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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE COMMENTS OWNER BUILDEX I'EI,CARATION
<br />I herehy ofiim under lcnolly ol p.rjwy lhnl I flm cxcnDl from lhc G'.r,acr.^ l-t.n\c trR r.r rh. rollowi.g rcNotr (Scc.7031.5
<br />Busines arxl Pro{csion c(nlc): A., Ciry or G,unry ehich r.qun.r a Fn n
<br />'o
<br />..nnrd, trher. imlrorc. dcmlhh .' +rn iny
<br />sru.rurc. pri,r ro iis ksu0trc.. ako rcautcs rhc otplicrd lnr su.h Frmir ro filc r si8rEd srlrcmenr rhlr tE.r shc i\ licdnsd pusu.nr
<br />k, lh. nn,vht,nr olrtt Conki.(tr's Li..n$d tiw (chnprcr L Connrn.nr8 wirh Sccrion rfin ol Divhion 3 or rhc Buqinc$ rnd
<br />Prcrc$ione Codc) or th.r lt or shc h excmpr thcrc,iom.nd th. t{sh lor lhc ollcscd eic'.ption A.t vi.taibnorsc.rirn70ll.5 by trny
<br />|lpnlicrnt ior n pcrnit sut'j(ls rnc a,,Dlico.r ro acivilpcnulryoioor mftrhDi filc huMrcddou&s (S51D).
<br />-1.
<br />trs o*ncr of lhc l,rolEay- or m, cnul{,}es wirh $!scs a\ rh.ir slc compenrarn,n, *ill do lhc sor* dltl lhc slmhrrc is nor
<br />inrcdcd or oflcr.d ft, ek ( S&.7(x1, Ansift{! and Profcssio.\ C.dc Th. Conracroa r Liccnc tj* does .or q,plt (' an oqmr of
<br />lhcnnrEny wio btrilfi or i.lllmvc\ riljmn, ud *ho docs slch w{,& hnn\clf.r hcis.lfor rhmugh hk or hc, own cnllllotcc\.
<br />prolid.d lhar such imrrchnrnh m mt inrelrdsl n oftrcd lor slc lt ho$ercr. rtc hildinr or iqrdtftnr is $ld withir orc )qu
<br />oI conpkrion. Ih. Ow.cr Buikkr siu hale rhc blrdcn ofl,ovin8 rhir hc or \hc did e' t{ild or itq'/.vc lh. pmFnt lor llE purlDs of
<br />l.isowrcrolthclropcny.nmcxclusivclyconrr0dfu$irhlicctrrcdc.nlrxcirr\k,con{tucrrhcltrqc.r(s..7o4il.rlu\irre\1
<br />d Ptr'fcssin Codc 'I hc cl)ntrcktr s Liccnsc Lnw doc\ nor r!,tly b rtr .r cr oltrip.rly\ho huild!ornnr( c\rhctdn.
<br />rtrd $ho conlmcrs r'or such projccrs Fnh r Conrr!.rorl9 liccn{d prriuxnr b rhc C.ntr..ttr s Li.crsc L1N).
<br />I rDcrcmpl utrdcr Sccli ll & l'C l{)rlhn rcr$n
<br />Da(. Orne.ltoR(itfs c!rN,m^ls,lrl(),\
<br />IIECIAEAIIQN
<br />I hcrchy affiontndcr Fnalry ofFrjuryotu ofrh.lollosioe d.clrrnrionrl
<br />_lhvcud$illroinrrinncdincrrcnla)n{rbsrlrl\unlnruorkcri.unrltn\ irin.i\I]n'lidrdntrhts..ri({17(x)ofrhc
<br />lixn (i'dc. lor rhc pcrftr'nxncc ofrhc Bork f(tr *hich rhc pcnnir i\ n\urd
<br />I hrlc iM qilln.in(ah w.rkcrl conDcn\orion irsurln.c- as rcquircd hyscrln,n 1700orrtt L$.rcod.. for rhc I]crlonlErcc oi
<br />Myworkcr'o tcn{ iqrinsur cc .rricr rd [,li.y nu $rrrc:
<br />qLtL\\1 * 14.
<br />-l
<br />ccnily lnur in lhc ncrllrmrc oirh. trork aor *nkh rhis F-lnir i{ islu.d. I rhill tror.nlplo! !try pcr$n in rny nrnn.r
<br />$ rsk,lr..nr subJtcr ro rhc wo*.s comlcnsarion laws ofCalin,niL ond lsrcc lfilr if l sholld hccoft suhi.c o rh.
<br />sorkcr' .onlltns,rnr. prcvn ions ol Sdiotr 37m ol rhc Llltnr Codc. I \h0ll. n]d hrirfi coq,ly $irh lh)$ [ovision\..
<br />Wr\RNING I'.ilurc kr rcurc NorlcB .orrpctrs$io $vcrosc i\ unln*tul. rid \hrll hi.r a'i onlplor.r ro aiNinalncrollh\ and
<br />.ivil inrs ut b uN hundrcd lhonsand dolldr (!lm,un). in rddnbn ro rnc cosl ofconFn\arn,n, d,nmC.s 0( fmridcd lor rhc&Ll,qhvq
<br />DECIJSAI1jINIhcmhy nnilndcrpci0]ryofp.rjuryrhxrIaDli.rtrrdnMcrpnrvisioroiChrplcrqlcomrmncins*irhsc.ri.n70m)olDnhn l
<br />ot lhc Blsinc$ and Pnfcsions Cod.. aJd nryli.rne h ii full rd..
<br />"nd
<br />cffrr
<br />C-(c L l@v617-(t. rL
<br />C(}NSTRUCTION LENDII\G AGEN(]I
<br />I hcrcby afiirn undcr FMllyolpsjuryth,I lfisc is 0 comlru.tion lcndinS rscncy f.r rh. pdrornun.. ollh. worl lo! whth lhh |Emir h
<br />nslcd (Scc :1097. Cil C.)
<br />AIELICANLI}ECI.Af,AI]ON
<br />I hclrby afiim undcr renalty ofEr,ury onc ofrhc r.ll.winE dftldraliotrc:
<br />DcnFlilioo Pcrmits-AstEsros Norilicarion FedcrrlRcEullrions(Iirk,s). Pan6)
<br />-Rcquncd
<br />l.tler of NorilEalirn
<br />lroniryd r rlr li erxlrrguhli,) {rcfnrJr! r\1.!o\rrikrnlr. ior tt)plirxhlL ri rh \ |nri.r
<br />-l
<br />ccnir rhrr I Mlc rcld rhn ardicrrnin lnd dlc rhar rtc,|.ve irln.mtrrn,n i( c.nd1.I rgR.- romnlplywith ull Ciryrnd ( ounry
<br />onliMnes lnd Sratc Lrwsrcl itrs r., hui[ingconsrtucrion. Rnd hcrchr lurhtri,. rcrc{nhrnc( of rhh CilyandCounlyrocnrcr trF,n rhc
<br />Jr!^r 'irtrri,,nr,ltn,nLdj litr
<br />'
<br />rstr!1.tr t rU!ae!-
<br />^l,pri(rn,nr.r,:enlsiln!,ure A'fi-x>
<br />rrm,i,tunn*'prin,,: 4?^( G
<br />1-r y,ty
<br />Site-Work
<br />Underground
<br />Light Standards
<br />Spas, Pool, Founlains
<br />Siqns (monument)
<br />Life Salety /Low Vollage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Bondino / Groundino / UFEH
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Bouqh)
<br />Ceilinos (Hard & Soflit Rouqh
<br />Ceilings (T-Bar Rough)
<br />a*l^r
<br />Rough
<br />Service l\/eter
<br />FINAL 4l2LlrY'*td.Nptd ^,/V\)Notes Remarks Etc
<br />ID/SIG.
<br />Pole Bases
<br />Under Slab / Floor
<br />lVeter Release
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