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DATE rD/srG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under SIab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torquing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />Meter Release EX|JIKE l)
<br />Rough r[-lJ u I l
<br />Service Meter SAI /tC B-43, 290, I i56,667
<br />FINAL
<br />Notes, Remarks, Etc
<br />ELECTRICAL.INSPECTOR RECORD
<br />oM6-Build.r D.cldrio,
<br />I hdby amm undr FDalry of Frjury lhal I M qmpt fom rh. Contracrm' Liensc L.w for 6t lollo*irg r6on (sd.703 I 5 BBinds
<br />@d Prol6io. Cod.) Any Ciry q County which Equi6 . p.mn lo @'lruc( altq, improv., dmolish o Epair ey strucrurc, Fior ro ib
<br />issumc., ,lso !.quirq $. appliwt fs iuch Fmn to fi1. a iigncd rl.lo6r thd n. o sh. is li@s.d puBumt lo 6c p.oviiions ot dE
<br />Conlr&Itr! Licds.d Law {Chapld 9, Comtu,cins with Sccris 7000 ol Division I of rhc Buins ed Prof$ions Cod.) or $al hc d
<br />sn. is .x.mpl lh.r.ftm ed th. bEis le fi. oll.Bd .xdprio, .A.y violniion oJ S..lio ?03 I 5 by y applimr for a panit subjall thc
<br />applimt to . civil p.nslry of not mw thd 6v. h!n&.d rlolla (1500)
<br />_1, d Mr of th. FoFny, or my ddor.6 wth wag6 6 tt.ir slc @hD.nerid. vill do thc wo* dd $c sErcluc h nd int..dcd
<br />d ofi@d fc a.lc { S.c.70,r4, Bsin6s ed Prca6ies Cod. T[. CGEtor's Licms. kw dd nd +d, 6 s @n.r of lnc p.op.rv
<br />who builds tr imFov.s th.rcon, ud who do6 su.h *ort hiBclf or h6!lf or thrcud hi5 or hd @. cmrloyB. prolidcd thar such
<br />impovm..a @ no( int ndcd d of?r.d f6 lalc It ho*cvd, th. building or improvmdt t sold wirhin @c yd of .mpl.!@, rh.
<br />OMd-Build.i will hayc $. burdn of provin8 thal h. or sh€ nol build or imprcvc aor lh. purF$ of r.l.)
<br />_1, a ownd oa tnc prcp.ny, m .xcl6ir.ly @nb&ti.g qrth ricds.d @ntactoR ro c@bucl dc proJdt ( S( 7044, Bsin6s dd
<br />Prof6sim Code Thc Corlrocld's Liccrr Law do.s nol .pply to d oMd ol prop.n, who buil& d inprovB th@n , md who
<br />cdtr&t! for cuch prcjdE vit[ a conEeto(, li6*d puE@r ro lh. corra.rort Li..nr. La* )
<br />_l d .x.mpl ud.r S.clion _,8 & P C fd dris rcaon
<br />WORKERS COMPENSATION DECLARAIION
<br />I h.Eby afiim und.r p..aliy of pdjury on. oflh. foll ingdccl@rions
<br />I h6y. dd will nainhin 6 Cinificalc of C6dl ro Sclf-lnsuc for wdkcB' @mFnslrion, s prcvid.d ftr by Sati@ l7O0 of tt.
<br />Labor Codc, for th. p.rfmdcc of th. wo* fd which Urc p@n is issu.d
<br />I hav. od will maimain vork.6 cofrF.sation insurucc, a rcqut d by Setion l70O of thc L5btr Cod., for rn. Frfmacc of fic
<br />sort lor *hi.h thir !.rmit is issucd My work6' compdsalion insuruc ffid &d policy numbcr rc
<br />Policy Nmb.r Erpir6:
<br />(Thi! rdio, nc.d not h. @mplcr.d if $c pa,rn h ro' onc hJrdr.d doll6 {l I o0 } or 16)
<br />I ccnify lnd in lhc pdfffi&c. of lh. wo* fs which ihis pmir h ksu.d.l shall nd.mploy d, pdson in dy m&no so s ro
<br />b.@. subjd b th. worr.R cmF.sation las of C.lifomir, ed.grc. thar itI should b.conc subjd lo thc wdk6'
<br />.omF.sarion prcvisions of S.clion 3700oflh. LabcCo&,I sh.ll, fonhwnh comply wnh rh.s. provisions
<br />WARNING Failurc ro scuc w6t6' @hp.nelion €ovaaAc is unlawful, d shall slbj.d s mdoyd io criminal laahid Md civil
<br />fin6 up to on. hun&cd thosdd dollm (l 100,000),in c.ldnion to tn€ cosl of omFniation, damrSa s pmvid?d ftr lhc Selior 3076 of
<br />th. L3bor Codc, inrdBt dd.tom.yk fc
<br />LICINSEDIONIAACIOAiDECIABAUON
<br />I hftby affim undd p..alry ofpqjury rhi I @ licos.d u.dcr p,oyision of Chagrd 9 (conhcncins with Sccdon 7O0o) of Dilisid I of
<br />th. Brsin6s dd PmfBions Cod.. dd my licasc is itr full foe ud cflc.t
<br />CONSTRUCTION LENI'ING ACtrNCY
<br />L'crcby .mm unds pdally ol psjury th* rhd. is d @nrtrl]ctio lodina agacy for rhc p6fm&e of $r *ct ftr shich $i! p€mn is
<br />is.d (56 309?, Civ C )
<br />I ccnify 0r lh. fcdcral rcgularions egadioS sb6rq r.moval m not alpliobk ro$ir proj@t
<br />_ I e'n8 thar I hav. E d il s applic.rion dd 5la& lhar d. abovc infomation is coEdl. I aSre to comply *ill all City dd CMry
<br />trdinac6 &d Slarc LBs Elarin3 ro buildin8 cNLncrid, ed h6by au|hdizc rcpr6al.riv6 of lhis Ciry d Cou.ty ro dla upm rh.
<br />abovc nc.rion.d propcny for insp.alior eurDs6 -Y -z---o
<br />APPROVALS
<br />LadE ! A.ld6
<br />AIf,IIEANIIDECIdSAIIQN
<br />Dcmolii@ Pcmi$-Asb€tos Notificatid F.dml R.Sulstions (Tid.40, P,n 6)
<br />_ R.quiEd ka6 of Norifi catio
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