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DATE IDiSIG.COMMENTS
<br />Site-Work
<br />Underqround
<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 />Under Slab / Floor
<br />Bonding i Groundinq / UFER
<br />Translormers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Facto Wired Unit
<br />rWallsRouh
<br />Ceili hSHard & Soflit Rou
<br />Ceilinqs (T-Bar Rouqh)
<br />lvleler Release
<br />L
<br />I0 ?
<br />?/a7p-a
<br />0LRouh
<br />Notes Remarks Etc
<br />Service lt/eter
<br />FINAL
<br />OWNER BUILDER I'ELCARATION
<br />I h.,cby dnn undcr Fnalry ol p.rjury lh.l I im cxcnpr fmm rhe Conta.roN Liccnsc t w for th. lolbwing rcas. (S.c 70ll 5
<br />Businc$ a.d Profcssidr Codc): Any Cny or Counry {hkh rcquncs r Flnil ro conslrucl. ah.r. inpnJvc, dctrDlhh or rclan lny
<br />slrclurc- prhr to ils hsuaEc. aho ,cqrids rh. rpplicanr r.r such Fnnir lo lilc a sisNd {,r.mn! rhd hc or shc is liensd lrr{sr
<br />kr thc ptuvhhns of rhe Conlructors Liccnsed L!* (Chaprcr 9. CommcrcinS wilh Sccrinn 7(D0 of Divhi.n I ol thc Busincs rnd
<br />Poli$ions c{dc)or lhar tr or rh. is cxtmpr rhcrcriomMd rhc h.sn for lnc allcscd ck.mlrn n Anyvn nlionolSdionT0:ll5 hynny
<br />amliclarr(rtrr.rn,irsrhrdrsrhcaprliconrloacivilpcnolryofmrmrcrh.nfiv.hundrcddoll0rs($500)
<br />-1,
<br />!s o*mroaficpo,tny, o.nrycmplot .s withw!8csas rhcn st c- ric.\arion. willdo fic wo* ond rlE srtulm n mr
<br />i.rcdcd.roficrcdrttrelc(5(.?044,Businc$andProfc$ionsCotlclltCtnradoisLiccnschvd.trno({DryroanowBol
<br />rhc pmp.ny -tb ttrilds or impn,rcs rhcm[.mlwho dor such *ork himrcllorhc^clfor rhoulh hh o! hct owncmPloy&s.
<br />l,olidcd rhxrsu.h impmmntemr inrc cJ orollcrcd,or ek Ii h.wcvcr. rhc tuilding or irqdrcm issh wirhin,,nc
<br />'srorcomplcrion. rhc OwNr Buiud will h.!c ltrc bunlcn ofnmvirs rhlt hc or sh. did Nr burd or inlmw rh€ PDItn, rd rrE [r4ns of
<br />L r\orncrofrhcpn,ttrnv, rDcx.hr\ivcll.onrrrclirg sirh li.rtr{d co r' a.t* r. L_o0{rucr rtl lrujc( ( St. 7t!'1. 3u!N\\
<br />arkl hilissi.n Codc llrcConlrmk, s t-i.ci\.1-rw docs norrlflrlo rf.*ncr.fl)()lcdysho huildsor imrrov.\ rhcrcon
<br />r.i \ho conrrrcrlarsu.hfoj..lswiihr(inrDcktr(9liccn\cdrr^urnrk,rhc(inrrrroisl,i.cn\c1trtr)
<br />I Jncrdnnruidfl s.!trotr .B &Pc r{rFtsrr-n
<br />WoRt<l R-S' ( lt)Nl Pl'NSAI'I( lN
<br />DLCLAXAII(]!
<br />I hicby rffiflnnndcr |{nrlry otpcrjry oic.frhc f{rbsmE dccl.mrion\:
<br />lhnvcdrlwillm.int0inaCcnificlrcolConscnrbS.lflnsrr.forsrlc^snnpcn{rnn,.aslmvidcdfnbyS(rion:lTlDofrh.
<br />tihr Codc. tu rhc Fjriorino ncc ol I hc worl( Ior Nhichrhc p6'nir is hsu.d.
<br />-lnarcnndNillmainlain*ork.^comrc.\rrionnrurinc.rsequircJ6ySsli,nr.l7ll0.rrh.hborCodc-torihdptrrornr^_corlhc work ior which lhisFrmir ir hscd. My*orkdj comI,cns0tnnr insu.lnce clricr,rd Flicy nun$ct uc:
<br />Cer:
<br />-
<br />Iccriitilhllirlhcpcrfornunce{)irhcworkrd*hi.hthisrcnnirisi\\ucrl-I\hrllnorcPby.rrypcnonin!n,m,nmr
<br />{ r lo bccom sobjd b rhc sork s conDcns{rion hws orcolirixnia dnd rgfrc rh.l ilI should lrs,r $bitlo rhc
<br />wo*c* .onprN,r n povnn'nsofSsrion 3?01) oarhc If,txtr Codc.I \l[ll. fonh*irh ompl, $irh rk)* pir,risidF.
<br />WARNING: r,ilur. () wurc Norkcn'comrcnsarion ovcDsc i\ unhstul, ut, shall \uhFl an e'nPk,ycr b dimiml PcMllic\ and
<br />livil [,cs trt b oic htrndrcd rhou\rnd dollri\ (xX)). i', Uirn,i n) dr .o{ ol .of,Dcfsrri,)n. dr rgcs rs Povid.d for rhc
<br />S.crioD.1076 otrhc li&tr Corlc.
<br />*, o*/,+/E 34 ' zt,-'
<br />!.l!!ri!!dUati
<br />I hcrcby ommunder ncnllryolpcrjury ihor I n'n liccnsl undn lovkion ofChstrd 9 (conmcrcing wirh Seclion 7lxl0) olDivisiotr l
<br />of lhc BusiRss and Prcfcssioas Codc, srd m, lkcn* is in full foN and clf(l
<br />t-7 9?t,69
<br />Yg/r4l t9
<br />lh.'.h\ rlltnrkl.r trnrlrtol N,juO rhnr ru.rim hndi'rsr!.,ry nrrhc ttr.loiinrn.c olih.$.rk nn *hichrhi\ P.nnil i\
<br />isucd (Scc lO9?, Civ. C )
<br />w""^.
<br />ATTIIIANI.DEII.ASANO!
<br />I hsll)y o|mr und.r p.nally oi lErjury onc of lhc lollowin8 d(hrari..i:
<br />Dcmnition Pcrnils A\bc{or N.rifi.rrion Fcd.rsl Rcrulllions (firlc4{. Pd6)
<br />Rcqutdd l.n.r ol Noriicari,)n
<br />I
<br />ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS
<br />,A
<br />+*a[s-{e€ncluit
<br />Lfo-l0tl
<br />lrlry hnqfr,a r.,fr t',, ln <-
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