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APPROVALS DATE COMMENTS OWNER BUILDDR DEI,CARATION
<br />I hcrthy rflh, undcr pcnalry {,r Frjrr, rhur I am crenDr lmm lhc Conlracrom Li.Ttrrc l iw lbr rhc n,llowin8 rcavt (sr 70-l l 5
<br />Busin.\\ rnd Pn)rcs\n,n Cdlc): Atry Cny .r C.umy wtich rcquircs e rrrnir k, conn c', slrr, inlrolc, dcnrlish rcNn u,
<br />strucrurc, rior lo irs hsuaftc.0ho rcquircsrhc aptli.,trr rr su.h Frnino r''lc r \igncd s,'cmnr r har tu or shc n liccnsed Nrsuml
<br />Io rhc provrsi.ns of rhc Contrcroa\ Li.cnscd Lf,w (Chaprcr 9. Commmnq sith Sccrnnr 7000 of Divhn,n .l .fthc Busincs rnd
<br />Pn,fessions Codc) or lhil h. or she h.rcmpt Iturcliomand lhc b"sis ror
<br />'h.
<br />trllc8cdcrcnflbn AnyviololionolScclion 70115 hrany
<br />atnli.ani r.rarcn r suhjftt rh. 0mli.an o i civ il pculr y ol nor morc rhan n\ c honrlr.d dollrs ($500
<br />-1.
<br />!\ ownc, ot lhc pmpcdy. or hy cnploles qilh wlses as lhcn sb conwnsrrion. sill do tlE work lnd rhc nturE i\ er
<br />im..dcd oroffcEd f(x $lc (5(.70.14. Bu\incs,.d folcsioni Cods Thc Contrcir's Liccn* tl* docs nor Jl)plyro an owmr of
<br />rhc nnlpcny who buikls or inrrcws rhcmn. &rl who dms {ch md hi'nsclfor hcrull.r rfiR gh hh or h.i own cnl,)Lyccs,
<br />pr.vilcdrhnr such nn|)iowmnts R mr iotcndcd oroffcrcd f.r eh ll how.v.( rh. boildin8 or inpmv.Dr n$Ewilhinonc,sr
<br />ofco'roklion. ltE Oxnq Buildcr will hok rtE burdcn of previrg lhat hc or shc dil nol huild or iryrow tte pmlcn, {or lh. purF$ of
<br />I. owncr or rhc F,pcny, a crcluivclt contmri"g $irh licctr{d .ontrkr\ t, .o.ntud rht p(&.r ( scc 7(}{4, Sunncss
<br />nEl tLri:sim C.dc rh.(i,ntrrchilLiu.n\c Lrsd({s rx rmlyk)atr.!trdolf(!nc ywho tuik\ or imrn,rcs rhorcon,
<br />.nd who .o trrh f(r su.h nfl)]({rr sirh a G,ntrd(n licctrsd purtrrnr t) rh. Coih.nn \ l-i.cfic ti*l
<br />-l
<br />anrcxcryl und.r Scclio
<br />rQntrESlLtaul[Ns rtoN
<br />DECIAAA.IIA!
<br />Ihcrchyalllflnu cr rEnillyof!sj$y one o, rhc lollownrS d(larliotrs
<br />-l
<br />h3lc a.d will minrain a CcnilErrc ol Consnr ro Sclf lnsurc for *ortcn compcnsorn'n. &s Fovided lbr by Strrion l?m or ihe
<br />L!bo! Codc, r'or I hc pc.forrorcc of lhc wort lor *hich thc psmit is issucd.
<br />Ihalcrndsillmi' ri'i wo r(o llcn\di,,n in\uramc. r\ rcqrtcdhrScdnrn.lTiX)ofrhcLrhorCodc,i.rrhcFrforfrrn.cof
<br />Ftr\rri,n, nrdrrn.c.rdicr MJ lxnic) u $cr:uc
<br />1
<br />)l-lLcn,ryrhsr m rhe pcrrorrumc,'rrhc s'trk ntr,h'chrhh pcnnir t hsued.l rhallnor cnplorsnytc*on in,nynMrcr
<br />A^ J\r, bct.nr ruhj.c' r.rtr.q .F omlcn{rotr lr*.,n( rhxid'., dnd JFR rhrr
<br />'1,
<br />\hnuld hcr.ntr \ubF{t r'thc
<br />wo s I conFnsaliotr ln,visions oi Sc.i ion l?0o of rE( tit r codc. , shall lnnhwilh $mply wnh l[os pnvni.ns .
<br />WARNIN(; Fsilurc h $.urc *o $l.. rpnsarn,. covcn'$ i\ utrh*tu|, rnd shrll suhj*r an c phycr ro aiDi.ol pcnrlttx and
<br />civil fi.cs u, to oft hundnl rhousnd doll|^ (Slfii.(X or comtcns nrn. dinDscs 0s [ovidcd lor rhc
<br />S(r i.n 1076 of rh. I irr C..L inr.r.( md ,noflEv s
<br />,","<-V/z-./tt
<br />^
<br />I hrrrh! rfarrn uDd.r p!mlry.rprrtur!rhi I 'nI
<br />DE{;LladII}N
<br />undcr provhi.noaChrlrcrslconntuncin8 wirh s*rbn 7uD) ol Diuisbn l
<br />or lhc ausinc$ and Pron$ions ({ c, lnd nryli.cnsc k in aull I
<br />?o\ q\ 1
<br />^",-?72"i t4 ro* Prxcrtir \
<br />coasralcuoNtENlracl{iEN.cr
<br />I heEt'y.ffirnr u !r ncMlly of Pcdury thnl lhsc n tr m.(dcrhn bndirg r8cfty lor rhc pcrrormncc of rhc work for ehich r hi\ rErmir is
<br />issu.d (S.c 1097. Civ.C.).
<br />A}IUCANLIECIdBAIION
<br />I H'y ffinn und.r pcntrhy of pcrjlry onc of thc folloBi.E dc.lml n x:
<br />Dcmlirion P&f,irsAsb.Nos Norifkdion Fcdcral R.gul io.\ (Ttlct0. Pd6)
<br />-Rqtuncd
<br />tlircr of Norarrdion
<br />I ccniryrhrr rhc ndcrul .csuldions rcElrdins.shc(o\ rcD.vilrrc noi rmlic.hl o rhh tmjccr
<br />I ccnirvrhd I h$r '. rhi\ri rfrl nrrcrhr hcrlnr i nnuri,r,i\.om.t Irgi.{t,.o'ntly*irhrllCirtrtr(lC,nNJ_
<br />od' n(\rtr,lSrrrc lrq\ rcLxri',!uxlhcrehr llrtxtri/c r.|]'c\citrrik\ oihl\ Cilr aod Cotnrt t, rdcr !lrn' ihc
<br />k,vc nrcntlotred |k rcny rbr
<br />,\Dplir nr or \srnr Sixnnrtr 4+ acr ^,",7/zo/8
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />as, Pool, Fountains
<br />Signs (monument)
<br />Lile Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Groundino / UFER
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />t'loof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soff it Rouqh
<br />Ceilinqs (l-$21 ffeuq61
<br />[/eter Release
<br />R ough -7-25-ly k.w$il)
<br />Service lvleter x
<br />FINAL K-E-[*v,w.\6t\
<br />Notes, Remarks, Etc v
<br />ELECTRICAL-INSPECTOR RECORD
<br />tD/srG.
<br />Translormers
<br />IT
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