|
ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS ID/SIG.COMMENTS OWNER BUILDER DELCARATION
<br />I hcrcby lmrm undcr Nnslry ol p.rjury lnd I on exenu ln)m rhc Conkr.t,6 Lic.i$ ltrw ror rh. r.llowing ustr'ls.c1ll.5 .
<br />Busincss r.d Pror.\sn,n Gd.) Ant ciry or (tJumy shi.h Equirs d pcirnn t. .onsrucr, rllcr. improrc. dcnFlhn or Epnn .ay
<br />slruclurc. Fior ro ns issuancc- oho rcquircs rhc applicml forsuch pcrmn h fit, sirncd darcmnr rh,r h.or srE h licc.scd PUBUtnr
<br />ro lhc provisions or E Contractols Licc.rcd hw (Cnnptr 9. ConmEncinf wilh Scction ?000 ot Divisbn I orrh. Businc$,nd
<br />Poltssions Codc) or thar lE or sl.( k cxcmpr thcrctoD lnd rlE bash for lhc lllcsed cxcnprn,n Any violari.nofsdi.nT0ll5 byant
<br />arpliclor nnapcmrir suhjcch rhc qrpli.a toacililpenaltyofnorntrorhnnfilchundrcddollds($soo)
<br />-!.
<br />rs owrer.f lhc pror.lr- or m) cmpl.Fc\ *irh *!3cs os rh.t sk mmp€nurion. will do rlt wo* ,ill rtr sn w is nol
<br />inrc lcd oroirc.cd for sle (Se 7(x.1, Buliftsrnnd Aofessions c(xi. Thc cl,nrehis Li..ns Laqdesnol alply ro !nowncr ol
<br />rhcpmFny who huilds or in{,Fvcs rncrn, ud who dms such mrl hinrclfor hc^.lfor rhou8h hh or hcr owncmployccs.
<br />F)rid.d r har su.h imlflwMh m ( inrc.dql or ofi.r.d ror srk Il. howclq. lh. tuikliry or impmEtunt is bld wnhi "k )rrr
<br />oio,rfkrhn. rlE Owncr Buitls sillhak ih. hrdenollovins rh h. or snc did nor buald., inproft rhcl)DFry for lhc Nqn\c ol
<br />l. *oricrolrhcropcny, a'hcr.lusilcly.onkrrine*irh liccnscd .ontrclon ro uor(rucl,tc prycct lss 7044. au\inrs
<br />nnd ttDf$sio. Codc ThcCotrrracrois Liccnsc l-,Nder nor lprlyro ano*id orp.(,pcnywho buildsor impm\rsrhercon.
<br />atrd wh. ..nr c*ror su.h pft)jc.n with r Conlrrbnr) li.cns.d pur$xanr IorhcCo ractols Liccnr lia)
<br />lrrdxcnu uMc. Sc.rn .a &PC frthhmcon
<br />Dite O*n.r
<br />IvoB[E&tl:auflr s r()!
<br />Dr:cLA-8Alt9!
<br />I h.rcht rllii'n uidcr !.ntrlrt.rpcrluryoic ol rlt n1l[,$in! d(hrnrnnr\
<br />I hivc.id *illnuinrain, Ccn iknrc of Cotr*.i b Sclaln\urc ntr sorkcr'.oDrpctrsdn'n. !s prcvidcd lorbySccrion llTl()ol rh.
<br />ttrh.r Axtc, Inr rlr t--.rl'orron.c oilhc *ork n)r trhi.h rh. I.n nnrucd
<br />I b.rc dnd sitl nsinrai. sorkcrc c.mrEnsarion insnhN.. ar rcqured b! Ser ion 1 r00 ot thc tjbor Codc. {or rnc Frfolr1@e or
<br />lhc work larwhi.hrhh p.iinir is issucd. MyworktrC comp.trsdi.tr ineu.in.c cMicr $d Flicynun$quc:
<br />L-*icr: - \i,\\rs -f,),!,4.r/ yrta\on
<br />?urrqqf-7J I
<br />-lccnilylhrrinlncncrrbflmnccoirheworkror*hthlhnpcrnrilisis\uc.l.lshrllnorcipbrdtPcronn'inynunncrs r\ k, t cotu srhi{r ru rhc rork.6 .omFrsrr ion hws of Crlif.mid. md ll8mc thll ii I should tEom sl,F.-'r h !L
<br />work s' conlPctrsrl ion povtions oi scdion l7u, of lhc ljtxtr codc. I shal[ tunhwilh comply irh rhos pDliri.ns
<br />WARNIN(; Faihrc () {dR {orlrn
<br />.ivil lincs !I) ro onc hrndrcd rhousrnd
<br />sccrnnr .1076 0frhc utxr codc. inrcrri
<br />,
<br />", glaoJtv
<br />cotrrp.tr\rrnn, $vcrugc i\ uil]$lul, rtrd \hrll {rhr.r itr .nro)qrr h rinin]l ll.ulri! rn,l
<br />Xx)). i. addnion lo rhc..st ofcomrcnsolion. dIMEcs f pnvidcd f(n rhc
<br />lhcrby alfirnundcr |t.trlr!orrcrury rh[ I *t u.dcr p,$vnn'n olChqns 9 (o,nmn.ing silh Sccrion 7tX)0) ofDivisi,n 3
<br />---------l-yqrc."",*b,\1b3-tcz
<br />114 tX tnr^v ea\'*vg-f trn
<br />CoNSTRUCTI(IN LENDIN(i A(;ENCY
<br />I hcrcby {llirn undcr FnahyolFrjury lhal th.rc n J consloctio. hndnrS a-lcncy fo. rhc pcrforilnft.r rh. *ork ror Nhi.h rhis Fr.rt t
<br />issrcd (s& 3097, civ c )
<br />AIILIIANLD&CI,ABAIION
<br />lhdrhyfimrndcr p.nrlry of p.rpry oft oflh. folhwing ddbrrrionr
<br />Dcmnirioo Pcrmirs AstEsros Norificdn,n Fcderal Rcgularions (Tirlc4{}. Prn6)
<br />R.qut€d l-.llc. o, Norifrri,n
<br />-l
<br />ccniryrhar lhc fcdcralrcau! ions rcsardins a\hc$os ren$vrl arc nolapnlic:hlc rornhrn,rar
<br />l.onityrhxr lhr\r rri rhi\
<br />o,dinrn..\rftt sirlr I]*s r.l l
<br />ri,,nr (rrrrl r rhcrh)m i',formrii,n isconccr I rBrL{!).o ylyqirh.llCilyind(innrry
<br />ri{rr h.rcbyr h,tri1.rc|'csctrr.lrc\of rh1.Cilyind(iunlyto.nrsurrrh.
<br />aborc trEnliorci lro|Eny lj]r
<br />,\ ppli€tri .r AActrl SiANlu
<br />Slvl. tt-1.<-f torr)^,".1:1lt
<br />Site-Work
<br />Un derground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / 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 (Rouqh)
<br />Ceilings (Hard & Solfit Rouqh
<br />Ceilings (T-Bar Rouoh)
<br />[/eter Release
<br />Flouqh
<br />Service [Vleter
<br />6/42.1 /-2,Wup
<br />Notes, Remarks, Etcl z-l{_-
<br />DATE
<br />FINAL
<br />.f rhc Busincs Nnd Pof.*o.sC.dc. tuxl nr! lkcnsc is in frllforc md cllsl
<br />- --r------
<br />----T------
<br />flt
<br />I
|