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bOMMENTSAPPROVALSDATEID/SIG.
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bondinq i Groundinq / UFER
<br />Translormers
<br />Torqueing
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Soffit Bouqh
<br />Ceilings (T-Bar Rough)
<br />[/eler Release J -/
<br />Rough
<br />Service [t/eter ....
<br />Notes, Remarks Etc.
<br />FINAL
<br />OWNER BTIILDETI DFJI,CARATION
<br />I hcrct'] lmrm undcr Fnnlry oa !.rjury rtar t d cicmpr lon rh. G,ikr.b^ Li.cn\c bw ntr rh. folhring rcan'n'rsN ?i,tl 5
<br />Busircss and Prole$ion Cod€): An, Ciry or Counl, *hi.h rcqlircs pcrnir ro .otr{rucr, .11... inProvc. dennnish or dlrn .ny
<br />{tocrum, I'riorro irs t\urm.. nko rcqunc\ rhr +plican! f(n such p.mn to fiLn lilncd {arcnrnr thrr lEor \hc i\ liccns.d pu*uanr
<br />nr lhc pn,vhnrN oi thc Cotrltuckr'\ Licen{d liw rchlnlcr 9. (iunrcncin8 wirh s..iion 7(xx) oI Divisiotr 3 ol rhc tlusioc$ ond
<br />l'R,r'c!rions Co,lc) or rlld h.orsh. iscx.hfl rhcrcfio'nand rh.hrsir fitr rhc rllc8cd crcnrrri.tr. An,viol ionofSRrbn70:lI5h,any
<br />,ppli.rtrr tbr.pcirnir bjc.lrthc lp!lic.nrlo0civilpcn.lryoinortrhrcrhmfivchundrcddollars($5m)
<br />_1, rs owncr .l rht ,,n,pdy. (tr nrt cmplot.cs wnh s.srl rt rhcr *r. on|*n\d hn. will do rhc wort rd rhc {Mm i\ mr
<br />nnc cd orofiircd n eb (S( 7(),14. Buinc$ and Pnlcssions (ixlc:'lhc Conrr.kn \ l-idnr hw docs n t urrply r. an owner ol
<br />Ihc pn,p.ny qli, buiklr
<br />'
<br />tr imprcrcs rhdB,n- a wh.docssu.hsorkhiDs.llorh.sclforrhmughhisorl$.sn.Dnloyccs.
<br />pn,viden rhrr such impmlcnrnr\ m nor inr$ild or oilcrd ntr \nL ll lFrc\ $. rhc hoilding or ilrll,rorNrnr t q,kl wirhm onc ]ed
<br />of c nDlclion. lhc Owtrcr Buil cr eill hlvc rlE hudcn of povins llHl hc or \hc did mr build or inrrovc lhc pmpcdy n, rhc I,!rF{ ol
<br />l. rsosncr.ilhc |n.|{ny, in.rlrsiu]yc.nrrarri',s wirh lic.n{d.orkrctt\t)..n{nrrrhct)ojc.r(Scc 7r}$.3u.inc*
<br />t'rotxsin, Co{lc: lhd (i,nrrcnr'\ Ln. \. Lawdoc\ ior "nflykr rtr.\Dcr ol fo|{rrtsho builtk or i,npmvd' rh.rtor.
<br />ltrd sho (rn rdch lor {.h lm]..n sirhrCo.ticrtr(s) li.cnsca pur\urnr rorhcConrrcttr s l-i.rnr tis)
<br />I nflcxcnrl undcr Sdior-. u & PC turhnr. vn'
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<br />n:08tr[Bt]!oufi:Ns IaN
<br />DECIAXAIION
<br />I hcrchy affnn ulll]rr l.i!,ry.fpcrrury.nc olrhc f.ll,,r'irg d.rlmliorr
<br />I hrvc drl willmii, ain r (tniicarc olcone to Sclf- Inrurc Iq sorkcr' compcnet ion. r pbvid.dtttrbySerion37(Xroilhc
<br />Lihr C.dc, fr rhc pdfdmrmc ofrl[ work Lr wlich rh. ,).nhi is nsucd.
<br />Il[rrnMwillnr airworkcrlc.nrFnsrrioniNunmc.!srcqutcdbyScdn:1700ofrhcLttitrCadc.IorlhelqljlnnrNrof
<br />rhcqorklnwhichrhi\rcirnilisnrucUMyworks(co'rpctr\0ri,,ni'rursdcccanicrtri lr,li.y nnn$cr !rc:
<br />Iccnilyrhn!inrhcp.rfoi,r!trf,colrhcworkro.whi.hlhist nir is i{{,cd. I shlll tror .mploy any pdnotr i ary nr0nncr
<br />v, .s tr, h.Rnn sutrj.rt lo IIE tr orkcn .omlrcns ionl{!solcalil{rnir-rndlg ilur irl lhruld tt.o'rc sh}Tr lo llt
<br />vork.r\.on'p.n\dn,nDrovisbns.lScdt,nlTL$ol'llELrhtrCodc.lshlll.r{'dhwirh.orflywirhlhos[ovhions.
<br />. \il linr\ rp t, om hr drrd thou\rfrl d.lh6 rS x).{ 0). h d'l(liri(r r,' rlN con ol c. txtr\ hon, th hlcs r{ rircvidcd ntr rhc
<br />srcrirr:11)7601rli.lrlxn ci c. ir crc{
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<br />Irt(t.AR\IIt)N
<br />I hcEbr omrm undcr lcnllly oa pcrjlry lhli I am liensn undcr F,vhion orCIEptcr 9 (smnrminB wilh Ssrion rfiD) nrDivni.n 1
<br />or lhc Bus,.c$and Prolcssions Codc.0nd nryliccnsc is in tulliorcc 6ndcfr.cr
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<br />I hcnh) rllnnliJcr If rlry ol t rryrhd r
<br />isuca ls.c .ilD7. Civ C )
<br />lcMin8 o8crcy I{n Itu pc.torturkc olrhc work lu shich Ihi\ pqm n
<br />AfILICANLIIESAAAIIO!
<br />lhcr$yamanundcr nctrllry oi perjury onc ollhe follooins dcchrdions:
<br />Dcd.lirion Pcrdnr A\h.dos Noon.arion FcdcrdlR.Suhlnrs (Iillc 40. Pan6)
<br />-RcI]ltcd
<br />lxtrc. of N.tin.d.n
<br />_l ccniryrlrrrhc ratral.cAuhiion!rcsrdins asti{os'oN,vdl rc tror rri,licahlcro rhis proicl
<br />rhc rk,vc inlnnn ior i\coirc.r lrgrrb.onllllysirhallailyo (tnlrry
<br />r. tuklhcrchyaurhoizc rqrr.\cnrrrivc\ ofrhi\ Cirl and Counry ro cnlcr uF,n rh
<br />b"t1
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<br />ELECTBICAL-INSPECTOR RECORD
<br />Sub-Panels
<br />Air Conditioners
<br />,,,,",q& /g
<br />2"--
<br />trnJfl \ AJd.\\
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