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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS Own.FBuildcr Ddl@tio <br />I ndby afim undq Fi.liy of pai!ry th{ I m dmpt fom rh. Conhcrm Liccnic Law aor rhc followin8 rc6on G* 7031.s Bsi.c$ <br />aid P,oi.$ioi Cod?)i Any City or County qhich EquiB I p.mn ro conslrucl, ahd. improvc, dmolilh or raair ey slrucluE. prid !o i6 <br />hsuac.,ahor.qutarh!.pplicanrlorsuchpffilrofil.a,igncdrr.i.n.ntrh.(h.orrh.isli..ns.dpursudttoth.Foviiionsollnc <br />Co.reror'5 Lic.,Ed kv (CfiaFd 9, Cmn.ncin8 with Scclion 70@ ofDvhion I ofrhc Busin6s dd Prof6sids Cod4 or O.r hc d <br />shc ir q.mpr thB.arom Md th. b6is ftr th. all.8.d .x.mprion .Any violaiion of S.cdon 703 I J by ay applimt for . p.mn $bj.cB thc <br />applicdt lo acivil poalty ornormorc thM fivc hudr.d doll6 (5500) <br />_1, s oqs of thc popaty. d oy mployG *iln vagB a $.ir solc cohp.$ado., will do lhc work Md lhc s!.!clac ii not int nd.d <br />or ollc..d tc sdlc ( Scc 7044. AGins ed Prof6ioru Cod. Thc Cont&tdt Licm. k* doq nd.!ply lo.! oms ol rhc propcny <br />who buil6 or imFovs lhficon, od who dc auch *ork hiN.lf or h6.lforrhrcugh his or h.r oen 6ployc6, prcvid.d tn4 5!ch <br />inprcv.menk @ nor int nd.d or off.Ed fm 5.1! Il hN.v.r, lh. buildine tr imprcvcnot is 5old wilhin on! yls of.omplcxon, lhc <br />O*on-Builda will hav! dE burd.n of prcving lhar h. o, rh. not blild or imprcv. tor rnc puQ6. oa s.l.). <br />_1. 6 owis oi 0'. prcp.fiy, m aclsiv.ly connm <br />"B <br />with lics&d cmhtoG ro conshct thc prcj.d ( S.c 7044. B6in6! ud <br />Prcf4ioi Cod.: Ttc Co.hcton Licds. Law d6 ior lpply to d osn6 of prcpcry *ho build! 6 ioprovB rhtun , od who <br />co.tmt for slch pbl.cB wth c Conr&b(, limsd pua@r io th. CoDr.ltot Li.as. Liw ) <br />D.t.r Ow..rl <br />IABKEI.ICAI4IIXIAIIOX.DECLAIA.IIOT <br />I h..cb, affm udq pcnalty of p.dlry oic olthc lollowiig d*lefioffl <br />I havc ad willnain.aii B C.ni,lotc of Consdt to S.lf'l.sur. for workcEi compchrarion,6 prlvid.d for b, S@d61700 ofrh. <br />Labor Codc, for tlc p.rfdr@e of $c *ori fd which lnc p€mi1 is i$ud <br />_l ha!. ed vill mainr.in wtrlcB onp.hsalion insuracc, a r.q utcd by Scction l70Ooflhc Labor Cod€, fsrhc pcrfomqcc oflhc <br />qork for which rhis p.flit is isucd My work6 €mp.nsalion insurane cuid ud policy numb€r arc <br />Poli.y Nuob.r:lExpi <br />#d;; <br />nor bc corpl.t.d if U. pmn ir aor Oo. hu.drcd dolls {ll0ol or 16, <br />rhc p.rfomecc of lhc work fd which <br />urc work6' compcnsqtion co <br />hundrcd $oBed dolls (!100.000).in a<ldi <br />inlcr6t dd atom.y\ f.6 <br />I hcEby affm und.rrcnalry of pcrj ury lhat I d li@ns.d und.rprovisior ofChapr.r 9 <br />rh. Butrnc$ d Prof6sions Cod.. an liccnsc is in iulliorc. and cli.cr <br />und.r p.nahy of pcrjury th3t thd. t a <br />hsu.d (S.c. 3097, Civ C.) <br />ATIIICANIIDICI.AAAIION <br />D.mohio. Pcmi$-Asb6rc Notificado. F.dqal R.gal.tiois (Tidc a0. P..r 6) <br />_ R.quircd Lcnd of Notificatoo <br />a3rc. ro conply wnh lll Cit, dd County <br />.bov. m.ntiohcd propcny lo inlFction <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 <br />EXPI RFN <br />Rough <br />Service Meter FEB O I 2019 <br />FINAL <br />Notes, Remarks, Etc.- - --,wi ssq: lrqa <br />_l m .xmpl undd Sedon _,8 & P.C. asthisl6m. <br />L.nd.rs Addras <br />tl = <br />=