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ELECTRICAL.INSPECTOR RECORD
<br />ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lile Salety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab i Floor
<br />Bondinq / Groundinq / UFER
<br />Translormers
<br />Torquerng
<br />Sub-Panels
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soflil Rouoh
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rou gh to/2-Utg 5,lr:r(
<br />Service lVleter
<br />FINAL 421hc r Wtot
<br />Notes, Remarks, Etc.
<br />OWNER BUII,DER DELCARATION
<br />I hcrcby rftrm undcr p.nllty of pcrJu.y lhar I m crcnp' rmn rh. conh.ioB- Lkcnsc t w fd lhc fouow,nS rqen (Ss ?0:l l 5
<br />Blsincss lnd Prufc$ion Codcr: Any Cily or Counly whi.h Equircs a permn to consod, altcr, inprovc. dcnFli$ or Et'!n any
<br />stdcturc. Itrior lo ils issulncc. aho rcqutcs thc lldicml for such lErmil lo ,i,c a siSncd slalcmnl thlt lE o, stE is liccnrd pursanl
<br />ro rhc povisions ot rhc C.nrEcroas t-k.n*d trw (Chlptcr 9. Conmc*inB *irh Sc.rion ?00o 6l Divi\ion I orrhc surin.s rnd
<br />PmfcssionsCodc)orlharlEorshchcxcmplrhcrcftomlndlh.h.sisrorrhc,llcecdcxcnrrrion.AnyviolnrionofSarion'70:l15hy!try
<br />amlicanrr(traFrmir\rbFchrhc,prlicanrroacivilpelanyofnormElhanfivchundrcddouus(S500).
<br />-1.
<br />as owDcr ol lhc pot ny. or nry cnlplorccs with wn&os N rhcir {rc .o mpcnsario n. will do rhc wort ud ltr $ucl@ h nol
<br />imcndcd or o,Icrcd iq slc (S( 7014, Busiric$,nn hohsiors Culc: Thc Conlruclols l,iccnsc l,!q docs nol arpl, t, dn owNror
<br />thc pDpcny slD builds or iDprovcs lhcNn- and wln des such wo* hi'nsclfor hciscllor lhmu8h his or h.r owncmployce\,
<br />providL{ rhnt su.h irpmvcm* m nor n cftLd.roft rcd rd sb. Il hu*cw. rhc buihnrs or itrq)mv.trn! is $k sirhin "n. 'trrof.onpldion. rhc Owmr Bxih.r will haw (h. burd.n .f pmvirS rh:r h. or shc dil mr boild .r nry$vc rh. ImFny fo lE IMTny oI
<br />l,.s owrcrorrhc ptulrny. nrnrx.tusnrlyc.nr r ng *irh lir.nsrl cotrtr.ron ro .onnru.t rlf pm
<br />ana hrtBsion Codc: Thc Conrrlcroas I i.cn\c lj*,.lnc\ nor aptly
<br />rnd --ho on(E.r s fd su.h ptulcd\ wirh.Conrtu ttr(!)Iic..scd
<br />€J5I
<br />I hcrciy rfnnr undor Ftrrlry.rp.rjury orc olrhc roll
<br />I h c md will 'nrinrrin r C.nificrtc ol Con\cnr lo Sclf lnsurc t(n tr orleri .1,mpcn\dn . rs ptu dcd fn h) SLi tun :i7m l rh.
<br />h6.r Cd.. l'or Ihc pcrionnncc ot lhc *nrt rhr *hich the prnnn i( knBl.
<br />I hrvcrnd *illmtrinrain work..r.o'np. srrion insurincc. r\ requircnbyS.crion:17(X)ofrhctrhorA e, for thc P.rfoniuNc or
<br />rhc E.*for*hi.hrhi\ l.nnir is ksuM My sork&J ..n1pci\rrii in\xi kd.ad.i rnd B,licy utrr$fidc:
<br />Ir.niryrlll inrhc!Lrri,rtrunccor'rhc!orin,whi.hrhi\p!rnril is i\{'.d. t n tln.r.nrployr ry pcr(in in rnynrnrr
<br />$ rsro h..onic \ub.Jccr ki rhc sortc^ .o\xtr\dnnr lrwr ofCalif(rnir. xnd xgrcc rhd rfl (h,uld h..ontr suDlLrl h lh:
<br />workcs strrrcn$ i(r|iovi\ionsofScdionl?fflolrhc l-rh.i C(dc,l shdl. foiihwirh .onrfl! wirhihos
<br />WARNniC railrc ro slrc workc.( co ,Fn\dii'n c.v.nrsc n unhstl.
<br />.ivil linc\ up ro,,m lundrcd rhouvnd do
<br />s-,,- {,76,,llh., "rf,. c^h -h-".^r
<br />,.,,,. tlcalzprs
<br />^,l
<br />I hcrc$ydlln[utulcrpcnrlryof p.rjuryrhd Ii tli@trB]
<br />oi llrc lrusincss md Profe$io.s Codc,. my liccns is
<br />'ctrri"U
<br />wirlr Sccrdr T(XX)) ol Divi\i, :l
<br />COISIAIJCIIANIENDIIIi.AGIM:I
<br />I hcrcby trfiirn undrr p.nrhyofpcrjurythrl rhnc is e manru.rion LMi.e a8.ncy lor rhc p.rini!runcc ol lhe solt ror Fhah rhis aamil n
<br />iisucd (S.. 1097, Civ C ).
<br />L-nd.r'\ N!'nc
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<br />APPI (IANTI)FCI ANATI(IN
<br />I ltrhy ilmr rndf lcnrlry.fp.rjfiy on. of$d full,)sin! dcchrarions:
<br />t)cmlilion Pcrnrils AsLslor Nolifi.atn,n Fidcrrl Rc8u l.t ions ( rilh.l0. Pan6r
<br />-Requicd
<br />Lcn.r ol Norili..lion
<br />I.!nilirl,xr (hclidcrrlrcguLri,,tr\(g Rln,!r\hcror,.nr)l
<br />ricon y wirh rli('ir!r (inlnylO ra'iy,hr r hiu '.rr,ha.,nnh.inn rir
<br />frJ'nJrcr\ rnLl shrc I n{. rchr ns ',, huiLl'ns c
<br />Jt{\c Nrii .d F,ncny l{tr
<br />,\ppli. lor AE$l Sitlnaltrr.
<br />rud lee nnn.(prinl): \ ,l'a:iEA
<br />D€:'
<br />I
<br />APPROVALS DATE
<br />u."*,X-
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