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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUII,I}ETI DELCAR-ATmN <br />I hcrby .rfirm undfi ,rnrhy of p.lury rh8t I m .xcmpr rr.m rh. Cona.loF Liccn{ L.w lor ltc tolbvin8 Eav,n ls..70.ll 5 <br />Busincss ,nd Prorcssion cod.) ny Cily or ConDrt shth r.quios r Fnnir ro con(rcr. rllc!. iryrove- .kmli\h .r ftrlt aiy <br />rrruclurc. Ilnorlo ils hsuoncc. aho rcquncsrnc omlicr.l lor ruch pcnnil ro lilca \i8ncd ddcmnr rharh.or shc is lrcnscd Fuuurir <br />b rhc pmvirio.s ofrh. Conka.ttr \ Licctrsrd La* (Chllprer 9. (nmmn.ins *irh sccrion 70q) of Divhion I ol rh. Busirr$ ard <br />I'n,lesi,nsCndc)orrhrr lEorihc i\ cx.nrrrrh.r.fnn.and rhc l,urt for rhc dl.B.d crcmpti.n AnyviolrlionofSccli.nT0ll5nyany <br />afrlic,d n, drcinir {uhjcc(rhc aplli.a,rl lo a c,!il p..dlry oi mt nucrhan fivc hund.cd dollm (5500). <br />I. osncr ofrhc pnrFny. or 'nyc'ryk,rks *iri *agcl ar rhrn v,h conv*n\dn,n. willdo rh w.* 0nn rht slulurc h frr <br />i.ndcrl ororcrcd ror sdlc (se.7(}l4, Busi,rc\s and Pmfc$ions c c ThcCofru.lff \ l,iccnsc l,wdo.\ troi dmly hano*ncr.f <br />rh. nor.dy who buil& or inDmvs rtEmtr. trRI qkr dd\ \uch w(r* hnnsclfor hcrcllor lhDugh his or hcr o*n cn,rloyccs, <br />polidcd rhrr lucfi impokm.h rc nn inr.nd.d or ollcrcd fo. \ak lL lx,wc!r. thc t{iklin8 or nnnmrcmlll G sold Nirhin dk lt <br />olconq,Eldr. rlEowncr ltuir:La sillhlvc lhchurdcnoflmvirSrhnt hcor{E ir fr,lttiuor i'tEo!. rh. lnlFiy lor rtE puqn\c of <br />l. is ow.rr ol lhc p(,pdy, anrcxclusivclyconlncting*irh li.cnrd nn Dclorlo llnstruct rh. rnjccr (Scc 7(n4. Bu\inc\\ <br />lBl EDftsstnt Codcr Thc Conlracrols Licensc l,sw dNr nolapply ro an o*ncr otti(,tcdy wh. builds or imtrovcs lhcrcotr, <br />an who c.rmch r.r such lfoj(ts wilh , Gntru.fttr(s) li.cn$d puBudnr to rhc Conrlacrois Liccn{ lj*) <br />I rmcxcnrfr u.dcr Sccr <br />Dsl. Orner <br />I1!.BXIBSj:QuIENSIlI!)! <br />DI1I.A.8AII}N <br />I hcrchf d0ntrr utrdcr !cnihyolJrriLtryonc olrh. tull(N irx rlc(lnfuri([1 <br />-l <br />hrv. furl will .uinrsin r c.d ificatc of Cotrknl ro Sclf.lNurc for Rorkcn comncnsolion. $ Ir.lid.d fttr hy sftrn,n :17(x) or rh. <br />kbr Cod.. for thc p.rLrturcc .l thc work lor which lfu pcrmn is hsu.i <br />I havc lnd *illmtrinuin uorkcri comp.nsdi(,n itr\uErce- ar rcqutcd bySccri,n.lTm ofrhe tibor Codt. for lhc lEihrmncc ol <br />rl'd \rorlt f(r ql,ilh rl,i\ N,n,ir n pC My *dkn. .omp.^"r,.n 'nurbfrc caEH lnd Inlry numhr ur <br />f7\4fw\1Vr"V <br />c^i z\ \t <br />I ccniryrhar nrrhc pcrb.tun.c orrh.*ork for shich rhi\ p.r.rir t i\\ucd.l rhrlltror ctrrtlorany p.ron inrny rtunncr <br />s) rsh bcconrc subj..l IoIhc wo*c6'conDcnsrlnnr hws.iCrllonria.ond uErcc rlDr il I\holld nc.o c{hl.crn,rhc <br />wolkcr' conlf'cnsatnnr rrcvisbn\ ol'Seclion :1700 ol'lhc Lstu Onlc. I shnll. a{,nhsiih .. Dly wirh 'h){ <br />pnvhior\ <br />WARNINC r,ilurc h \ccum workcn ompcnsdnrn .dvchgc is unlawful. nnd \hrll subjc.r 0n cnrlo}lr t' oi'ninal lEukics ond <br />.ivil fin.s ut b onc hundr.d rlx,xsrnl dollrs (Slm.ooo). in addiliun lo lic corl olcomF.nqliotr. d nSci rr rrovidcd for rhc <br />sc.ri(D 10?6 ofr)r lf,htr culc, ir fic{rM [onry's <br />^", <br />-l ]I,.11 <br />IECIASA:III]! <br />I hcrcby rmrn undcr pcnrlryofr€rjury lhal I !n li(ns, lndcr rm6ion orChaplr 9 (comnrming wiln Scclion 7fi)0) ot Diision :] <br />ol rhc Businc$ end Pn,fcssions Code. ond my ltcnsc is in full forc and cLEl <br />,r" -l C.,<t-\G?-\\o \.il lx <br />taNslf,l]l:IrlNL[NDlNclcllcr <br />I hcrcby.tfirm undcr rcnrhyofrErj!ry rhd rhcrc n a.onsrdction lcndinc (8crcy a.r rhc FrldnEncc olllr work for w,richlhn Fmn i{ <br />issucd (Scc.:1097, Civ. C ). <br />dstc mnrnncd rmlcn, lq msFrlnnnurns s -r. <br />Appri.rn,or^p6,sism,u\ NA> / <br />p€m.ename,prin,,, Jo )fui t"rttli^ l-r-''q I <br />l-\('s <br />Site-Work <br />Underoround <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Si gns (monument) <br />Life Safety /Low Voltage <br />Fire Alarm / Dampers <br />Communications Cable <br />Buildinq <br />Under Slab / Floor <br />Bonding / Groundino / UFER <br />Transformers <br />Torqueinq <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rouqh) <br />Ceilings (Hard & Soff it Rouoh <br />Ceilings (T-Bar Rouoh) <br />lVleter Release <br />,A <br />Rough 7-Zo-tg h-tLtr) <br />Service lvleter <br />FINAL 7-7t-14'lwfiv4t,21 .,r{>) <br />Notes, Remarks, Etc vl <br />L.ndclr Addr.( <br />- <br />i lIIU!:AIiLDlil.td&Uta! <br />I lrNby rin n undcr jicnrlrt ol tdjuy o rc nl lhc loll,,wirrr dc(l {riin\ <br />I).Nniri{)n Pcnnir\ A\hc(o\ N.rifi.nrtr)n [;rdcful RrBuhri(,n\ II'r1r.10,I)d6) <br />Rcqum,l 1..(.r of Norifi .trri(rr <br />-_l.cnilyrhJ IIB tn.rul r.g,,Iri{,n\ r3r'di'rga\h(no\ romnrlr.c trrt]tl'.xhlcn)rlrisfhl..r <br />1 <br />I