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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER DUILDER DEI,CARiTION
<br />I h.r.b, amrn xnd& p..ally ol Frrury lhal I m crcmfl lrcm lhc C nlr,.rois- Liccn* l-.{ lor lhe follosins mrs'n (sE.7r l.5
<br />Busincs a.a Prctssion Codc): An, Ciry or Counry whkh r.qutcs o lf,rmn ro consrrucl- llrcr- inpt,vc, dcmlnh or rcnrt an)
<br />{d.rxrd, trnrb irr hsnnftc. rko rcquircs lh.rptltanl aor such Fnnir lo liha sistrdl "rcmd rhathcorshcnliccn*d Pur\uanr
<br />ro rh. nmvisiotrs of rhc ConrEcrois Li..n*d L:e (Ch.tr.i 9. CdmnrncnrS wilh Sccrn,n 7GI).t Divkn 3ofrh! Businc$.nd
<br />ProltssionsCodc)orrhsr h.orsh. iscxcmpl lhcrcfrcnmd rh.blsis lor lic lllcscdcxcnnrn,n AnyviolalhnofSsri,n?Oll.5ryaiy
<br />,ppli.nnr rdapcmi subjc.rsrhc 0tplicanr lo acivilIrnrlryofnoi,rtrcrhr fivc hu.dnd dollars ( $5(x,
<br />-1.
<br />rs o*rcr ol rlt lf,or.ny, .i my cq'ror.cs with w.!cs $ rhcn $lc ompcnsrion- will d{] rh. "nl d,i r suluE t mr
<br />inrcMcd or ofi.rcd fo. elc (Ss.7044. Busincss ond Protcssions Codc: the Conta.nr\ Lkcn* riw dcs ml a,)ply lo an ownd or
<br />rhe pDpcrly sho blilds or impo!.s rh.d,n. dd wh. dcs skh worl hinrtll or hc^elf or rhoogh hir or h.r own cmJtlotccs.
<br />trcvidcd rh,r su.h imtbvctu s e mt inrcnded n oltcrcd for srlc ll h.wers lhc hildins or i,irpft,rcmnr is $ld Nithin one ,tr
<br />of.orplcrion, rhe Ownc' Buildd willhrvc rh. tnKkn of pmvins rhor tE or shc dil mr tdld or irq,nE ibc ptr,pcn, for rlt pqn$ of
<br />l..sownciorrhcrnrpcny..mcxclusilclyconrrrclins{irhliccn{d.onrn.tudh.o.{nrllhct('jccllsa 704,1, sunncs
<br />r Pmlissbn C.dc: ThcConrmtn s Lic.ns. LawdNr nor ryplrk, nno$ns oflfup.nyu'ho 6uild\or in'lnr.s rhcrcon,
<br />nnd who cu in N for su.h prcjlrrs sirh a conn acro( n li.cnEd purrtrmr k, rhd conrturor's !-t.nsc ljs)
<br />I rmcxcnrpr undcr Sccl
<br />]YABtrE8S!CI)!IIENIirrIION
<br />D[CL/ISAII(,!
<br />I hcrchy nfilrnundcr len0hy of pcrj!ry ole ofrhc nnk'sing d.chrriidns:
<br />I havc dd q ill mi' iin a C.nific.tc ol CoNcnr t' Scllr lr\urc nr Norkcrr r.nltr Nd nnr. as 8)vidcd lir by Sccrn,n .1700 .f rhc
<br />l-aktr Gic. iq rhc Irrfortuncc.frh. uolt ldwhi.h rhc t).ynir t hsucJ
<br />l hrv0 rid sill trri,rlritr sorlcrr .orlpcnuiion insur]mr. x\ r.qui dbySccri( 171X)oilhcl
<br />r \ n{rtl Mr tro,[c,r om'f,tr\rnutr nau'iD-r (s'cr rr] n,ll\ nu
<br />FDL elolrul Lnswo,,o Con/,,*
<br />ihor Codc- in thc frrfonuncc or
<br />ina ql //t
<br />-l
<br />ccnilyrhar in rhc If, Lr.rNcofrhcwork tu whi.h rhis pcirnir is i(!ucd.l shallno(dnnlordny Pctron in lny mrtrncr
<br />nr s ro tE.o'rc suhjcd ro lhc *orkcrs omp€nsarion la*r ot Clliromia. rnd ,erc rh,l il I should bcconrc shFd b rhc
<br />eo&trr ..nI.nsarion fl.visions ot Scclion :]700 oI ihc Lrtnr C.de. I \hnll. r(,nhwnh .o dy wnh rho$ tmvniois
<br />WARNING: F{ilurc lo sccurc workc* smp.trl.rn ..vcragc ir unlaqtul. ond shlll suhj..r an cntlo)c. lo rimin{l Fmlri\ rnd
<br />;*,;a;u** r r:y#: W* ^
<br />IIIENSEDIIJNITAqIAB
<br />DECI,AAAIIAN
<br />Ihcrchy arfirinLnds Il.nulrt orr.riury rh l rm lianscd undcr tmvhion of Chaprs 9 (.om'hn.inB wilh Setion ?(x)0) or Divhio. l
<br />ol rhc Susinc!\ md Pr)lcsion\Codc. r 'nyli.c !c n in full nrcc inl cllc(r
<br />.r)(zt:
<br />N Q4qca1
<br />1/+4rltg .-"*",
<br />APIIICIIII)ISI.AAAIAN
<br />I rsry,inm und..0cn.lly olpcrjury ore ofrhc nnhwin8 dshr ionr
<br />Dcmlirion Pclmirs Asb$d N.lific,lion FcdcEl RcSnlnliotrs (Tnt 40. Pan6)
<br />-Rcqoncd
<br />kltcrof fi.rir'cdi,.
<br />Counlylo cnlcr ulmnlhc
<br />/
<br />l.d'l) hd rh. hdcalrccularion" rcBardincr\trr"\ren'".dlJc n' {nlr$lc to rhi. Ir nFcr
<br />lar..n'ry,ldIhrrc,{drhi.unllk'rrtr,nJJri{arcrhtrrrh.'h, IJE'et,.mplrw
<br />o d'r.F!c.and Sr!rc litr\rl,rin-s rohxrlilmgr rdcr n. rd hcrch),drh'ruc(r_c\ctrrJInc.,'r rhnCtr,rnd
<br />ilff.ffi:l';2ry/<* {7L- Da. .
<br />remiremmrprinr,:r.- 6 rq":r"r'/llknl)
<br />ru,/1
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Life Salety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bondinq / Groundinq / UFER
<br />Translormers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilinqs (Hard & Soffit Rouoh
<br />Ceilings (T-Bar Rough)
<br />lvleter Release
<br />Rough
<br />FINAL I 7//rh* e WM-/t>,
<br />Notes, Remarks, Etc.
<br />-+
<br />Service lVleter
<br />Ihcrchyrlfirmundcr0enllryofpcrjuryrharrhscisaconitucri(,nlcndr8a8cncyl'orlhcperl'oDun.corrh.sorklor{hichlhisJre.m n
<br />Nsxcd (Sc. .l(r9?. Civ. C.).
<br />lJnnfl'. N,mc
<br />-
<br />l Jcr',.4,t.t,r..
<br />I
<br />I
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