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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monumenl)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding / Groundino / UFER
<br />Torqueinq
<br />Sub-Panels
<br />Bool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Sollit Rouqh
<br />Ceilings (T-Bar Rouoh)
<br />It4eter Release tl/6 /ri 9r\ (tr
<br />Rough b 5b".tb\
<br />Service [/]eter Irr\*1"U v-v){10
<br />Notes Remarks, Etc I\ ,/2
<br />$r-v
<br />olvNt:lr tlti[,t)t]R Dtit,cr\fi AlI()N
<br />I h.r.by trrfirn xndd l.Mlry (,f p.rjrry rhur I m cienrfl nom rh. ConlmcroF Liersc tiw for rhc aolbsin$cav,n lftr:l0ll 5
<br />Busincss {nd Pror.s\n,n Cod.)r Any Cny or C.xory which rcquir.\ r Ix n t' conndcr, alrs. idtrolc. &flnish ur rcFn uny
<br />strucrurc. rrior lo ns itsuancc, trl$ rcquircs $c amli.anr for \o.hpcrnir ro fi|. ! sigftd {srcm.r rhr h..rshc is lic.nsd puFuanr
<br />ro rhc rolkii,ff .fihc Conr&lq\ l-ienrcd ljs (Chaoer 9. ComnrcncinE *irh Scdion 70(X) ol Dilhion 3 .frhc Boiin.ss s.d
<br />PmL$ionsCod.)orrhrrhcorshctcxcmprlh.rcfn,mrodrhchnsisfirrh.alhScdcx.'nprtun An,vt srion.iSdtion?0.11.5byrny
<br />rprrlicanr fora pc,mir ubjecrslhc qmlicllr ro a.ivilpcn.llyor.ot moElh nlc hundrcd doll.r (3500).
<br />-1.
<br />$ owtrcr of thc ,,oFny. r, my ery)n,)Es wiln wr8cs,1rh.n oh.omp.trsrlion. w'll do rtr worr dld rhc nrrlm is ml
<br />i cndcd oroficrcd io! slc (Ss.7O44. tsusiress and Profcsions Codc: ahc abntruclois Li.cns l-nw docs nol atply to Br owrcr of
<br />rhc pmltny who buills or n4rorcs ftmn, nnd sho d.cs sEh *od. hioFelr.r hcrclror rhnusfi hh or h€, ow. cmployc.r,
<br />prolidcd th suci impmrcmnls e mr inr.ndod n oltaBd for $L li ho&rq. rh- hoildint or ay'0mvcmnr is sld wirhin .R )€r
<br />or corylc'i,n. thc Ownq Bu da will harc rtu burd.n oi povine rhd h. or sh. did tur hoil] or inpmk rh. Imp.n, ror rh puisr .r
<br />-1,
<br />asowncr.tlhc prcrny. r'ncxclusivclyconlr{crin8 wnh Lccn{rc cont&lns to.on(ru.r rh. pmjccr (Ss. 7(}1,1- Busir'c$
<br />0trd ft.tsck,n (rodc: Thd Contlcior\ l-i.cnsc Lnw docs not upnlylo u. owncr.fpropcny who builds or in,pn,vcs ihcrcon.
<br />ond who.onlElsiorsuchpmjNlsqilhrConlacro(s)li..n\cdpu!$m'lorh.aoftncktrsLicctr€tjq)
<br />-t
<br />amcrcmlt undcr Scdion-. B &PC lor'hhrc.$n.
<br />Dale: Omcr:
<br />wotxrns' cotvlpmtslttrx
<br />DICITIBAII!}N
<br />I hcEby llfirmundcr pcnalryofEriury onc oflhc aollownlP dcclr.lions:
<br />Ittrlcudwillroinrrin!CcnilicurcolC.nsctrrlosclf.rmurcrorworkcsonpcnsarion.0sprovidcdforbySrrion:17{x)otrhc
<br />ffi;lbr ths n rformoncc of lhe ro* for which lhc p.rmir h issucd
<br />will mi.l.in work.ft comFnsarion i..ulec, ns EitliEd by s(rion 3700 or rhc tjh.r Cod., ror lh. Frrolrumc of
<br />,\
<br />I.cnifr rhrr in rhc p€rfortun.c {)frhc work fttr shi.h rhh lE.nir i\ h\ucd.I \lullfr cnl[lby aiy p.r{n in rny minnfi
<br />$ !s ro tuorE subjd i0 thc work cs' .o nrrcnsar ion hws orcaliro.ni{, .trd rAe rhd if I should bccoflr sh]cd lo rhc
<br />$or[cr!.annpcnslrionpovisbnsolSsrionS?uJoltl..titnrCode.lshall.fonhwilhcorplyvithrhospmvGion\
<br />WARNINC: Frilurc to sccurc worlcn conDcns0rn,r covuhgc is u.hqrul. !trd shnll suhjcct .n cmphrycr to niminal rEtrlhics and
<br />civil finc\ tro Io onc hu lhousand doll6 (Sloo.uD). nr 0ddilion ro lhc con ofcompcnslrio., damEcs $ lroeidcd nn rh.
<br />Dtt t, t,\'t I(r\
<br />"'u,'Code, a.d my liccnr t in full rbrc lnl eitiri qtqlGtI]a llY
<br />CA!$f,I]EUANIINDIXGAGEICI
<br />I hcEby 0lirnrund$,Enillyofpcrjurylhar rhcrc is a constocrb.lcnding ngcncy for lh. p. nnnanccofrhcwo for which rhis,crnil is
<br />issucd (Ss. 1097. Civ. C.)
<br />AIPIICABLIIEC!.ABAIIIIN
<br />I hcr6y onnn undc. p.nally olpcrjury on. orfic rolhwing debarion!:
<br />D.mlirion PfinirlAsh. o! Noiificario. Rd.rrl R.guhr k n! ll irk rg). Pan6)
<br />Rcquircd tr(cr of Norifi drion
<br />-l
<br />ccnili that rhc ndcral rc8ulariotrs EglnlinS rsb.Ios rcft)valarc nor {flicrhL ro rhn p.oj.ct
<br />l ..dil,v rhrr l hrv. tux,lrhn rm
<br />.dinrnc.\ rnd Sldc I rq\ rchrir8
<br />rtov! trEnli()ncd pmp.ny ror
<br />,lDDlir nl or \xrnl Sixn lu
<br />n lnd (sre rhar rhe alivc infornarn,n hcotrd I
<br />iry consrrucrion. oid hcrcb]3gEizc lrlnc$nrar
<br />, trirh nllciryrnJ r u y
<br />, -.r.."d,r,-L.,--,h.tloiv
<br />Pole Bases
<br />Transformers
<br />Air Conditioners
<br />FINAL
<br />.\
<br />t4ndd r Nrft
<br />-
<br />trtrd.as Addrcs\
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