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DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lile Satety /Low Voltaqe
<br />Fire Alarm i Dampers
<br />Communicalions Cable
<br />Building
<br />Under Slab / Floor
<br />Bondinq / Groundinq / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soffit Rouoh
<br />Ceilings (T-Bar Rouqh)
<br />1/l{/,<<\*Y
<br />Rough
<br />Service [/eter
<br />FINAL llz8ltl ,1///4f.i
<br />Notes, Remarks, Etc
<br />ELECTRICAL-INSPECTOR RECORD
<br />OWNTR AUILDER DEI,CANA'NON
<br />I hcrchy iltm u fi pcMllyoflc{uy lh l incrc.!, fn,n rhc c.DtrsctoN Liccnr ljw lor rhc n,lh*irg r.!v lscc 70.\15
<br />Bosirrcs and Profcsion Codcl: Any Cn, or Counly *hich rcquircs u p.rni' k, <,nsrflcr. slrcr iaqin,v.. d.nnrlfh or qri anli
<br />$ddur., trintu irr h\u8.... ,l$ rquirs rh. lPrlic,nr (n \!ch Frfrir ro filc , ngncd sliI.n$r rhat hc or shc h licelscd ll!rt!.r
<br />i. rhc pmvtions oi lnc Conlncro. l,icenscd l.$ (Chaprc! 9. ComDcncins airh Sccrn,n 70([ or Divi\ion ] ol thc lrusirrc$ ind
<br />PioLrsi.n*Cbd.)orrhar h.orshc is.r.nfl rh.refro indthch ie f(r rhc r llr!.d .xcnp r ion Any vi(ndio oI Sdion 7l):l I 5 hy flny
<br />anpli.n nr.lcnnir suhjcclsthc applic.nlro !civilFcnrllyortror 're.c thun fivc hundrcd dolhrrlS500)
<br />L ui own.r orrhc polcny, or tr'ycmplo)ecs wnh w,e.s,s rh.n \,h.onI.nsdion. willdo llE *oih {n the (mrE is hr
<br />inbntlcd or onar.d tu ule (Se.7od,r, Busirc$ snd Pmfc$ioN codc Th. ( onrloclols Licetrs Llw docs Nl apdy lo an o*ncr .r
<br />rhe pmpeny who toilds or improw\ rhcrNn, ald *ho docs \uch so* hnnsclaor h.rrlror rhtuu8h hh orhfi own c,nrl.yccs,
<br />nrovided rh.r such inpmrmnhrrcrn, i cnd&l.r ollcRn tu !ft. 11 tk,wcB- ih. ttrildina or ilrFrurcnr n sld rilhir' rn. )u
<br />of.onDlcri.n. rhc Own.r Bnih.r sillhrvc lhc bunlm ofpmving rhat h. or shc did tror build or inlJlmvc lhc lmtEny hr fic nuqx,$ ot
<br />-1.
<br />rso$rcrofIhc J)I,|rny. trflrcxclusivcly cotrlrudiry wnh li.cnscd co reron ro c.nnrud rhc pmjccr (Scc 7(Xl. Bu\i,'r\\
<br />Mn n.is\i,n Cod.: Th. Conkrru s l-icc.r Law docs nor lpply,o nno*n.. ornR,!.dy sh,, huirds or inrprotcr rhcrsn.
<br />rtrd qho onrm.rs rlr su.h rrej(ts wilh ! Conn".ro(I li.cnscd,ursurtrr lo rhc Co rlcru s l,iccne l,u$)
<br />Idmcrc rtrxndcrSc.ti r .B.&PC forrl,hrrson
<br />D.re: ovm.
<br />wonxrr-s' cotnprn:slrttttt
<br />D[clalauaN
<br />I h.ruhy rmrfl und.i pcn.hy or tl.rjury.nc oflh iollopinS d..ltrrrions:
<br />lhav.alxlwillmiinrrinrCcni,ical.orConsctrltuS.lf.lnsunttr*ork(rompcNrtiotr.!sprovidcdlorhySccrion-r,mofrh.
<br />llh,r Code. tff rhc pdiuoatu. olthc work ln which rhc pcrnir i\ isucd
<br />Ihrvc nd will mrirair wortcrs rompcnsation iNnmNc. as rcquicdbtSecrion]?(nollhcLnhorG ., tui rhc PcnonM.cc ol
<br />Ihc s.rl for which
<br />'hn lrirnil is hsucd Mypork.6 conlFfls.liotr insurircc caFicr d Brlty numbcr sc
<br />Poltuv Nu ,h.r: Ernics
<br />,_l enit rhui i', rhc F.nrmai.c or rhr w.rk r{tr shich rhn p.flnir i\ i!\u.n. I $,ll nor cnrd.y.ny lErson ir any nun.c'
<br />v, d\ h trco,tu {'hrc.r k, rrr *ork.ir conrlcNrri.tr hw\ .f CllirimD, ind igr.c rhd ii ! (hotrld hccoDE $bjccl x' rhc
<br />sokc^.onrtrn\!ri,n,prcvti.n\olSL{i,,n.17(X}.frh.l-atxtrCo(L.l\hrll.l(trrhwirh.onplyBithrhospovisn,ns
<br />WARNIN(;: f{ilurc ro {.urc *orkcr' conlEnqn'n .ovcnAc i\ utrh {'lrrccr rtr c ,flo}.r r' d ri l Ntr lric! r d
<br />conrnrn\rii,n,. dnnirScs n\ ptur'dcd liir rh..ivil turs up ro o c hundrcd lhousod aolltrr\ ($100.(xxjr. ir iddiri,
<br />::::I)ryp^^
<br />I hcEhy !fitnr!urcr pcnllryorpcrjury rhrr I u'n !i.cn*l ine wirhS..rnn Tlxx)) ol l)ivtlon l
<br />oI lhc lru\incs 0 Proac$ions Codc- lnd myliccnse h in
<br />qr/
<br />I hcrhy rrfin u dcr Fnnlry or Frjxrt rhd r l'.to is r ..iiturri.i LMn'g lhct(rlonuncc ol rhc $orltnr*hichrhn r^-nnir i\
<br />nnrcd lscc 1097. Civ C )
<br />APPI I(]ANTDF(:I ARNI(IN
<br />I lhsy,fln ruMf ,rnally ulNlury otrc ol rhc tullo*ing dcclrirhns:
<br />t)cnxnirion trcflnir\ A\hcdo\ Noritudim Fcdcdl Rcguhii('n\( lirh 40. P d6)
<br />_Rcquircd !rncr of Norifi .rriur
<br />I ..diry rhd ft rcdfial mgularions ESardin8 asbcnos r.mvdl an' nor {nlic,bh lo this pmj.ct
<br />l..nil) rlrr I hrvc rcrn rht rpflicxrion rrtlnI. r lr,,h\r rh rr.r
<br />'.
<br />t i{ci r l'!nra'r,q'l} ( h rll.'ir\. 'dr'uu1r\onliruccs and Skrr. Ljtrs rchri,E t' huildiDg c
<br />!h.\( nEnriotrd lnr'cny f,tr insr[fn r
<br />ADDllcrnl or Acml Sien.lure: V \
<br />/./""
<br />rr\ollh \( !r Ll(,,etrr\rio(r rotrrD/ .- )'?xlrc ', a'
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