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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Underoround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Bool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soflit Rouqh
<br />Ceilings (T-Bar Rouoh)
<br />lvleter Release
<br />Rough 1.L\. tb ))at*('9
<br />Service Meter
<br />FINAL 1.Lt,-t9 l)zJo-&'4,4))Notes, Remarks, Etc
<br />OWNAR BUILDER DELCANA]'!iJN
<br />I hcreby rffifln udcr Fmlry of Frjury rhar I on cxcmfl fmnr rh. Conl,rroN l-iccn* ljw tor rh€ rouosing rcn$n lscc.?oll 5
<br />Bn\ine{ and Prcfc$ion Codc): Any Cn, or Counry shich requirc\ a pennir k, &n{ru.r. ,lrcr. in!,rove. dcnnnish or Eflrir My
<br />sl[.rue. Fior ro ns is\urtu.. ,ko Equircs rh. lptlicrnr r.r .nch Frmn t fiL . signcd slaicmnt lhal hc or sh. h lienscd nhu.r
<br />b lhc tmlisions ol thc Conlrocrols Liccnscd Liw (Chaptcr 9, Connmrcins lirh Sccrn,n 7U)0 .r Divirion I ol rhc BusiN$ rnd
<br />Pmic$ions Codc) or rhlr hc orshc irercnrfl rhcrclromand rhe bost fff rhc,llcgcd crcmlrion Ant viol0lionofSsrionT0.ll.5 by{n,
<br />appli.rirfnari.rnrirruhF.krhcapplicrnrroa.ivilrcnrlry.fnornoerhMnvchundrcddollm(3500)
<br />-1.
<br />us owncr oflhc !ro!cny. or nrycmtkryccs $ilh wrsc\ $ rhcn sol. coarp.nslri{,n- Qilldo rtr {ork mlrh. {ncrurt i' trur
<br />int.ndcJ o! olI.r.rl ir {lc (Sc 70.1.1. Bu\i,rc* md Pruf.ssion\ Cdlc 'I'hr Gn rNrur's Li.cn* t]w docs not .ptly ti an osmr ol
<br />rhc nn'Fny {lx' huikls or inlpror$ rhcfrm. Md *h, dms \&h sorl hi'ntcllor hlnclfo! rhnu8h h$ or hcr owncmployccs,
<br />flovidcd rhir such iDnnEmnh 0re nol inrcfrLd o, offced fi, rrlc li. howevci rh. huitting or nilR,v.mni i\ skl wirhn onc }!d
<br />of.onDlcrion, rlr Osn r Buildcr wlu ha\r tlr burd of8,vnr8rhd h.orshcdit not build o. irnl,mvc de laltny t, rh. p!ryrM of
<br />-l.
<br />rs owmr ol rhc pmpcny, amerlusivclyconrru.lins wirh licensei cotuacnns ro coninrci rh. E..j.cr lscc 104,1. Blrnc$
<br />atul Prr6rin, Codc: Th. Conts.ror's Li.cnsc Law do.s not spFly n) in owncr oiproFny qho huilds o, inpror.s rhcrcon.
<br />lnd who mnrack for sch rrejech wirh r Coilrudo(n liccnscd pur\lanr lo lhc Crnta.kr's Lic.n{ tje)
<br />-l
<br />Mr cxcmfl undcr Ssr ion-. B. & P C lor lhis lcoson
<br />Dsl. Ormr:
<br />rvomrus' colrrt'rrs,tirr rr.t
<br />lrDcl/&ula!
<br />I hcrcty rlrtnr utuer Dctrllryol pc0ury.nc{frhc t'ollowinr {lcclarali{)n\:
<br />-l
<br />hrlc i.d will nmn .in o Cc.l ilnlc ol Conscnr ro Scll lnsurc lor *0r*6 Nmpensdion, as l,mviiLd ror by scclFn 3?m oi thc
<br />tibor C.d.. rbrrh.p.rr.flnarccolrhc trork forNhichth. pcflnil n hnrcd.
<br />-l hnvc rtrd willnrinriin wo.kcs conwnsalion nrur!rcc. !\ rc.lutcd $y S.crbn l7(x) ofrhc tjhor Cod., ror lhc F.fonruncc of
<br />rhc qork for whrl lhisrErnrir is issucd MyworkcG mnlpctrslriotr i,Nurnncc catricr rid r.li.yntrmh.rd.
<br />Catrir:-
<br />I ccnily rhlr i. thd pdraortu....fthc wor* ror which rhi\ p.rmir is issu.d. I shrll nor cryloy lny pcnon in an, nrrnncr
<br />b s h hcorc subjcct lo rhc *o cm omDcnlariotr loss.f CuliLnriu. lnd ryrcc rhd ir l \h.uld h..om subjNl ro thc
<br />workcn conrFnerion ptuvtions of Sccl i,'n .lr(l) ol lhc t tn Codc. l \lull- ronhsirh c. Dly s irh rh.t Povkions.
<br />civil nncs up ro onc hundrcd rhousand dollarr lS ri rhc co( of.on,tln\rr(rr. dxnr8c\ r\ 0rnidi lnr rhc
<br />Sc.ri, llr7r, .f r h. l tnr Codc inrcrcd7-1?-/€
<br />I h.Rhy lfllnnn ., FnrlryofFrlury rhrr I Mt
<br />DECI,AMIION
<br />u.dcr povi\ion ofCh.pts 9 (conrnErcins wilh Sccrion 70(U .r Divi.i.n .r
<br />.l rl'c Busircssand Pofcssions Codc. afrl mr li.cnsc
<br />? -l<>Lnci\c Cla$
<br />-
<br />/-7
<br />","7-/€' / Q e7'\
<br />C --q
<br />I hrrhyrlfiirnuD.lcrp.nrlry.l|*rltrryrhi consfl.rion )cndine rgcE, for tlf, pcrlbrnrncc of rhc *ork frtr shi.h rhi( Fanir ir
<br />l\\'.!1lsc. l1r9?. (iv ( l
<br />, APPLICANT DECLARATION
<br />I lmbytrRmrutrd$ p.n0hy otpc@ry onc ofthc followinB d.clflrolions
<br />Demlnkrn P.nnirl Ash. os NotifEarion F.deral Rquhrions (Tnh40, PM6)
<br />Rcqxired Ltr.r or Noii.aliotr
<br />,B@ t .on lywirhall Ciiy!trdCounry
<br />ivcs ofrhis Cny ud Counlylo enrs lrln fic
<br />-? -/qJ8D.r. a4Dnlicnnr o. EeZ siBnot (*'z A N q{.u,
<br />Site-Work
<br />Transformers
<br />lV/\nNNc: I'.rlurc tJ scurc eorkcr conrDcnsalh c.vcrasc i\ unhsiul. nd shall \ubJccr M cnltk,)rr b .nnriml Fnrlrics and
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