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ELECTRICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWNTiR BUILDI1R DELCAR TION <br />I hcr.by afnrn undcr p..rhy ol pcrlury rh l m cxrmfl fmnr thc Co rackN l,ic.n\c Ltrw fttr lhc iollowinS,crsn lscc70ll5 <br />Busn$r and Pr.fcssiotr C'.dc) Any Ciry or Counly which ,cquircs r Frmir t .onno.r. rlrcr. inllrovc. dctrr'lnh ,{ rcn3t,sny . <br />srrcrure- ! orto irs is.utrtuc. lls rcquir$rh. a?plkdr fo' such,trnn ro,llc. siancd (atcnEnl lhol hcor sh. ir liccnscd pnr\unnr. <br />ro rh. Fmvi\i.ni of lh Conk,clrtr\ Liensd L.{ (Chrylq 9. C,nrEncing snh S..rio. 70(x) of Dnhioo .! of rhc Bnsin.ss a.d <br />Pofcsn.s coJcl or lhal h.orsh. h cxcryl thcrcfron und lhc b{sk Lr rh.dllcgcdcxcmPlion AnyviolllionofS..rbn?0-1l5by,ny <br />amli.! lbr a lE.nir subjds rhc spplicdr b!civilrcnlhyornor mordhan 6!c hundrcddollar (S5@) <br />-1. <br />dr owtur or rhc popcny, or my cnlployEs virh r08cs as lhct s,le comrcnsdion. willdo rh. sork dllE slructurc is mi <br />n mdcd or oficrcd for slc (Se 7044. ausimss and Pmfcsions Codc The conrm.ktr s Li!n{ trw docs trot lpoly h nn owncr of <br />rhc nnpcny who hoildr.r iqehs rh.tutr .rd who d6 ru.h $ork hinscll or hercll or rhrolsh hi\ oi hd .wn cn9loyccs. <br />f"ovidcn rhrr such inpi.rrmnrs m mt inrcndcdoroficr\tforsk.ll lDscrci rhc lDiLrin8 or inlmrv.mnr is {,ld qiihinonc }$r <br />or.orylcliotr llE owrcr Build€r will harc rhc lnrdcn of pmvill3 lhlr hc or shc did nor build or in{,mw tlt pmp.{y fo. rhc puqns or <br />-l- <br />asowmroflhe pmPcny. amerch\iltly.onkncrin8 wnh [c.n\cd cotrtrcroE lo cotr(rucl lhc proic' (S( 7044. Busrncs <br />lnd F$ll\\bn Codc: Th. Co.uerols Liccnsc Lrw dcs noral)ply ro !n o*Tcr olpror.rry who builds or nnDrovcs thermn. <br />and *ho onrrlr ror $ch p6irk snh a conrm.rods) li.cns.d luhu t rorhc Co.rracrois l,iccnsc Las) <br />-l <br />! crc rfl un,lcr Sc.r0 <br />o"*. x <br />tdrtrhFR5' coMrFNsarI(rN <br />DIT:T,$AIION <br />I hcrcbyi[nmu ]cr pcnrlryolpcrjurr.n. otrhc n,l['sins dcclmri(,'\: <br />I halt sdrill roinrain sCcnificdcofCoDscnll('Sclansurc i(tr wo*ra dnnNns i.n.os provid.d for nyScction:17(l() orrhc <br />IihrCodc. ror rlE F rolrmccorrh. sorl lor whi.hlh. tfynrir is is(ucd <br />I lDr. itrd willnuirhir Lvor[cri corDcns i,n] itr\unrcc. rs rcq nrd htSLtrion lTlr{)ofrhc lihor Codc. iorihc P.nnnntucol <br />lhc work tu which rhhncrmil i\ s\ucd Mysorkc$ o'.p.n{iion nNura (d,ricr Md lrlicy nunrbsnrc: <br />Frnn.s: <br />I.dnitr rhd in rhc p.rhrnxrftc oflhc wort for which rhis n rnril is h\ucd. I \hrll no'.q)by rny Ftron i. rn, nr4oncr <br />b as ro teom subjNl lo lhc sortcr'otopcnsri,n lass oaCrlit,dia. mrl a!rc. rh,l ill should bc.om suhFd n, rh. <br />*o*cB' smpcnslion rovnions o, Sccrion :17(rO ol lnc Llhor Codr. I rhJL nmhwilh .onlry wirh lhor lr.vhnrns . <br />WARNING: FriluE ro $.urc sorkss o,npcnsliotr .ovcE8c i\ unlowful. and \hall \ubl.ct ab cq)|,'y.r lo rinrinol Fqahts md <br />civil fincs up 6 .n. hrndrcd rhouslnd dollan (Slm.uro). in lddirior lo rhc coi .fc. Dcns,iion. dtrm08es ar Piovidcd aq lnc <br />Sdrbn 1076 ofrh. tjho. OLlc. inlercsl lnd ullorrcy s fccs <br />ApPri.-,, L( <br />t r(t Nstn ( oN'fIlA('loR <br />IIECLAXAIIO! <br />I h.rcby rflnn und.r r.nallrolpc,jurylhlt I snr liccnrd undq F)ri\i.n orChrnr$ 9 (omm..inE wirh Scclioo 7ux)) orDivi\i.n.l <br />or rh. Bu\i,r* rnd Porcsions Codc.ond nryliccns h i,r tullforcc ard eflccr <br />co$irBuqr&NrElolNclcllll <br />I hcEt y oafirmundcr Fnahyorr.ijDry lhal Ihcrc is. onsrfl.lhn lendinS ascnc, ioi <br />'hc F.raomn.e orthc wo.k for *hkh lhn pcmi n <br />nsucd (sE 109?. civ. c.). <br />AftucANft icuaarlaB <br />I hcftrby anim u.dcr p.nslryofperFryonc of lhc followiiS &rlmrions: <br />Demliion Pcrnirs Ashc os Norificdrion Fcd.ml R.Buhions (Tillc40. P0n6) <br />-R.q!tcd <br />L.{c, ot N,lifrarhn <br />I .cnni thri dc fcdcral icBularions Esa ins fl\hc{os,cnrvnldc nor nPfli.rhh ro rht pmjccl <br />lhovc mnliomd prolEnt <br />Appllconl or 8enl Si$, <br />P.nrite Dm.(prlnO: <br />Underground <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Lile Safety /Low Voltaqe <br />Fire Alarm / Dampers <br />Communications Cable <br />Buildinq <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 />Ceilinqs (Hard & Soflit Rouqh <br />Ceilinqs (T-Bar Rouqh) <br />lVleter Release <br />Rouqh <br />Service lvleter <br />l-t-\-w ,)rl <br />Notes, Bemarks Etc I <br />Site-Work <br />Under Slab / Floor <br />FINAL <br />| .n.t^r'\ ,lJ,r.\ <br />tl