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ELECTRICAL.INSPECTOR FECORD <br />ID/SIG.COMMENTSDATE <br />Site-Work <br />Underqround <br />Pole Bases <br />Liqht Standards <br />Spas, Pool, Fountains <br />Siqns (monument) <br />Lite Safety /Low Voltage <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bondinq / Groundinq / UFER <br />Transformers <br />Torqueinq <br />Sub-Panels <br />Air Conditioners <br />YRoof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rouqh) <br />Ceilinos (Hard & Solfit Rouqh <br />Ceilinqs (T-Bar Rough) <br />Ivleter Release <br />Rouqh <br />Service lvleter <br />J/eJcl {raFINAL7-tt-/u <br />Notes, Remarks Etc <br />()tyNIiR IrtrlLI)t:R Drl,clRl-n(r\ <br />I hcrcby dffifln xMcr pcnally ot Friury rhtrl I ufl cxcnfl fon rhc Conrtacro6 Licensc Llw for rhc fofi'wing rcrv'n (scc'7o31'5 <br />Busirc\s d Profcsio. codc): <br />^ry <br />Cily or Counry Rhich rcquire{ a Fnni r. condtu.r. ahct. iq',orc. d'tnmlish ;r mnrr tnv <br />srrcrurc. prinro irs ksuancc, aho r.qukcs thc otdicanl for ru.h Pcanil lo filc I siBncd slltm rh,l rEor shc is licctrsd PuNanr <br />b rhc rrcrisio!. orrhc Conrraclols l-i.cnsod kw (Ctaplcr 9. ConmcNi.s $irh sccrion 70m or Divhion 3 olrlr Burnr\s rnd <br />Pmf€$ions colc)orrhol lE o h. is cxcnrtl thcrcfror d.d rh. bash lor rhe aucecd cxemPlion. Anv viol0lionofSc''irn?0ll'5 bvanv <br />imli.s lor. pcmir suhjc.hrhc opplicanl lo !.ivilp.nahyolnol fr)e rhr 6!c hundtcddolles(S5OO). <br />-1, <br />rs owm, otrhc pretEny. or ny.mploltcs wirh wascs rs rheir solc onrlcnsari.n. willdo lh. wotk dd IIE (tur$ i' n' <br />inrenhd or oticrod ntr ;k (S( 7044, susincs ond Prcfersions Codc: ftc C..ltacrois LicenE tlw d@s nol opllv ro 3n owncr ol <br />rh. ImFty eho lDird\ or i'ryroYcs rhc@n. oJd sh, des su.h trnrt himrcllor h.selfor rh$uBh hn '. lEt osn'mplov'cr' <br />p,""ia.a rru *.rr impm\tmftmfrn inlcn*i orofI.td,or slc.ll,m{etr. rhc t{ildi'rg or i'Po!.Eni issoh*irhinotE )tu <br />; coryLrion. rhc Owmr BuiHd *ill h!!c lhc hurden of Fovin8 rh.r tc or shc dd ml tuih or inlmt rhc PDt'ny for Ih' I,urln* of <br />,. !s oBrcrolrhc Fop.ny. amcxchrikly.ontacrin8 wnh liccn\cd .o trtrocl ors h cunitu l tft pmrd (SN' ?Or4 B 'itr'r <br />Md hnls.ir C"dc 1h;C;nrrucrofs Licc.sc tiw dcs n.r amly ro an o$i$ or p.orcnv who huildsor inPto!$$crcotr' <br />rtrd eho onlncls tor !n.h polrk wilh ! C. turodt Ii.cnscd Purlanr ro fic ConrEckr'r Ltcne ljs) <br />I mrcxcmpt u.dr Sd( <br />WOR(f IIS' COMPI]NSAT'I(tN <br />DECI"AB{IJI}N <br />I hcrc6y rfiir rundcr Fnahrorpdjxryotrc tllhc folk,snrs dc.ltr0lions: <br />-t <br />h!!c {rxl will nEinloin ! C.nillcslc of Consenr ro S.lalnsnrc for wort(r omPcnsrn'n. a. pmv,l.n lot bv sdion ]7m or rh' <br />bnr Cdc, fr rhc p..rolmnc€ at thc srt for which r,E nml is nsucn. <br />-l hdvc rnd *ill nuinhin {ork.s' coml*nsalbn in$mn.c. as requftd bv Scclion 3700 or thc tihor Cdlc. ror lhc Frltlrtrc' of <br />rhc work for whkh rhis Dcmir is isscd. M, wqk6 conpcnsalion iisuan.c carhr and Flicv ntrmbn rc: <br />Polic, Nnn$$:-ExPtcs <br />(.cnifyrhlll ir rhc pcrr.nuncc nllhc*ork ror whih lhi\ pernrir i{ issucd.Ishrlltror cr ov trnv P'i\on h nnv DU cr <br />h ns ro bcc.'rt subj..l krlhc wort.rr .o nrN nsil io n hws ot C,lil.rni!. a rgmrh0i ii I \lbLlJ ltotrr. {rl'i..rntrh. <br />wortcn compcnc.lt n Pmvhion\ orsdiotr 3?00ofrhe L2b.r Codc.l shrll rodhwiih onPl, with lhore F'visio's ' <br />WARNING lailurc ro surc workcis .onv..sarion corems€ is unliwirl. ann rbsll su6jd an cdplovu lo siminrl pcmlris ond <br />.ivil liNs up b onc hundrcd I <br />Sccr ion ]0T6 of rhr lllhn Codc, <br />h.usrnd dollnr ($lOO.lxxl). i'r addirdr lri lh..o{ ol i,nr. (lnnrnA.\ r\ t)r,!i(l.d 1.. rh. <br />3 -tI L <br />DECI.AB{UAN <br />lh.nbyalfirnunilcrl.ntlryolFrju.ythdlamlianan!fldctF.visionofChaplcr9(comncinswirhsetioflTOfi))'rDiltion:1 <br />oi rh. Bnsincss md Pmfc$ionc Codc. and my liccnse is in tull lore ,rd cffect <br />x c 3 L <br />)-,? x.^*" <br />APPLICANT DFCI {RATTON <br />I h.ft5y lmm under p.n,hy of lcriury orc or ihc follo*inB d(l,mlions: <br />D.'tornion Pcrmirs Arttiros Notifical iotr Fcrrci.l Rcgut.iions lTirle tl0. Pd6) <br />Rcqutcd Lcllcr or N.lificaion <br />-l <br />ccnifyrhd rhc fcdcrol rcgul, ions rc8a.ding as}fdos rn{,val rrc nor4'plic0blclo rhk InI(r <br />)txr. nrnri(n'cd r)niJ'crry ktr i'rs]trr .7-3- ,P <br />Dpli(.nl or A*c.lskn rrru *lz 41 4 LAA b^.,^ <br />APPROVALS <br />I:aISBIJCIIONJ.ENDIIG.trCDNCI <br />lhercbylffin.!nd.rFnallyolFrjurylh,rlncrcisrcon{rucri,nhndi.s.seftvforrh.I'f,fo,ron'collh€*orilorwhichlhnlEdirh <br />ii\u.d (scc l09r.Ci! C I. <br />Lcn,lc,'\ Nrnr <br />rll