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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNDR BUII,DER DEI-CANATruN
<br />I hcrcby rfllrn und.r pcnalry ()I prrirtry rhat I a'n.icB ,n,n rhc Cotrkrcror Liccnrc lj* for rh. r.llDsirrS rclqrn (Scc 70.115
<br />susincs ffil Prolcs\ion Code): Any Ciy or aou.ty phi.h rcquncs r pcrdt k .ondru.r. nlrcr. imProE. dcmli\h or ftIEn 0ny
<br />{n'crurr. prir h iB nsurtuc. rlso rcqunes rhc.ntltanr lor such pcrnrir b filcr\i8nLi nrlcnHr rhalhcorih. n li..nsM Nnu0nl
<br />lo lhc [ovki.ns oi rhc Conlra.xtr \ Li.cr*d hw ich+rcr 9, C.nnncrcing wir[ Sc.rnnr 70(n of Divkion :] ol rhc Busin.$ rnd
<br />Profc$ionsCodc)orrhlr heor{hc ncx.mpi lhcrcrio oRl rhchlis lor lhc Dllcscd.xcmflinr. Any vnnrrionotSccri('n70.115 hyan}
<br />rpplicanr rua p.mrir !ubrc.hlh. q,rlicrrlk,acivilI)cnalryornor'*ncrh,trfivchtrndrcdd.llrtrs($500)
<br />-1.
<br />as ownrr ot rh. rnFny. .r .nt cnlloyNs wirh wagcs rh.t$lccomptnun.wil&rlr*ortandrhc(Murunmr
<br />in.idcd or.fiircd for slc (Sc.?1v,1. Busincs lnd PFicsioo! Cntc: Th. Contacntr s Li.cnsc l-l* docs n.r arPly to rtr o*ncrol
<br />rhe porcfly wha huilds or irytr.rs rh.6)n. drd who des suh *o* hnnscllor h.sclfor ih({rBh hh ot hct nwncmployccr.
<br />provid.d rhrr su.h iupmrc'rcnhrr n imcndLrl orofi.frl fd\b.l[ hotrcv.r. rhe hildin8 or imPovc'tunr h $kl wirhi"r 'cJtrolm.DEItun. rhc owncr Buildcr $illhavcrhcburdenorpn,vh! rl hc or shc did ml hrikl or ir,!,,rv. rhc pmPcny lor thc nurF){ ot
<br />-1.
<br />isowncrolrhcpopcny- amcrch\ntlyconrrcriiS s h |i..tr\.d .onn rclon lo snNr cr rhr !tu1..r(scc 7(!,1. ttunncs
<br />md h'fra\i(nr Codc ThrContnctr's I-iccnsc Law docs nolrlplrro !noqncroflr.fc y sho buikll or imfrovc\ rh.rcon,
<br />rtrd who.ontm.r\fdsuchprolccl\*irhaConrnrronnliccnscdrurui b rhc (nnhclff s l t.n\c bs)
<br />I r crcnrrruidcr Sccliotr-- L & PC inrhr rcasoo
<br />Dolr: OBre.
<br />]laBKEA[lA&ttINSAfll.lN
<br />I]II;LI.BAIION
<br />I hcrchys,li rtrn crpci,lryor|[Itrl,ncoillrciollo\in8nccl[!'ions:
<br />I hrk xlsill tuinrni'r rCcdifi.0rc.aCon\cN roScl,rltruc |,tr rorkcr\' conlfl.n\i.on. r( Providcd fqbyScdtrr:l?(X)uliht
<br />lilxrr Cnlc. lnr rhc pcrroriunr olrhc *.rk for tr[i.h thc,unir is isucd
<br />Ihlrrtrdwillmi rirNork.rao rncnsalion inu.a(c- tr\ rcquncdhySlrriotrlTU)ollhcl-ntorCodc.f{nrhct'.lfonnMccof
<br />rhc sork rd whf,h rhis |rriniri\ hrucl. M!,*orkcr'comnctrsati{n' in\urancc.rnicr rxlNlicyrunrhcr c:
<br />I.c ifyrharinih. fl.rfoflmnccol rhc work ior whichrhtFrnrir i\ is\tcd.l \hrllnorcn{'l()y{nypcr$n in (ny nrnncr
<br />$ s to ltonr subrrr ro lhc $orlcr' cornpc.\arion law\ or Calili'rnir, dnd agEc rhd il I \htuld tE$tu hj.d ro rhc
<br />sorkcn' .ompctr$r ion provhions of Sccr ion .r?00 of rhc ljtxtr C(xlc. I rhnll. linhwirh coDply *irh rh)sc ln,vsions
<br />WARNIN(i ljrilure h {crrc w.rk.ri.onrDc \.ridr c.v.rnAc i\ uthwtl. md shrll\tbjr.r rrr rn{loycr l0 oimirnlr'lfrlrics nd
<br />civil finc\ up h o'r hDidr.d rhouritrrl dollrN ($|fir.({xrl. ir diri{nr co{ of co rl,r \[n . thurScs r\ nflxnl lnr rhc
<br />Srdiinr.loT(, ofrl[ l. litr C d.. id.r.( ind lirorrcy \ lics
<br />I ?o tppttr^,t
<br />I )t.t( I ,\r,\ lt()\
<br />I h.(by rflirnx.d$ tl.mltyofpcrjury lh l mlienanunncr pmvi\n,n or Chrrrd 9 (contrNrcirs sirh Sc.rk,nrftnr.fDivisioi I
<br />ol rhc Rusircsand Pmt \\n,iscudc, kl.rr liccnsc is i. full f(rcc atrd ellirr
<br />,,,.,,..rt^," 4 /l---r /L., >
<br />IONIISJJCI]ONUIDING.{AENI
<br />I hcrcny tlitnr lRlcr pcmlry or rdjxry th rhct i! n.onjrucriotr lcnding rscncy t rh. p.rlonn,icc oflhc work for qhich(hiJrmrir is
<br />h$rcd (Scc. .1097, Civ. C.)
<br />-l
<br />ccrrily rh0r rtc acdcral resularions Esarding asb.{tos rcmval nrc R opdicablc ro rhn pej..r
<br />-l.cniryrherIhav.r.adthis"pdt.lionandshl.lhollhcalnv€infor@rionir.oft.r.I!8rctocom,ywnhaUCnyandCoutrlyorJinrn.c\ xnil Srar. Ii\s rtlrrirU k, hull(lltr!hori,c r.frcs arn$ olthn Cily md Coxnr, i'.nr$ upotr rhc
<br />rtxivc nrnri,nnl r,l{ny lnr iNt{.l(
<br />/1DDliLinl.r]\|l.nl Sitnnlr..
<br />I'ernik{ nnnr(Drinl):
<br />",," y'tqy'qa
<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 />Communrcations Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding / Groundinq / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilinqs (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rough)
<br />l\,4eter Release
<br />Rouoh
<br />Service Meter Md//a *tu 2?1, tro// )
<br />Notes, Remarks-Etc./ \J\1
<br />0 t 5
<br />24
<br />"7 Q-?
<br />FINAL
<br />L"rdc,'\ Nr tr
<br />-
<br />trndr'. AJ'tc\
<br />-
<br />APIUIAN:LDEIIAIAIPN
<br />I hc.6y aJrmr und.r pcn,lry olFrjury orc oflhe foilowin8 dshrdionr:
<br />Dcm.lirim Pcnnih Asb.sos Norincrlion F.dcral R.Buldionslrnt 40- Pfi6)
<br />Rcqutcd lrncr of Norifi carion
<br />T
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