|
ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUII,DER DELCANATbN
<br />I herchy rflilm undcr p€nalry {)r Frjury lh,r I m cxcm/ lNn lh. ConlftloB Liccnsc Llw for rhc following rca$. ( Scc 703 1 5
<br />Bnsin.* arld Pdasion Cdle)r Any City or counly shth rcquncs ! IErnil h onsrrucr. ahd, in{mv., d.mlhh or EIon any
<br />srtu.rurc. prior ro irs nsurmc. !l$ rcquncs ficlpplicant lor suchl,cmir er filca iigftd st,rc'Enl rhal lrcorshc is liccncd puFlanl
<br />h rnc I,rolisions ot rhc Conracrofs Lic.n\cd bw (Ch0pt.r 9. ConxncminS wilh Sccrn]tr 7000 of Divnion I .ilh. Busitrcss {nd
<br />Pmlcsions Cod.) or rhat lEorshc ir cxcrnpt rh.rcfrom.nd rhc h.\is for thc al lescd cr.mlr io.. Any viol.rion oa Sd hn 70:l I 5 l,y ony
<br />lprliclnr lor r pelnir suhiccB rh. iprli.,nrro,.ivilp.nrlryornortuerha.6vchlndrcddollurs($5m).
<br />if(-ln' o*,f,, ol rhc lmrny. nr my cmnl,ryccr *irh tr zacs !s rtcir sL .onlFnsar i.n. will do rh. wo* .nd rh€ derm is fln
<br />' lilc lsl oroficrcd f.r el" lsd nr44. Bunncs rnil ftotcssions Cd. Th. (bnlr(clols Liccnr tjw dd. nor {ply lo sn owmr of
<br />rh. FNFny who hu,lds or inpmws l,Em.. an $ho dcs sEh roi( hnnscltorncrslfot rhoughhil or h.r owncmplorccs.
<br />providcd rhar such impokEnh m nor inrcnd.d u ofier.d tor slc. la hlwcEi !h. hliLli.g or intmwmnr is w}J eirhin oft )tf
<br />ol on{'lclirn. thc Owmr Builds will h!rc rrE bnrdcn of pdvtB rh, hc or shc did ml build o! irymrc thc rqdy n, 0h purl,r$ o{
<br />-1.
<br />tr\owlcrolrh.pDpcay, sncrclu\ivclyconr il! wirh lr..n\cd .onacror ro con(rucr rh. pmFdlsc..7tr'1,1. Busnr$
<br />and ItLssirnCodcTh.Contaclor'sLiccnscLawdocsnol!p!lyroarosncrolpfuPcnrwhohnildsori$ptorcsrhcrcon.
<br />lnd sho coorrlck for such pn&.rs sirh i conh.ktr(, li..n\c'l pu^urtrl ro rhc Conrrrcror'\ I-iccns u*)
<br />I xmrrcnttr utulcr S.di,)
<br />"^,.:${2.L/Qa1{""*.L
<br />DECI IXA.IMN
<br />I hcrchy rmrnrndcr pcnrhtof pcturyom of rhc li)llowinB dslnrations
<br />-lhavcanleillNi
<br />. a Cenifkar. .f Con*nr k, S.lHniur. to. work.n com!.nsolion-!s pt,vid.d frtr byS€lion 37(x) oflhc
<br />tnhor Codc. lor thc Dcrforronce o, rhc work for whi.h lhc ncrmir is issucd
<br />lhrv.iid willmrinrain snkcrs. .onlrtr{rion insuro .c.0s rcquir.d l,ySc.ri,nr.l7(nofrh. tiborCodc.lorlhc pcrn,m,ncc of
<br />rh. qork for which r,ris p.nnit is hsucd. M y *orkq s comNNrl ion insurrncc caricr dd f,li.y umbcr fl c:
<br />P.n,c! Numhf, _l''
<br />l.Lll !fl r'lj rh,t in rr'c F.i j,Hn. r I lhc s' \ tn sl (h Ih^ F"ni r hsucd. I \l'rl'
<br />' S ^rut.or* rhrar"rtcw"lrch'conrcn.diotrlJq."rC,rrr.mra. Jn,l'gmrhr
<br />woficre' conrNnsnriotr ,mvhions of Sccl ion 3700 oi rhe ljho! Aic- I +,11. i,nhwiri
<br />nol cnrloy rn, !e^on i'r.trynEnrcr
<br />if I shukl tEcorx \ubj€l
<br />'o
<br />il'.
<br />r onply wilh rhosc pmvni,,i\
<br />IIARNIN(; Failorc h $.urc workcr( conrNnsnri(in covc ac is unhwri'|. nnd shrll srbjd t cmpk)ycr lo simiulPcndrh\ rnd
<br />civil fin.\ ot k, ond hudr.d thournd Jolhr ($lul.oool. in ondirion lo th. ron .f.o D.ntdion, d.rmgcs !s Prorid.d rin rhc^:";ri'N C-odr, iucrcn d rtrormv ' Lr'
<br />LuLL^,,,,*,,*
<br />IECIdSAIIQ!
<br />I h.rby arrm undc. pcn.hy or pcrjury lhol I am liensd ufthr rm$ion ofCh.prn 9lcommrcin8 vnh Sdion 7000) orDilisn,n l
<br />ot lhc Ausimss lnd Por..sn,is Codc. ,t my liccnsc is in tull forc ot cfid.
<br />!&NEIEIJCIIONIENDINCAIjINII
<br />Ihcftbyamrnundfip.nally.rp.rjurylh thcrc n a conslE.lion lcdin8 Bsency ror rh. lxrronnncc oi lhc work lhr snth rhh Frnir ir
<br />isskd (Sc. :1097, Ci! C )
<br />A.TII.ISANLDI:CI,ASAIION
<br />Ih.(.tyafiinnundqrcmtryorIcriuryonc.rrhcl.lloqing ccl,nriotrs
<br />LINrlnion Pcrnit!Ashc{o\ Norlllclrion lrc{lcEl R.grlriions (Tirlc 10. Prn6)
<br />Rcquircd IxIcr of Nolilicarion
<br />lccditylhtrt rhc rcd*dl rcguhln,ns EgrdinA rsbcstos rcnDlalre nol lppliclblc t. rhh tmjc.r
<br />((.m,r1 rr*' I r,*" *,t rrr lrnltrri n anldorc rh hc ski! inroiourid, ir conccr.I aEero.ompl, *irh allcirylnd cou,,ry
<br />illdm,ne\ lnd Sr.rc Llws rcbrins n, huildinp c,,nqfldn'n, sd hcr$y aurhrrn! etncenr0rirs ofrhn Cil, and C.untyr. cnrcr ult,. rtr
<br />0hov. rtrrDrnl poFnv lq h.p.crionnurF).. I
<br />^*"*,..,^i^,,*""."i di eto$s'- ^,,- t /zX /Zstlpd,ature(D.io:( il|Q_LAEN jl 14-t^/
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bondino / Groundinq / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soflit Rouoh
<br />Ceilinqs (T-Bar Rouoh)
<br />Ivleter Release
<br />Rouoh to *
<br />Service lvleler vl
<br />FINAL W4",u</-D7)
<br />Notes, Remarks, Etc rl UI
<br />->
<br />t<1 rQTi
<br />tVtV'4
<br />cMic'
<br />-
<br />l.cn l.-'. \JJ'.*
<br />I
|