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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />I-n\ oanerofrhcproDcn!.orhyemployccswilhwn8cs.sIhcnsokconpcrn ion.willdolh.wo*andlheslrucrucisnor
<br />idc,xlcd orotur.d r(, salc (SLr.7O.i4. Bu\iics and Pr.fc\d.ns Codc 'fhc ftnkrtn s l-kcn{ t:w docs nor ,trly b ,n o*n$ .l
<br />rhc |!)lEny wh. btrilds or npmvcs ltEmn. r.d w}xl dirs su.h *b,1hifr\clfor hfi{llor rhmuSh his or hn own c,nployccs.
<br />PR,vidcd rhf,r such inrlnorcnrnh rc nor iDrc'rdd .r .ftarc{ tur elc. Il. how.vcr. tlE tnrildill3 .r ir\ootco.flr h bTd eirhir' .nc )rr
<br />olconrrk,ion. rhc Owncr Builhr willharc lhc t{dctr.rrorils rhd rr or shc dil tr.lhuiklor inlpn'vc rhc,mFny for rir Nqxrc ot
<br />-1.
<br />dsowncrollhcroptny, ancRlusivcly.ont.rins wnh licen\cd cont,cknsro.on{ d
<br />'hc
<br />Fr..r (scc. 704-1. Busncs
<br />,nl PDrssi,n Codc: Thc Conrrrcrors Liccnre LoB docs nor oppl, h anownfl olprclcny *h(' builds or inrp.orrr rhcrmn.
<br />and who.onti.Nforsu.hpmFls*irhtrGJntrckn(nli.cnEdpuFuanrt,rhcG)nt(rof\l-i..nscLaw).
<br />lrnrcrcnrFr uM$ Sc.rion .B &PC turrhi\r.ann
<br />Dot. __ O*n€.
<br />wonl<FRs, co[rPFNsar()N
<br />IES,AEAUaN
<br />I hcrcht iflir'n undcr pcnah! of r.rjory o.c ofrhc ftnb,iq dcclarurion\:
<br />lhtrLc rltrrll 'r ri'i I Cca itudr of Coi\rd n) S.lt ltr\ur. rnr *o'kcN .o U.n$ri(m.A lrcviddrorhyScdn .lTrirofrhc
<br />L.horc{xlc. f{trrhcpcrronuncc ofrhc*ork f ehi.hricFnnir is is{rn
<br />,l h.rr.nd sillmnn rir Borkcr' .omlEtrsarion in\urn.... r\ rcqut d bySftrion l7(X)olrh. Labor Codc. lor lhc ,t.rlormncc ot
<br />rhc qork l'or qhi.h rhisJ).rn r is issucd. Myworkc( conlil.nrdnn i'rsunn.c. ricr oxl Fli.y nun$cr ml
<br />'strrlc firnlqzBtx
<br />Iccniryrh inrhc|E rb.rnrNc oilhc work turwhichrhi\rcrnrir iskrrl.I\Mllnolcmpl.ynnypcnoninrnyn nmr
<br />$ rsh hc.. f, \ubjc.i t,rh. s. cN ..nrpris ri.i lrwsol (nlii{ntrir- Md,srurrh r i{lnn,uld $.{onr \uhic.rhrhc
<br />*o' kcr\ .o rtf,rqrnu ln,vnion\ of Sc.ri{r l7{X) of rh. l ]htr Cdc. l \lull. lr)nhsirh conl,ly wirI r h.* pR,vaidN
<br />WARNINC tuihrc lo {curc qorkcr onpctrsdn,n .o\tngc is unfuwrul. ,trd sh.ll suhiccl ,r cngl.te! to diDinal p.tr0hics.nd
<br />civil fines u,) lo onc hutrdrcd rhous.nd dollas (3100.000, in ,ildiri,)n b rhc ofconl,cN rion. ddmxes $ nrovild for lhe
<br />Sdcri,, 1016 olrh.Ixhr('.1. i' .i!:{ rD,lxr
<br />,",",- Eiic
<br />lrsc
<br />l)t.:( I \R\ll()N
<br />I hcrchy rtuntu.d.r pen,lryofpcrjurt rhar I nn liNn*d undcr povisn,i olChapr.r I (.ornrncing *irh Sc.rirn 7fix)) ofDiri\ion ]
<br />or rhc Businc$ and Pror'csbns Codc, md my liccDsc k in tull r'ore ntul cl'rd.
<br />^
<br />lbllctbG.t t0 116- c AC(
<br />I ncEby arrn u.dm Fmlry or p€rjury lhd fiec is ao.so.raoo linding aScmy for rh.,,.nolflN ofrn wort for vhich rhh Fmir b
<br />is{u.d (S€c. 1097. Civ C ).
<br />A?ILICANLDES.AAAIIOB
<br />I noE6y 0llrn x.dn petr,lry ofrcrjury onc ofrhc lolbwnlg dehmrionll
<br />D.moliriod P(oi8 Asii.sos N.riti.ariod Fed.6l Rcenl{ionr(Titk rl(). Pd6)
<br />R.quircd tller of Norifi .rlbn
<br />-l
<br />ccnilyrlur thc fL.dcEl r8ulari.ns rqardinS rsbcstos r.mlal.rc not apflicotlc h rhis proicl
<br />+IccniiyrhJrlhf,!dfrrdrhisrnpli.rri{nr rn (arcrhrrrhc atync inlnirnrrion i\.om.r lrgrekicomply*irhrllCirynidCoudr!
<br />,rl, n.r\rnJ slxr.lf,*a,rhr ngrr hcrchyiurk,nrrc[.scnrrriecs,'f rhkCiryJi C.utrryrocirduF{r)f
<br />rh)lc mnliomn lropcnylr +4 ]<hkrt VNtriL
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lile Safety /Low Voltage
<br />Fire Alarm / Dam pers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bondinq / Groundino / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof To p Equipmenl
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouoh)
<br />Ceilin gs (Hard & Solf it Rough
<br />Ceilings (T-Bar Rouoh)
<br />Meter Release
<br />Rough 1/rz/, K 1oJ trt
<br />Service Ir/eter {
<br />FINAL l/fl /te ,.')c/1
<br />OWNER BUII,DER DELCARATION
<br />I hcrcby lmrm undcr pcnahy of rcriury lh0l I m .kmpr rmn rh. cont,cron Lkcns llw for lhc followinB rcrsn (Scc.?01 1 .5
<br />Businc$ lrxl Profe$ion Codc): Any Cily or County *hih mquncs 0 pcnnil to <nslruci. alrcr. improlc. dcmohh or rcplt rn[
<br />sd.rue, lrin r. i$ islarc. Bh. reqnies rhc appltanr for such rEmir ro lilc a lisncd naremor rh hc or shc ir lic.n".d tu6ua.r
<br />t, rhe pmvnions of lnc ConlEctols Liccna'd tir (Chopt.r 9. commcminS wnh Scclion 7u)0 of Division I olrhc Burinc$ and
<br />ProLs{i{,r Cddc) or rhur hc or shc ircxcnq rhcrcfromrndrhc b,sn for lhc allcscd cxcmFrion. Any liolarioiorSc.rionT0ll.5 bydny
<br />atplicanl foru F.nhi' subjdk rh. ap,'licrtrr lo rcivilp.ndltyofton noErhr. fiv. hxndrcd doll,F (S5ftr)
<br />kndcai Addr$
<br />Notes, Remarks, Etc.
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