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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG,COMMENTS
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lite Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<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 Rouoh
<br />Ceilings (T-Bar Rouoh)
<br />It/eter Release
<br />Rough
<br />Service Meter
<br />FINAL 0ll(,o 116 .A6b
<br />Notes, Remarks, Etc
<br />OWNER BUILDEN DELCARATION
<br />I hfichy aflirn xndcr !.nrhy of p.rjury rhd I { crcdpr lDm rhL Conrador Lkcnsc l-rw fur rh. idlowihS rcrsn (Seloll5
<br />glsine$ !d Profc$hn Co{c): Any Ciry or Cornty qhich rcquircs ! pcnni rn consrrucr. !hcr. improvc. d.mlish or Ep'n any
<br />ntudure.idorlons nsurrcr, al$ rcquires lhe appliconl ttr \uch ncmir h fi le r \iEred n,remnr rh!' rx or \hc i\ lien{d pu^o2m
<br />lo rh. ptuvlsion\ oflh. conra.rols Lienscd Lj* (Chq'rcr a. comncmtrr! s h ScJ'on Trrxr.r D'vnE r '{rhc Busines and
<br />Pmlc$ions Codc) or thrl hcorsh. icxcno thcrclionre rh.basisr{,rhcallc3edcxcryion.AnylnnllinofsN'hh70115bylny
<br />aprlicsnr rora pcnnir lunjcck rhc atplicsnrb,cirilp.tr!lryoinornxncrh,nfi!.hundrcdd.lh^IS5u))
<br />r. ds owtrdorrh. |x)Friy. or my cnlplorr.s wnh wr8csrr rhcir slc compcns0tiotr. willdo lhcNorl. lhcnMlmnnor
<br />i cftL1l orrflcrcd Io, srlc (Se 7(144, Busincs lnd P,ofc$ions Codc:'Ihc Conrrrcroir l,iccnsc liw docs nol trmly o,..wn$or
<br />rlr ptup.ny who bxilds or nnpturs rhtrctr. u whodo.!rxchk) hinNlI.r hcscll or rhtuuEh his ii. hcr ow. cnlployccs.
<br />p(,vidcd rhtrr \uch impmvc'ftis ur trn intndcdornltrcd lirr v'b lli howcw. rl[ hiklin8 or nnpNv.nrnr is sol.l {irhin nnc ,(.tr
<br />oicomtlclion. the Owmr Buildq *ill havc lhc burdcn of[oviry tlur hc o! shc did Bn hlild or n otr,w rhc pR,rrcn, fttr rh. tx{r,*dr
<br />l. rsoNncrolrhcpoprny. r'ncrclu\itclycontacring $irh li..nql conrrct,c ro .onnrud rhrtRic.rrscr 7&-1, Busnr$
<br />atu }hrE$hn(ndc:]'ft Cotrki.lo.s Lic.nsc Ij* docs trorit)ply t,r !n o$ncr o, propcny lho builds or nnnrolcs rhcr.on.
<br />and tho.onrrchlnsu.hlri..hwirhrCuntucbnnlicq,+dlur\xanrrorhcCotrtr.tr\Li.ctrs.tis)
<br />lrncrch|n untlcrSccri{B. & PC hrrhsrnsotr.
<br />Irrt. O*ner
<br />trgtrtrLtstrouftN-t ltoNrf,(t .8trIlQN
<br />I hrr.by rlln'n undcr prDrlryolpcrJury.nc orrhc r(ilk)$i',C Jc.lrrrri(n,\
<br />lhrle ud $illnDinraii aCcdiai-arcofC.nknr h S.lf lnsuE fd sorkc6- ..mf,.n\rtion. ns pNvidcd LrbyS(liotr 37(XJoflhc
<br />I jho! Codc. in rhc pc,loreE-^c of rhc {ork lor whkh rhc Fnril is ir\ucJ
<br />Ihrlcrid*ill'minrrintro.rs.onFn\rrn,nin\rran.c,r\rqotodbyS..Ldnl7mofrhrhtxxCod..(nrhcpcrformh..cuf
<br />rlr sork Lr shth rhi\ p.rnrir i\ nsu.{ M y w.rk.^- .om!cn! i(n n6urtrd.c caricr dd p.lry nunrh.. arc
<br />P.li.yNumhcr Expncs
<br />-l.cnity
<br />rhor ir rhc ncrlonnancc orrhc work irn *hich rhir rcnnir is issucd. I \hrll ior c'tpk'r rny tt6ui in niy n'.nncr
<br />v) asrobcom subj.lr rorhc wo c.( co nr!.ns.r ion iiwsorc,lituflli( rtrd {3Erhll ill sl.ould lBonE sublccr lorhc
<br />$orkcr conrpcnelion [nvnn ns oISe-'ri.n ]Tmolrhc trhor (inlc.l siall,lodhwirh conpl, {irh rlx'{ pmli\n,ns
<br />W,{RNING: Failx t, $.ur. worl.n .onD.nsdDn.o!ch!. i\ unln*lirl. rnd shrll suhF_t m cmplorr lo aimiml neMhis and
<br />.ivil 6n.s up r, oic hu*lrcd rhous0 d d.ll&s (SIoo,UI)), nr rddiriotr !' rhc cos oicomtEneriotr, danuScs as povided Lr rhc
<br />5!!rion :1076orrI lnhtr(i{ir i' crr{nndnnor$'\rrL\
<br />".,.,?l t r la \/^". L, ; ^nr Lrl:lstLllrNlx^trlLB/ \ ILIjrLBATIIJ!
<br />I hc,cr^\ Jtrj,,r utr,1.' .crJr\ ., rdru, r 6n L\cn{n un,lc. f,.ri.r ' ,,r.hJr'- o, 1,
<br />,,1'5r Brr ..rr I Pn li-n r. (-,,d...trr1 \ l'.)rr i. i'r trl' 1{.r,.rJ .11,.r
<br />Gez
<br />nnrf,n.n! {ilhSNriotr 71IX)r ol Diviri,r :l
<br />(- L.<)Eas 1l
<br />((z A; r-{t Ua-
<br />I h.rch)_ .linr unlcr Il(nrlrl or pcrjurylh
<br />i{nrdIScc.30r)r, Civ. C )
<br />n'crhn bndi',S as.ncy itrrhc p$fon1M .c ofrhcsdk lor shich rlris trnnir is
<br />AT&ICANIIJIgIAETIIIJ!
<br />I tErcby aliinn undcr ncnally ofpcriur, onc.frhc r'ollowirs dccliroll.n\:
<br />D.nblilion Pcflnils.Ashcslos Norificoriotr arderal RcruhrnnN arirlc,l0. P!n6)
<br />Requncd L.trc of Noli&{i('n
<br />fcd.nl rqu lilions rcsdnnrs $trslosrc rJvrlrrc nolupli4hlc ro lhhlrUcd
<br />lnvc rcn.t rhi\ rpplicdnnrlnddarc rhlrrltr ;lhnc inlomarnr ncorccr Ia8reck,.ofipltwirhallCiryrtrdCutrnry
<br />Srdc Lrsic rri'!t k, btriltli',i, . rtrd hcrchy r rho'i/c rcl)R\.nr riro\ ol rhi\ ('nt rdd Cutr ryn, cnrcr rt). nrhc
<br />9, nZ P"7 ?- tr'rz
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