|
ELECTRICAL-INSPECTOR RECORD
<br />DATE ID/SIG.COMMENTS OWNER AUIDER DDLCAR TX)N
<br />I hcrchy urfinn uRldr lcnilry (Jl tcrrury rhlt I !m cxcnrpr fronr rhc Cditrr.ttri Liccnsc L{w lor lhc nnbwing rc.$n (SN.?0-ll 5
<br />B!sinc\{ a'd Pmrc\sion CMc): Any Cily or Coul, $hi.h Eqoi,c( , trrmn b con(ruct. alls. nnptuvc, dcmlish ot icPrt any
<br />sru.rur.. prio o irs hsurrce. ako requtcs rhc applicM! rorruch p.rmil to filcn sisncd sr cnrnr rhd h.orshc n liensed lrurslnr
<br />ro rhc provi\ions of rh. Contr.kn's Li.cnscd tnu (Cluplcr 9. ConnncncirlS wirh Scdio. Ttloo oi Division I orth. ausincss.nd
<br />Pn,rcs\nnrsCorl.)orlhrl hcorslrc is cx.nDl Ihcrcfnnrhd rh.tusi\ nr rnc.llcSed cicmplion Anyvnndn,nofSeclbnT0ll5hy!i,
<br />applicant hro,cn l {bFcrsrh€ stpli.anr !, r.ivillcn.ltyoinor flxtrc rhan filc hundi.d dollrs (SstxD
<br />l. tr\ owmrofthc Dtutcny. ot nrycmployccs wirh {!gc\ as rh.ir n,tr (rnNtrsili.tr. willdo d- w.rk anl rhc nnEtuc h nor
<br />imo ctl or olt'crcd lnr slc (SN 7014, Busin.s Md Prof.ssioN C\lc: Thc Conrru.ttr \ l-icctrt ljw d)cs nol 4plr ro an ou(r of
<br />rhcpnrlrny sho bu ilds or irqni)vc\ tlf,B)n. ond wlm d{Er flch $r'* hin,s.lf or hcrscll or rlmugh his o, hs own c ltlloyccs.
<br />prov idcJ rhlr su.h i'ntrovc'tu s e mt idculcd ot .lTcGd hr sh ll to*$ri rhc h{iktnr8 or mFovc'nd n w'tl *ir[i'r otrc )trtr
<br />olcoDrplcli'n. tlE Owrcr Buildcr *ill hrvc rh. hurdcn ofJtrovnB rhll h: or $c dtl n.r hlild or n\rolc rhc nmFly for rhc Plrln{ of
<br />-l.
<br />rso$ncrotrhctnpcnr- tr'ncrclr\ivcly(dikdcti,rS *xh li.ctrrcdco rr.irs r. L$nnrud rhc nrcrrr ( Sc. 7or4- Bu'i^-''\
<br />md th,fcsii Codc ThcCotrtrrcrols Liccnsc Las dijcs oor amlyro "iotrnn oflroPc(y*h. huildror imfroucs rhcrcor
<br />rnd who conrncrslor \urh pmrcc( wirh rC.nlra.ktr(s) liccnscd n!6uanr b rhc conh.cttr r Licc.sc tnw)
<br />-l
<br />ncxcmfl lndcr Sccrn,
<br />Dlle
<br />- -
<br />Osn.rl
<br />WORKERS' COMPFiiSAT(N
<br />DECI.ABAIION
<br />I hcrchy afiirnudcr |Enoll, of pcrjlry nnc 6rrhc rollo*ine d(ld{rions:
<br />-lhavc "idwill mainrdn n Cdnill.Nrc of Cttr*nl to S.lllnsrcnr*o c^ co'nPctrsrtion.r( Providcd fq bt Sc.rnr l70O ol thc
<br />Lrhor Cqic. for lfic pc.fordancc or rh. w.rk r(r Phih rhc lnmir i\ hsucd
<br />-l
<br />havc rnd will m, inrain wurlcrr conlr.nsrlion insunrcc- as rcqrird hy SNr im .17(X) ol lhc liho. Odc. ld rhc F*rfon.an.c oi
<br />....,., c.at\ r
<br />rqr'. F.u"d Mr q.rtrs. .or'nfl '''i{' iru' tr. r.rarr .'nl F li, ) 1. trI'.' tr.c-c='.-a-ia, -tu> Co+ba 5s4@/-{-/ -/1
<br />I c.dify th.r in thc pcrLnuftc {,lrhc work ntr shi.h rhR rcnnir is irsucd. I \hrll nor tnDl(,) rny P.ru in lny nrumr
<br />s $t, hcmn* sobjrd t,lhc s.lk.s co r|En$tion hw\ otcrlilon,ir. rnd,sft rhrr ill should bcnnm tbrlt' r. rlt
<br />workc^'Llnnp.isridit'ovhi(,n\olscclnnrlTO0ofrhcl,!t'orCodc.l\hrll,ronhwirIconDlywithlho*In,visrns
<br />BARNINC l'ail(. io rcuru sorkoi
<br />cilil llncs u! h onc hun&.d rh.trsdnd
<br />Sc.rn,.1076 oirhc l-a|,tr Gnlc, inr.r.{
<br />,,,.:21:l -tE
<br />.o'nncn$nnr covcmpc h unl{rtu|. md {hrll subr.r m cmploycr ro Gininel Fnaht\ otrd
<br />dollrs ($lUr.OLrO). in lddiitin ro rhc.o{ olconD.nsation- donEr.s rs lr.vilcd for lhc
<br />nrr,,**,@bkt<L
<br />UCENSIDJONIIACIAA
<br />IIDCI.ASAIION
<br />I hrEhy aiirnrnddr pc.alryolFrjury thal I mr liensn undcr prolhio. orCh0,,rd 9(onnErcins *irh s.crk.?(xD) olDivtion l
<br />of rhc Businc$ and PDfcsioos Cod.. r m, lkcn$ is in tull IoEc atn cffcd
<br />b Z611Z
<br />7-//:/6 ...,."",.. @5 Jz=lE
<br />colsralqualuENlllc-dcllcr
<br />I h.rcby rmrm undcr rEnllry or pcrjury rhd rh6. is s snsiru€lion lcnditrS lsen , t{tr thc P.-dntrErc. ol lh. sork r.r whkh rhn IErn l i
<br />ksucd (Scc.3097, Civ C ).
<br />ATTLICANLDICI,IIAITO!
<br />I r$:i4afi under I'cnahyolDcrjlryoic ofrh. lnlbwins delmrirns:
<br />Demlirion Pcrnirl Ash.sos Norifi.ation lidcral Rcguhr ionr (Tirlc .10. Pr6l
<br />Rr{lrnrd LL(d of Nurili. i(
<br />_l ccdiryrh,l I hrvc tuid lhhtrDllicrrionund nalc lh.rhn'cintnnnninr is.otrccr Iisur'..nrflywilhdllCilyudCounly
<br />oKli.ni.c\ ad Sralc ljws rclrti.3 lo hu hrrurktrizc rcpcsnlaris ofrhn Ciryand Coutrry ro cntcr ulrtrrhc
<br />ole morioncd popcny for in
<br />r\pDlnrtrl r l,]rnl sirnrturr
<br />4252_
<br />7-tl-/8
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Sions (monument)
<br />Life Salety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bondinq i Groundino / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouoh)
<br />Ceilinqs (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rough)
<br />Rouoh sht/,t tub?/t-/r\.--
<br />Service Meter
<br />illtallr Amdm,lh./
<br />Notes, Remarks, EJti
<br />l ,.?/1^
<br />APPROVALS
<br />IVleter Release
<br />FINAL
<br />Lrnlc''. Nrmc'_
<br />-l
<br />ccnily that rtc fedcral r.lohrbn. nS ding ash.nos rcrmvnl orc nor lptli.nbL to
<br />'his !ojd.
<br />F
<br />=
|