r ily rhrt I l c
<br />'cnd
<br />rhN rtDlicdi,r nRlnxr. rhxr rh. xhrr i'rln'i nr kcorccr IrsrNk'..mpltwnhillCilyarlCounr!
<br />rizc r$rascnrrriE! ofrhi\ Ckr rtrd Counryro cder rt.nrhr\ and Shrc Llqs rchliry lo l,urld
<br />rb.r. mcnrnnrd nioF-.ny tur i sF_cl
<br />L)44.1P
<br />,,,",f4tut
<br />iIGZ,i
<br />ELECTRICAL-INSPECTOR RECORD
<br />ID/SIG.
<br />Liccnsc chs
<br />-Liccnsc
<br />Numbcr,
<br />-
<br />Drr. - Conlrmlor
<br />txiJ.i\ Addrs
<br />-
<br />,\pplnxnl or.'\[$l Sirn lurr
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