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ELECTRICAL{NSPECTOR RECORD
<br />DATE ID/SIG.COMMENTS OMa-BuildoD..letion
<br />I h.rc6y sl6m undd pcnllty olpajury th.r I M.x.npt loft ttc Conh.io6' Licdr. Li* for rh. folloeinB c$on (!cc.7031 5 Buircs
<br />ed trciBion Codc)r Any City d Cou.ty wtich EquiB ! p.mit to conEmcl aird, ihprcv., dmolish tr Epan by shclur., Fitr lo ia
<br />iseec., alrc r.qute th. appliEt fd such pdnit to fiI. a sign.d nsr€mdt rhar hc or sb. t licoscd puaudl ro rh. provisiG of thc
<br />Co ,&ldt Ltascd t w (Cbapta 9, C6m.n.ing wid Sat,on 7000 6f Divirion 3 ofrh. BEinas ud Prcaario6 Codc) dfi.r hc tr
<br />lhc is q.frfl rh@&om od $. b.ir ld ttc dl.gct! .imflioi Any violad@ of S@!o 703I 5 by r.y arplicer for 6 p.m $bjeLr $.
<br />appli@r to.cililp.nalry ofnot norc dd fivc luidr.d dolls (t500).
<br />_1, B oM6 of th. popqry, or ny dpl.yG with wa86 4 !h.ir iol. @p.nsalion, will do th. work and rh. structw is not inhdcd
<br />or ofiq.d fo salc ( S4.70r4. Bulind sd Prof6i@! Cod. Thc Cotrd! Licd. Lrw d6 nd apply to u ovnd of thc prop.fy
<br />who builns or impbve rho.on, od wno do6 such *ork hiNclf dhdcllor ttrough hh orhcr own.mploy.B, provid.! $ such
<br />improvncnn e nor intnd.d or off.Ed for..l. Il ho*.vr, lhc buildins or improv.mc"t is rold within on. y.eofcompl.r'o, th.
<br />Own('B!ild!. will h.v. 0E burd.n of proving rh4 h. or sh. nor build or improv. fo. (h. p!rp6. or salc)
<br />_I, d o*na ofth. prop.ty, m d.lBiv.ly conracting wirh lic.nsed co.rr.cro6 to consttuci rh. prcld ( Sa.704,4, Asin6t d.l
<br />Prcfdion tu : Th. ConE&br! Lic.ns. L:v dG nor rpply ro ownd ofpropdiy who buikh or improv6 lhaon, Md who
<br />coiE'&ls fo' such proj.ct wirh a Corero(, li@s.<l pusuar to rhc conracto.s Liccns. lnw )
<br />_l M ?x.mg undd S.criM _,8 & P C. f6 $is Baon
<br />IABSEBS-CQMIEISAIA!,.qECLA
<br />I hdcby aff6 und.r pcn.lty ol p.rju.y on. ol $. foll@ins d.clmtioB
<br />_lh.v. ed *ill maindi!. C.difiet. olconscnr lo Sclljnru,c lor *0116' conpos.rion, 6 providcd lor by S.ctiof, 3700 ofihc
<br />L.bor Codc, lor thc pqfmdci ol lhc vort for which tn. p.mit is i$ud
<br />_l havcod*iU mhldn *dkc.s @npolarion insuacc, 4 ,cqut d by Sccion l?00 ot thc Lnbor Codc, for rh. pnfomec. ol th.
<br />wort for vhich this F il is issu.d My wor*.N' comrtu{ion insuru@ cri, &d policy numb.r m
<br />Policy Nuhbd:-EIPts
<br />dffiffiffi;fd oi. huidrcd dolls {tl0o) or la,
<br />offtc Libor Cod., I shall, fonh*ith.'o
<br />WARNING Failurcro seurc work6 cofrpai ion e cnploy* ro dihinai pa.ltis {d civil
<br />finB uploon.hu r.d lllourdd doll6 (l I00,000),ir iddnion to
<br />thl Lrbor Cod!, inr.rd sd.iom.yt fc6.
<br />o. du'36 a povidcd for th. S.clio 3076 of
<br />I hctcby amm undcr Fnslty ol p.rjury th6l I M li6&d und.r provision of
<br />rhc BNinBs ed Prcf6tionr Codc, &d my limsc h ir full aorc and cfacd
<br />I haby .ftim mdcr F.6lty 6f p.{iu.y ther tlft h a dstuclion I
<br />i$ucd (Se. 3097, Civ. C)
<br />of th. w6t lor which lhir plmn i!
<br />APPLICANT'S DECLARATION
<br />D.mohioo P@it5 Aib6r6 Noificdoi fcddol R.guialios {Tirl.40, Pan 6)
<br />_ R.qutd L.ncr oiNoit.atie
<br />_l €nify lhar rhc icddal ESulations r.Bs.ling 6b6r6
<br />/da.aity liat t h,* n-, nft.epliorior dd 11.@ndy with all Ciry &d Counr,
<br />odinuG ed Stal. ta*s rcldiig lobuilding
<br />abov. motiond lropc.ty ftr inrpctio.
<br />ol thii City ed County ro 6tc, opoi $c
<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 AIarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / 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 EXPIRF n
<br />Rough FEBOI i 019
<br />Service Meter
<br />FINAL ,9O, CC/
<br />Notes, Remarks, Etc.
<br />APPROVALS
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