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ELECTRICAL-INSPECTOR RECORD <br />lD/SlAPPROVALSDATE COMMENTS OWNER At II DER DEL(ANATX)N <br />I h.lcby omirn under lcn,lry oi lcriury lh0l I rn crcmpr riom rhc C nrJcxr^ Lrcnq La* r'n rhc r'l['trrn-! rcjrn rscc70:115 <br />Businc$ lnd Pot $n,n Codc): Any Cny .r Connry which rcquircs a PLrmir ro @nsln'cr. slrd, i'ntrovc, dcfrrlth or El'it anv <br />sdcrur.,,rior ro ils issurcc, lh. rcquiEs rlrc rylli.anl fot skhFnnil lo filc! \igDcd n .rrcnt lh hcor\hc is liccn\cd l]!r$rnr <br />lo lhc n()lisnff .l rlr Cotrt0dor's l.iccn{d Lrw (Chrprcr 9- Commdh.tu8 *ir[ Sccrnrn 7000 or Divilion ] ofrh' Btrsi"s trtrd <br />l\orasrtnrsCodc)orlhalhcor\hc is cxcm[ rhcrefrc snd rh. b3\h ntrrhc allcsed crc.lriotr AnvvioloiioiorSdbn?0.]l5hvanv <br />dpplicr lbr a pcrmil subjc.rs rhc applimnl lo aci!ilFnrlryornor mrclhatr fir. hundnddollaF(!5(x)) <br />l. !s owocr ot rhc tn,rxny. o ny cmPtry.c\ wirh *ag.s as rhcn Y'h compcnsrl ior. will do rhc wolk d rhcderm n mr <br />intcndcd or offci.d Lr Mlc lss.' ?0.14. Bnsncss nnd Proicssions Codcr Thc Cotrrddoi{ Li.cnsc l-ov dEs nor lPply lo aD onmr of <br />rhclmFny wk,brildsornnpovesrheK)r.aidqhodocssu.hw)*hinxclf.rhc cllorrhro shhiso.hcrownc rrl.vcc{- <br />p.ovidcd lhor such in,rornrots arc frn inr.tolcd or off.rcd lot sk ltl h'*cvd. rh ttrilliry or itrrpowm.r h $6 *irhin ' c )cr <br />or.onpkr bn. rh€ Ouner BoiUn sill hrtt rhc ltrdcn of troling rhtr' h. or sh. dil mr huild or inuorc rhc polHlv lb! llr loqht or <br />L is osmr of thc pmpcnr. r'n cxclusinly c.lrEcrinA wirh li..n{d coffacfuA t' con(rucl lnc pmj.cr (SN lO44. B"i'' * <br />! hnLssi'nCodcr ThcConlradois Li..trsc Lrv docs not opPlrh atrownerolI'n,Pcny*ho buildsor imfrovcs lhctco!- <br />and who connlcr tn su.h prcj.{ts *ilh u C,xnndon s) liccntd purs@r ro rh. C.nhclois Liccn$ Lrw) <br />-l.mcxcmpr <br />undcr S..rtnr- <br />Dole: Osn.r: <br />womrns ionri'rr.rs,lrron <br />DTC]r|AAIION <br />I hcrchy rlln,nundcr p.mlty olpcrjury.nc olrhc rouostrg dLtlnrlions: <br />I hrvc .rxt will nEinlain a Ccdir.arc oi Con*nr ro Sclr lnrun fn workcc cory.ns l ion. ns pmlidcd (.r bv Sccl ion l?00 or llr <br />Laho, GxL. ror rhc t).rfonume of rh. work ior whi.t I he l,cmir i\ itsucd <br />Ihrvc nd sill nrainrain *olk$a conDrnsariur i'surafr.. is rcqnircn b, S k r?mofrnc ljbor(idc. r'ot rhc li'rrorh'nd 'Irh. work for which rhn pcnnl is issucd Mywork.B comrcrs.lion i.surlncd.rricr d P.lic, nunh.i rrc <br />lixPtr\: <br />- <br />-l <br />ccnify rhdr in Ihc nrrlirrunccofrhc wo* forshich rhi\ Fnnir is i\sucd.l \hrllnorcmllov rny pcBon in itrv mf,trmr <br />s $ ro h.cotrE sbJLrr tu rlt wo{crs convrn\rri(,n lass ol Crlitu.rri!. un a8rc.lhdilIfi{,lldlEco.rcsubicli'rhc <br />sork.h'conpcnsalionnn,viri.nsofSccrion.lT(x)otrh.Lat rCdc- l shrll. r.nhwir[ conrdr $irh rho* pn'vi\ir)n! <br />WARNIN(; Ijiihrc ro scurc workcr conrFtr\xri{r co\.r {c i! xnl0rYiul. r r h oiniml ll.trrhs rni <br />civil li.cs up lo om hundred rhousand dollaR (tl(x).{xn). '.sn ron.l(r,6 ofrhc lib.' Cdc, rtrrcrc{ snd sro@J'r ros..v <br />D.l.: - npptiol: A <br />dinr'scs r\ prd .d lLtr llt <br />I hcrc$ylifirm!ndcr p.tr.lryul ltcriurt rhd I nnr li.ctr<rl undcr ion orchlus 9((n!*n.ing wlth Sali,n ?00o) olDivi\i{8:l <br />{ <br />hsucd (Scc. 3097. Civ.C.). <br />trndcr's Nom: <br />- <br />t.ndci\ AdJrr\s <br />AXTUIANLIECIABAIJ!]N <br />I hott'y r,iinnund.r pctr0hy oa!.riury onc ollhc folhwing dcclon i rs: <br />Dcnmlilion Pcrmils Asbc{o\ Noiilicalnrn rcdcol R.guhlions lTnle'r0. Pd6) <br />Rcquircd Letr€r of Norifi carion <br />-l <br />(nify rhrl rlrc fci.rrl rcgulaliotrs rcBirding !stic{o\rcnhvrlric nor lPPli.rhlc k) rhis J)roF.'r <br />lcrnilyrhrr I hrrUcrlrhisrPnlicrri(n, r d nrlc lh lrhc <br />[) <br />I rgr.c tr conrply {irh nllCiryiDi (iurY <br />.dinrn.c\ !nd srrrc trws rchtiry ro hoilding.oni <br />rldc nrtrrirrd rr)p.ny l(tr nr\i{.rron <br />ty <br />"""'::-";'/#d-" <br />Site-Work <br />Underqround <br />Pole Bases <br />Lioht Standards <br />Spas, Pool, Fountains <br />Sions (monument) <br />Life Safety /Low Voltage <br />Fire Alarm / Dampers <br />Building <br />Under Slab / Floor <br />Bondinq / Groundinq / UFER <br />Transformers <br />Torqueino <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rouqh) <br />Ceilinos (Hard & Soflit Rouoh <br />Ceilinqs (T-Bar Rouqh) <br />Rouqh <br />Service ltrleter <br />FINAL lvii*/r tNflf <br />Notes, Remarks, Etc. <br />Communications Cable <br />It/eter Belease <br />or rhc Businc$ rnd l'(nt$dr Codc. ffd '!y licctrst i{ i'r full i,rc r cffc.r <br />/\ltrliunl or ,1geDr Sitnrlutu