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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE IDiSIG.COMMENTS OWNER BUILDIIR DET,CARATIoN
<br />I hcrcby uiirn undcr Fn,lry or l.ijury rh,r l qor cicnu riom rhc Conrrscton Liccnse L.w lor the followins rcs$n (Scc?oll5
<br />Bxsines arxl Proicsriotr C.dc): Aay Ciry or Counry whi.h r.qui6s a ,Irnf io con(d.r. .lrcr. in!,ovc. d.fr,hh or rcll,tr Jny
<br />srtu.iurc. prir b ns hruancc. rho rclun€s rh€ arplicanr for su.h Flmir ro lilc tr siSncd shlcmnt rh8r lt or shc k licctrrtl pursnnr
<br />lo lhe lrovisbns of thc Conlmctors Liccnscd tiw (Chaprcr 9, Comn.ncin! wirh sdcrt,o ?0m or Oivtion I or rhc Bu\i'ress and
<br />Ptulcs\ions Codc)orlhar hcorshc iscxcnDl lhcrclromand lh. bnsi{ for rhc dll.gcd .x.mpli,on. An, violniionofseri,nTOll l ht;y
<br />.pplicanr rofu pcmrn subrcckrhc rpplicanr ro acivilpcnaltyornor rmrcrhln five hu rcddour6(!5tD).
<br />I. os osncr ol rhe pmncny. or my cmtlor€cs with sagcs * rhcir $lc contxnsarion, will do rhc wr)* rd rh. edm h nor
<br />inlctrdcd or oturcd ror eh (se 7044. Bulircs,nd Pmfessions Conc: fhc Conrrccrois l,iccnre lj* docc mt amly ro ar oNncrof
<br />rhc ImFny who build\ or itrll,roBlhcmfl. and who des ssh m* him{lror lrmclfor lhmuSh hh or h.r own.mFloyccs,
<br />p,ovided rhor such nrymEnrnrs m mr inr.d.n or oocrd t, $lc la
<br />'FEE.
<br />lhc hniklins or i,r{,oE.Enl is su wirhin om F6
<br />or compLrid rh. Oen( Blilder will h!rc rhe l,rdcn of Fnving rhd lt or shc did not huild or nu.orc fic ImtEny for thc luTnr of
<br />I. d ovftr of rhc F,n dy, am .r.h\n!ly conrrncr in8 wnh liccnscd conrrocroF ro constrcr rh€ pmjccr (S(. 7044. Busine$
<br />rnd h.f6si,tr Code AhcControcror'sLiccns.Lavdocs..rspplrroanown*orpror.dyehobuitdsorinpr.v.srhcron.
<br />rnd who conra.k tu su.hlrojeh wirh a ftntBclo(t liccnscd puGuanr ro thcC.nrracrols Liccn\c L!u)
<br />I nNcrc rt, t .r Sc.rir
<br />-.
<br />B. & P.C aorthh rcason
<br />lr.r€ Ovmr ..-
<br />UOBTEBS:JAMIINIAIION
<br />DEI!.AMIII}!
<br />I hcrcbyarfirm undft p.@hyorp.rjuryon. orrhc follo$ins dslr ions:
<br />-I
<br />h,vc ard will@inrain u C.dincarc otconsfl ro Sell-ltrsur. ior workcrl conlFnsalion, ss trvidcd lor by Scction 3?00 of lhe
<br />ttr&, Codc, for rhc pcrlorromc or lhc vork for which lh. F.mir ir ksucd
<br />-lilBvc lnd will'minr n *o.k rs .o'nFm ion in$En.c- as rcquned by Section 3700 of the tlt'or Code. for rhc p.rfo,mrc oa
<br />lhc rorl tor"hrhrhE mm r\ Esuol Mvsorldi .ummn\ation insu'ucc cmi., sJd mlilv numbc' m
<br />.*- S, /.1.' )-/^-1 ,.-.- l 0 at u. l1-
<br />-l
<br />ccniiyrhrl in th. pcnnrm.nccofrhcwork lor whi.h rhi\ rrnir h h\ucd.l \hrlliot.'nployn y p.^on hrnt mrni.r
<br />$ r h hcom suhjcd to rhc lorlcF on'Fn\ation laws ol Ctrlifdnria. ft, agN rh.t ifl shnuld tEcom suhrd h r1r
<br />workcr'comf.nsrri.nlrovhioisolScclionlT0OolrhcL.txrftdc.lsh.ll.fodh*ilhconplyqirhtlr,kprovniotrs
<br />WARNINC: lrailurc h surc wtrkcis cospcnsdi.tr.ovcagc is nnl,wtul. rnd sh,ll \ubF.r ar cmtk,y.r ro rin !,1r.fllrin 0nd
<br />c'vil finc. ur ro om I'undrcd lhou.nnd doller. ,llrilr{(rr. '4dl 'o h, rtx.\nr ol ..nD.nqr,n. Ji'tu-!.( Js nr.rd.d lo, rh.
<br />s61tr.n $?{a or , h. l.orn, c.dc .., "i -d "ib' *\ ,,k"* / I
<br />,.,", 8'2 /- I t ^,,,V,/-!) o-^./ CIJ
<br />_,,2' LtiENsEn eoMlR^croR
<br />DECI.ABAIII]N
<br />I hcrcby.flirnuoder Fnalryoircrjuly rhur I am liccnrcd ulldcr pmvkion olCh.tlq 9(conrmncins wilh Scclion 7l)(ro) olDivhion.l
<br />ot lhc Ausincs ud Prcfc$ions Codc. ud nryli.ctrs. is innnrn,lt'"d'ir..,
<br />ti o
<br />&^at-tx-
<br />gtNsrBlcuoll,ErDlNc
<br />I h|Eby aflirn !nde! Fnrh, of perjrry rhlr therc h a conslru.l ion Lndin8 UcR, ior lhc n rlormrcc ol lhc wo.k for vhich lhn Fnnil h
<br />hsued lscc. 3097. Civ. C ).
<br />APIIICAffIDECIA.BAIIII!
<br />I lIEby alilm unds Fnalry or !.rjury o.c of thc following del{rtrl ions
<br />Dcmlirion Pclmils-Ashcslos Nolific.lion Fcdcrll Rcguhriotrs (Tirlc :ro, Pan6)
<br />-Req!ncd
<br />krrerol Norifi catbn
<br />l(n,li thrr rhc lcdcftl mluhr i,inU c!rdiDg r\n (o\ rcN,vrlrrc Dor rDfinrhlc b rhi\ nolccl
<br />-lccnifyrhnr
<br />I havc rcrd rh$opp lrrrif,rtulnn.rhrrlrxlrn. ,im ri,tr, A.on.r lx !tu{n,.onDlr- *nh rll( n!r n (i{df
<br />!r(lirrtrccr nklShrc Lr(! 'chrut iinrandhcrchrturhffiTcrfrc{nrrrivrsofrhi\CiryandCo!trryrocircrupo rhc
<br />rho{ ntrtrri,rrd |frN'r, lar
<br />\ppliri l or AA.nt Sixnalur(
<br />,'- I C/". t-
<br />,n*, tr^j /'t f,
<br />Site-Work
<br />Pole Bases
<br />Light Standards
<br />S pas, Pool, Founlains
<br />Signs (monument)
<br />Lite Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding / Groundinq / UFER
<br />Translormers
<br />fqrqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof To p Equipment
<br />Walls (Conduit)r\
<br />Walls (Rough)k,Wrt:\
<br />Ceilinos (Hard & Soffit Rouoh
<br />Ceilings (T-Bar Rough)k,wL
<br />lvleter Release
<br />Rough
<br />Service l\,4eter
<br />FINAL t^(tl?r'vwv
<br />Underqround
<br />Factory Wired Unit
<br />qY
<br />\/1
<br />Notes, Remarks, Etc.
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