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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE IDiSIG.COMMENTS OWNER BUILDER DELCARA IoN
<br />Ihcrchy.inflund$r.ndhyofFrruryrharIi,n.rcmprronrhccontncro'Lc.tretiwrbrrhcnnhringrcrson(Se70.1r.5
<br />Busincs !ftI Prcacsn'n Code) A.y Cily or Counry *hich rcquircr ! rcmil ro con(rucl- !tre,. improve. dcmli\h or tup3n ai!
<br />nrudurc. pri$ lo ils i$unm., aho rcquncs fi. Jppli.ad for su.h p.rmn b fib n silncd nn[ftni rhd h. or sh. i{ li.cnrd pusuotr!
<br />rr rhc pri,lisions ollhc C.nrrartn s l-iccn*d he (Chaplcr 9. Connncn.ins sirh Sccri.n 7fiD or Divi\n,n .l orrhc ausincss ind
<br />Pnnts\i,NCod.)orrhdhrorsh.hcxc'npirhcrfionandrhcba\isfdrhcDllcgcdrxcqrn .AnyviohlnrnofssrhnTO3l5hrrtry
<br />aprlicanr tor i pcrnir sunjcclsrhc !p,,licinr lo rcivilpcnilryornor mrclhrn tivc hu.drcddol1,6 (S5OO).
<br />-1.usownfofthcptur.ny.ornrycnDlo$cswirhwaec{{srhct{,kcoilpcn\arn,rvilldorh.wdrkdirhcstrulurcismlinlcndd or oliircd lo, sk (Sc.70,14, Busirc$.nd Pmfc$i.ns codc: Thc conrracrois Lkcnsc tj* docs ml anply ro 0n oNncrof
<br />nr pmNny wh. hriLls or nnprdB rhcd,n.,Jxl who d{xs such wort himscllor hcrsclfor rhourh hh.r h.r osr.'npk,yccr.
<br />[ovidcd rhar such impmEEds m mr int.nicrt or olTcrci f(x sle ll. lh*.rd. rtE huiuint or irqnvcmN is $ld wirhrn nm yr.tr
<br />ol compLtim. rhr Owki BuiLid trill Mtr rlt bxrd.n ot pmving rhlr h or shc dil br buill oi in $vc rhc pmtdy for rh. purF * of
<br />-1.
<br />$oqNr o, rhc FniDcny. aftcrclusivclycotrt cri,rB wirh li(.scd contr.roN !,.onstrud lhc pmicl (Sa ?O14- Bu:inc$
<br />ond lbftssirn cldc: Thc Contr.r.r'r Li..nsc l-a* docs noi,pply i' 3n owns ofpn,p.ny wh() build\ or nnfiovcs rhcrcon.
<br />nd who conr.lcts lo, such rroicl\ sirhaContracto(s) licc.scd pursuon orhcO'nrrncrols Licen* Ir*)
<br />-l
<br />trnrcxcnrpl u crSdior-. tl & PC liirlih r$qnr
<br />l)are O*ner:
<br />rYo.BSl:&5:!A[tfE rAlto!
<br />DES,AAAIIO!
<br />I hcrchyafinnu tcrNn.lryolpciury{ncofllEiollotrinrd.chnri(ff:
<br />-l
<br />htrvc dwillmdnrair!CcnifictrlcolConsctrllosclrlnsxrcror*.rkcm'.otrWnsdnnr.N providcd r'orbyScclion lTrl).lrhc
<br />bh.r Cdlc. rff rhe P.Irqmnd or rhc hrt ror *hich llc pmir n i\sucd
<br />_l harcandwill minraitr workc compcnsation insu.!n.c. as rcquimd h, Scction l7O0 ofrhc tjbor Codc, aor lhc pcrfomme ot
<br />rhe worktu sfiichlhhrrnril is tscn. My sorkcc compcnsln,n i.suratur cnnicr uxl Flty numbcr uc:..s+a++ f"'"rl
<br />/:12ll4 s ./.l*l,q
<br />I c.nifyrhnr in rhe pcllbr@rcc or rhc *ork fttr shichrhh p{flnir i\ hsucd.l shall nor cnployanyrcr$n inaiy'nmftr
<br />$ rstu bc.om \uhic.r lo thc w.rtcr' coinNNdt r l ss dfcalifdnr. md ilrco rhd ifl sln,ulJ h$unE subjccr ro nE
<br />wo*cis' c.qrnsarion fov(iois of Scct ion ]100 of rhr ljhr c(dc, , shrl]. fon h$irh .onlply *irh Ilbs |)^,vistnN
<br />}!ARNIN(;: FJilurc n) sctrc $orkrr( con,t.n\rri{D .ovctgc i\ uthrrnL rnd shrll suhjc(r rn rn,Iloycr h ai t.rlI* rlrir\ rkl
<br />kr onc hundrcd rhou\rnd dolhr\ (ltl(X).lXI)). in rddiri,,n ro rh. .od ol.o 'np.nsrrnrn, dxnugcs a\ phvid.d lnr thc
<br />Srcri(n]076ofrhc LrhnC{xlc. inr.rn rnd dkrmy \ lic\
<br />*izolrx
<br />!]r!IJ-BtMf
<br />I lrrchy rlinnuhdcr puMlryorF.jury rhd Lnr utrdci phvision ofCh.rid 9lcomnrncin8 wirh Sccliotr
<br />ol rh. Busincs und Phf.sions Cod.. and my li.dn* is in full n,ft ml r'yr.r
<br />lotlq3bg*l$C
<br />CQNSIf,IqIION.LIiNDING.AG.ENCI
<br />I h.eb, aror u.dn FulryorFrjury rhd $d. j3a onirudbn kndang de. y for d. p.rromftc ol rhc work aodhich lnis pc.mil is
<br />isi!.d (Sr :1097, Ci!.C.)
<br />A,SILICANLITECI,ASAIION
<br />I hcnby 0nim u.d.r Fmlry or lcrrury one ollh. folkwing dccldrarions:
<br />Dcmlirion Pernirs Ashc{os Norifi.arion Fcdftal R.Buldioni (IirL 40. PM6)
<br />R.quiE{ tdl.r of Noiff,albn
<br />-l
<br />ccnilyrh0t lhc {cdcral rcFullrioN rcsddina orbcstos rcnnrJ arc nor$r,licoblc lo rhis pmiccr
<br />#r*rhrr I lx,vc rcrd rhisrpnlicrri,,n rtulnrrcrhrr n ncomrr I rsrLr t,(nntly Nirh rll Ciry inll C.unrt
<br />trJ Srrr.la$\ rul rill3 n) huil i'i8c rurhtrh rcfrc\cnrrnc( olrhn C[t ntrd C.unryr. cflcr UFD rhc
<br />nlr,vln.nri,nrLt pn)|rrny ft n
<br />Appli.nnl or Asenl Sisnrlu hirrrberlq\1A.!\L
<br />glz,,ltz
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Salety /Low Voltage
<br />flre Alarm / Dampers
<br />Building
<br />Under Slab / Floor
<br />Bondin g/Grounding/UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipmenl
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ce ilings (Hard & Soffit Rouoh
<br />Ceilings (T-Bar Rouqh)
<br />Rough T/n-/rc ixrtr
<br />Service ltrleler
<br />FINAL UE /lv cvl f*
<br />Notes Remarks, Etc
<br />Communications Cable
<br />Meter Release
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