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ELECTRICAL-INSPECTOR RECORD
<br />DATE ID/SIG.COMMENTS OWNER BUILDER DEI-CAR,4TION
<br />I h.rc$! nmrm uMcr p.mlry oI pcrjury rhdr I d cxcmpr riom rhc a,nrrcbN Li(nsc t w f(tr lh. rollowirg rcasn ls.c 7{).11 5
<br />Businc$ and Profc$ioo Codc): A.y cn, !r Coumy whkh rcquir.. r Pcmir b ..ndfl.'. ahcr. nl1l)rovc- dcmli\n or tl(ir r y
<br />id.rurc. prin b irs issu .c. oho rcquncs llrcapplicrnl ittr \n.hltdir ro fiLa ngncd slolcmcnr rhlr tcorsh. is licc.scd tu umr
<br />ro rhc povnn'is of rhc Contr.ror's Licctrscd ljw (Chtrltc! 9. CnmrmncinE wirh s..rion 7m0 of Divrion I of rh. Btrsi|css rtrd
<br />Pn,r.*n rsCodc).rrhlthcorshciscxenrDtlhcrefn,mmdltcba\nfi,rhctllcS.dcxcnDrn r A.yviolart,nors..ri)nT0ll5bynn,
<br />opflictrnr fu r pcrmil suhjccls lhc aptlicrnrro,.ivilr.idlryornormt ttutr Iivc hundrcd dollar (S5([r)
<br />-l.
<br />ns owner of rhc l)l,ricny. .r my cmplorccs qith w{Scs trs llrt \olc conrF \dri{,r, will do rhc work ond lhc slMirc n nor
<br />inrcndcd or oficrcd irr slc (s(.r()4-1. Busincss ond hofc$ions Cdc: rhc G r,.ttr \ l-iccne La! dmr nol arply ro ,tr oBmr ol
<br />rhc ItuFny eho builds or in{'mves ihcRrn,,nd wfu)dds\nrh*lrk htnsrlfo.hcrcllorrMxshhhorher.*ncmploycc\.
<br />prt'lidcd ihDr sDch inlp.,wnrnrs arc nor inrcftlcd o offdql tor sL ll howcxr rh. tdilding or i'qftv.mnt is {ll Nirhin onc yu
<br />ol.rn{'k!bn, rhc O*ncr Auit]n willhaw IIE bu(hnofpmvir8 rhor lr or sh. did ton f^i[ or i'rqmr thc pmlEly for rL PtrF)* ol
<br />-1,Nownerofrhcptup.rly.amcxclusilclyconrrrrinssirhliccnrd.orNb^loconslruclrlEplri.cr(s..7044.Bu'inc$ind Piof.\si..C.dc IhcCotrrraclois Liccns.l-rw dkr mr rrplyr. nnowncroltropcny*h. tuildlorinrrmvcs rhcrmr.
<br />snd sho co rucls rff st.h pm]..ls wilh I Conrmcl.(O liccn*d pu6uanr l. rhc conta.rols Li.c.sc tiw)
<br />I hrv. rnd will,un 0in workcri compcnsrrion insur,tu.. 11 r{uncd bySccri(,n.1700ofrhc Lrhitr Codc. for lhc nqfttroDnc.of
<br />lr^t (pcm r is i\scrJ Mtwo,kcn cofrp.nsdnnr i'r{urituc cricr alxl plicy nun,b.r m*rl- c o\ \^ ;h:
<br />1.\\1tn,
<br />! ccnili rh.l ir rhc pcrlonnimc ofrh. sork f.r which rhi\ |x.nn is i\\uctl. I shrll nor c lPloy rnl nN.tr ir tny nrnirt
<br />$ a! ro tf,con{ sbid k, rhc $o.kc^ conti..srtion hw\ or Cllir'ornir- rnd Srcc I h{ n I should hcL.m $hicd o rrt
<br />workcr' .onrF-n\rrn,n tii,virons of Sccl ion lTUr ot thc I trhtr Crtlc- I \hrll nflhwnh comply wilh lh){ Pfl,ltiotrr.
<br />llARNlNcr Failu,c ro {curc $trkcr'conrjTnsari(,n.ovchCc i\ unhr'6r1. {rd \hall \ubr.!' m cmploycr ro simimllrcrxi.(,id
<br />civil nncs up ro onc hunnrcd rh.u\dnd doll0i! (S100,fi)0). ir addirion ro rhc co{ of.on{cnurion. duuges !s pR,vidcd for ih.
<br />*u'6-ri"tt'tUtu'"'
<br />"l
<br />!ECI.Af,AfIAN
<br />I bcrby arftrn uMcr FnshyofrcFrylhd I !n lieo*d !ndc. ptuvirio n . f Chaplcr 9 (omm(ios *nh Sdion 7000) olDivision l
<br />of rhc A!si.e$ aod PerBsions codc. rnd nry bccn$ n in flll fo,e ml .fim1.
<br />6?-)-
<br />'"'"pg5 qazot0
<br />C(TNS RII(]TI(IN I FNDIN(; A(;}-NC'
<br />I hcrby illtn undcr ncntrllyolncrjuryrh r rhcn isdoNrudion lctrdir8ngcnc, ixrhcp.Ynrmn.coflhc sorl hr*hichrhisJ). nit is
<br />n\uoJ lsc. :loq7.( \ (-)
<br />Lcndcis Addrcs:
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<br />AITLICAIIDICLAtsAIION
<br />lH', anim undcr pcnalryorp.rjury oN of lhc iolbqnrs delaslnrns
<br />Dcnrlition PcrmirlAsbcsro\ Norifi.ariotr Fcd.nl Rceul0rions (1illc40. Pan6)
<br />-Rcqnncd
<br />Llttcr of Norif@rhn
<br />lccnilyrhd rfu icdcrulrcguhri,rtrs rc3eli0! ostE(or rcnDulrr nor qrtli.rhl. h rhi Dm].cl
<br />!41.'cnilJ rhzr l hrv. x JJ rhh u,rl\0rnn ml {Jrc rl-a, rhr ah . inl.anirn'n r. !ntrd l rsm h,-.r'lirun.r.LnJSrrkl,'s.rlJrnrtrohuidiry.,,n{ru-n'lrrlhcnhy'Lrh{/.r.tr..cnhri\..,{r .omply*ilh rll CnyaFd Counry
<br />'" t'rrG'"6'$'IUTBahovc mnrioncd pmpcrry for in\F.rion ,rulrc$s
<br /> oDli.nnl.r la0l silnnx,re
<br />I,rrrifrrtrxr.(prinr): Or;d A.n
<br />Site-Work
<br />Underqround
<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 / Floor
<br />Bondinq / Groundino / UFER
<br />Translormers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Faclory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Soffit Rouoh
<br />Ceilinos (T-Bar Flouqh)
<br />Meter Release
<br />Rouqh < /"/lb >\6ry
<br />Service IMeter
<br />FINAL 6fi'>/lz ,\?z
<br />Notes, Remarks, Etc.
<br />APPROVALS
<br />lrn!.\.n!n trndcr S.!lk{r .lJ rir'( ritrlhAr.rlrr
<br />lrih
<br />lllllthltxll.lllxtl,N-srl.lQr
<br />DD(trlBAlI9!
<br />I l('rhvrlln rtriJ.r t).trr](v.rj,(.ilJ_on. olrtu 1nll,)N nJr dNL ,rr(r\
<br />Irhn(i o.nrrhcN.rofl r rcolrh.s,rIli $1,(h]h.J['trrI n str.,|
<br />,.r,tr\.\,,$. \p41o.ql€*.r-*'
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