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ELECTRICAL.INSPECTOR RECOFD <br />ID/SIG.COMMENTSAPPROVALSDATE <br />Unde round <br />Pole Bases <br />Li ht Standards <br />S S Pool Fountains <br />monumenlSiNS <br />Life Sale /Low Volta e <br />Fire Alarm / Dam rS <br />Communications Cable <br />Buildin <br />Under Slab / Floor <br />/ UFERBondin/ Groundi <br />Transformers <br />To uern <br />Sub-Panels <br />Air Conditioners <br />mentRoof To ulE <br />Facto Wired unit <br />Walls Rou h <br />Ceilin Hard & Solfit Rou hs <br />-Bar Rou hCeilinS <br />lVleter Release <br />Service lvleter <br />FINAL <br />Notes Remarks Etc <br />r)\\ NUR It lLLljR tril ( ,\R,\ M)N <br />I hcrcby afln'n rndfi Fmliy of p€rjtry rh,r I m cxcmtl fronl rhc conracloN Lic..s. Law forlfic ldlowinS rc0en (Sc'7011'5 <br />Business &d Pmf.ssiotr Code): ny Cny or Counry shi.h nquircs I Fmii ro co.siflcr. alrd. inDmvc dcmli3h or EFir anv <br />srocrni.. ttrior ro ils is\!aNc. als tequircsln applid lor suchrm ro nhrsisrEd (dcm.t lhal hcorrh. h liccnsd plruor <br />ro lh€ polki.ns oflhc Conl,rn, s Liccnscd Llw (ChaPrs 9. Commncnrs wirh Sccrion 7(r0 or Divisiotr I ofrh' Btrsin'( r <br />Pn,rc$ions Cod.) orlhor heorshc iscxcmPI lhcrcfrom, $c bNn for ih. ollcgcd cicnrrrion Atrvviol.tionofsdion70ll5branv <br />anpli.inl lor ! Dcmir sxbi(k lhc atplica.r i. d civil pcnolty of rcr ,sr. rh fivc hudrd dolles (S500) <br />l. d ovmrofrhc Dn,n ny. ot my cnq,lore\ wirh wn8.s 0s rhct blc..nPuns*ion. *ill do rr* vort ud lh' sMm is mr <br />inhnLrl or oftrcd fm $lc i Se.?044. Busifts ind Pmfc$ions Cod.: TIE ConlB.roi s Li.cnsc L!$ d..r nor appl, ro di oRNr of <br />rhc tmFny wlr, boilds or nrtmhs rtEisr aod who des such wo* ninsclfd hcrkllor rhioxsh hn or ncr 6wn cn[lovccs' <br />pfl,;id;drh "!.h imtrovcmnh m nor intcMc<l o! oneFd r(tr eL.Il ho,.vEi th. buiuina or iq,.vcmnr hsU wirhinorc vw <br />;f.on!,lcrhG rtE O*i; Builller will haw tlf hir&n ol Prcvi.s lh lI or shc did mr tdiB o. inlPrcre $. l'oFiv for ltE purlxr* ol <br />-1. <br />a\ownfiorrh. pmpcnr. r cx.lusivclycontadi4 wirh li..nsd contudoE to cnn(tucl ln pojcd (S(.70'14. Bxri'rs <br />a l Ptulissbn Codc: iha Co rr.rols Licen\. Lrwdocs rcr afllyb,nowns olroPdlvwho buildsor inlprovcs lhcrcoi' <br />atrd who conru.s for such pmj<r\ wiih . conhcto(s) liccisd Nnunl lo lhc Conridols Li..ns. hw). <br />I rmcxcnrpr !nJcr S..ri.n- <br />Dire: - Oemr: <br />wo{x!.Rs, (:oMPENS I.I}N <br />DECIA.BAIIO! <br />I hcrchy alllm unJ.r p.nilly of pcriury oN ofrh.lollowin8 dalarark,ns <br />-lhavcandeillnuinl{inrccniiEar.ofCoiscnrk,scif'lNurcforsukcscon{Eo\ario..Npovidqlf'rhySNlinnlTo0ofthctih.r Cdl.. ror rhc lrcri'omu . of thc uork tor *hict rhc n .nril Ls ns&d <br />Ihivcnndwillmrin'ainworlcmco'np.ns.rioriNurancc.!\dqtricnhvS(lionl?moflhcljhor('odcforthcI.r'nnt'or <br />Ihc $ort ior shich rhir !.irnil is i\\ucd Myw.rkcts cor.p.nerbn insurarce clnici xl polic, numh'rd' <br />PolicyNunrhcr-_Ertncs <br />-l <br />ccdiryrhal inlhe lcriohrn.collhc *ork ror shi.hihis |Enni i\ n\x.d l shrll nor cdpk,v ,nv lcrsn in invnrnncr <br />n, Nh bcconE srbJcd b lhc wtrkqs onpcnsdion h$s of Cllir{ffi,. nM !8rcc rhd irl s,nrld hcom \ubiccl t' rh' <br />workcs om!.n\dn,n pmvirions or sc.ri rT0o ni thc ljtor G . l shall. tnhsirh .onltllv $nn rh)r Pt'vti'ns <br />WARNIN(;: Irdlurc ro {curc q.rkcrs .-r.Pcn!inrn ..!(ri8c l. trtrd sh!l| suliccr rtr cnr o)t. ro .nntNl Pcnalrics d <br />civil fincs np hr orc hundrd rhousiM dolls (SltD.ou). in n. dtrD !c\ rs trov cd fr rhc <br />;"::'1 ti"8,i <br />inrcrc( rnd dtunrY-\ lccs <br />DECLARAT(IN <br />lhcEhysl6rnundfFcn.llyofPc.j.ryrhrlmliccnsnlnllcrpmvkiotrolCh,rrd9(ormncingwirhScclionT0Oo)'fDivi\ion:l <br />ol rhc Brrsntslfd Pnni$u trsCodc. asl n,y li..nsc t i. <br />Lq(]>a4 ZA <br />CONSTIIII(:T!(IN LFI\DINC ACANCY <br />lh.r.byalftmundc,Fnahyoltcrjurylhlrrh...isr.oNrflcriorrbnding,8cmvntrrhcP.rrorminlToflhewotklbr*hihrhisI.nniris <br />issucll (S.c :11)97. Civ C ) <br />AI&TCiIILDICLABAIION <br />I trab!.mnn udcr pcuhy or Nriury onc orrhr rolbwnrS dc.ltlaliintr <br />tlcmol nrn PcnnnrAshcslo\ Norifi carion lcdcEl Rcsrlrri.ns (Tirlc !$. l'ano <br />_Rqut d t trclolN.rillcdion <br />l..nnyrlril rtu f.(lcrxlrcluL i s r.!rd'r.fn\rli,. nor 11,t)lixlr]. !) ih\ nrol..r <br />-l <br />cc ili rhar I havc rcld rhis,IPl,.atio <br />ordinrn.csrtrd Sr.rc l-r*\ rlrriit robu <br />ili)v. trulio cJ I','Nnr itr <br />,{Dplimni or AXcnl Signntur: <br />Site-Work <br />Walls (Conduit) <br />Rouoh -l) <br />'4;h,,)Q.9't6 z .- u/-t <br />Lctrdcr'. A,l,l'($ <br />-_-