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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS ()$'Nl:R BtrIl,Dall l)Ll-( ARA rl()N
<br />I h.rcb, ,ltrn undcr t nrhy of Pcrluly lh{r I d .r.mpr fmnr rh. Co.r0clo6 l-iccn$ hw lot the follosiq rcsnr (Scc'7011'5
<br />BusnEs fl'n Pror.tsiotr Code)r Any Ciry or Counly whi.h r.qnircs ryemir b .onslmcl slrd improvc' dcmolirh 'r EnJn inv
<br />srrucruc-r!i.roir\nsutrrce,rkotquncslhcalpli.!flnt*udhpctnrilx,fiLrsi8mdsrcmnlth.llEorsh'iqli'ctrrdPutsuanr
<br />b rhc Fmvnions of rh€ Cont,crols Lieni.d tjw (Ch.,)lcr 9. Con'mn.ins wilh s..rion lmo of oirhhn I of rh' ausnrs nnd
<br />Prorcssions Codc) or rhar tuorshe iscrcnfl th$cliomand lhc hasis for rhc lcs.d.x.nPlion Anvviololion"S"rion?0:ll5bv!n,
<br />lpnlicrnr roi a Fflnir subreck thc aprlicrnr ro ocivil,,.nrlryofnoln!ftrMn fivc nlndr.d doll$ (S500)
<br />-1.
<br />a\ .wNr ol lhc Ir.Fny. or ny cmrrLrccs wirh wa8cs !s rhct $k com|{nsr b. will do rhe sork ar rhesrndm;\ nur
<br />;;nB or .,lscd r; st (Sa ?Or4. susimss and Prele$n,ns code: ,nc Contadoir Liccnsd hP dfts n'r qrlrv ro an o*n'r or
<br />rhe F)pcny Rho lioildr or inpms rhcrn, ard who d(s qct nrk hinNellor h.*clfor lhnugh hh ot hc! o*n'nlt'lolccs
<br />ptuvid;d rhlr skh inl)nNcnrnc m frn hrcndedoroficnd rorsk lt lbwcvcr. thc l{iuine or imprc!'m k"'kwilhino t vu
<br />;r..nplcriotr. rhc O*n$ Bxikis wiu havc rhc hndo ofrovins rh,l h.orshcdid n hrild or inrlmt tlt pn'pcnv for llE pu{Ds of
<br />l..sow.crorrh.popcny.amchlusivclyconlftdins*irhli...scdconrado6ro.oo(rucrih'lm]ccl(Scc 7014 Bu\inc$
<br />md Pn,tcssbn Codcr ih; Co rocrolsl,iccns.Llwdocsmlapnlvro,no*nctoaproPcnvwhohlildsorin{tort\rh'r'on'
<br />rtrd who d'nta.iifor such prclrck wirh a Conrrdo(t liNn*d puNuor k) lhc Conlricxt l Liccnr Las)
<br />In cxc'npr trndn scctio
<br />Drte _ o*ner:
<br />woRI<Eis' cottlPrNs rl(lN
<br />DEEI,ABAII9!
<br />I lrrcby aflirmundn lEMlry ol l].r]trry onc oilhc {ollosing dNlaorions:
<br />t hav€ ud will tuinrdn a CcnifErc or cotr*nl to Sclr l n{re rar workcr conDrnsll ioo. !s Eovidcd for bv ser ion :u(x) or lh'
<br />tlhor Codc. for ihe pcrfor.mcc of Ihe sort ro. whi.h lnc Pcmir ir irsu.t
<br />I hnv.:nd slll rir rirr qor[ds .onDcn\{rion insxrnn.c. as rcquircd bt Scdion.l?Ol, orrhc Lobor Codc. [d rhe ll.rfonMrc' oI
<br />iotr ilNurnmc.ffiic, md lflhl nu,nhd dc
<br />Icc iry lhrr in rhc perronmncc ollhc wor* lor whi.h rhis P.rf,ir is iisucd.I shsll not cmplov env lcrwn in snvnanrcr
<br />h s lo hc;om $bJr.iro lhc $oikca oaUcnqrt,n hw\ ofcnlifomi!. nnd ogEc lhal ifl \hoxll tEcom subFct lo the
<br />wo eF conn isi,on l)rcvisidni or sccl ion 37Oo or rh. tlbor Codc. l shnll. ronhqith complv wilh rho{ Pbvkions '
<br />IVARNIN(;] F.ihtrc ro {crF workc^ co'nFis ion i\ rnln$ful. rntl slrll suhicl rn enlrolcr ro si nnal I.mlris and
<br />cilil llncs ut lo om hu drcd llDulnd dollrs in d i(r ro rll.o{ ofconrt*tr{rion. damagc\ ,r lroviicd f{, thc
<br />Sccri( 1074 lrtu l-ahtrCod.. inlcr!{ dndfl,rtft
<br />DECI,AX4IION
<br />Iheret'ylmmUndcrpcnolryo,IEliurylhdl!nlic.o$dUndcr0mvhnofchaPlg9(con.EncinaQilhscclhnT{)00).f.,ivkion]]
<br />ol rhe Blsitu3s Md Pmfe$io.s Codc. .nd my li...s h in tull forl !d cndr
<br />,+it)18 Dc,.o*-a>
<br />CONSTNUCT!oN LIiNDIN(] A(]ENCY
<br />lherchrl'ffi.nutrd$rctr.lryorPcrruryrhrrlhcci\n.o.(d.riotrlcndi'rg,scNvlorrhcp.rloruunccotrhcworktushi'hrhG|rc|mili{
<br />is\u.d (Scc .1097. C,v (- )
<br />t trdq s Addres
<br />AIIUCANLDECIdSAIIOIi
<br />I h.rhy afmn ondcr p.nrlly of p.rilry om ofth€ f{,lL*ing dcclallhns:
<br />oomlilbn Pcrmik A3trsros Nolifi@r ion Fcdcr.l Rcsularions (Tirlc '10. Ptn6)
<br />-Rcqltcd
<br />tr .rof Nolificarir
<br />, r.nilyih.l rhc fcicr l r.Pularions r.BUdinA d\lr$or rcnmvrlrrc .r tr|)Plic$lc i,rhi\ ptojc'l
<br />l.cnilrrh$ llu\crcl'd rhisnpfli.rri(trr d \rarc rId rhcxhr. ifturnnrion i\..trccr I xgrcc h..nrtly u irh rll Cirt rnd Courry
<br />ircs ffrhn ( iry rnd Couriy I' ctrrcr trrin rlto(l x rr\ ro(lSlrrd lr(\ r(lnr huildi'r8 cuD(fl rclior. rd hc'chy rnlhornr rcPrc'cnlul
<br />$ort rmnriotrcd pmp.ny lnr
<br />Prn,il( nnnr rp.irrlr:r10 \<ef ",,," =//tlt\
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Lile Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bondinq / Grounding i UFER
<br />Transformers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Soffil Rough
<br />Ceilinqs (T-Bar Rough)
<br />Meter Release
<br />,7' .\
<br />Rouqh 7-t1-)K D.t4-rc,
<br />Service l\ileter i./)a(
<br />FINAL K-l9"lv k,wlLl
<br />Notes, Remarks, Etc ".
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