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ELECTRICAL.INSPECTOF RECORD <br />DATE ID/SIG.COMMENTSAPPEOVALS <br />Site-Work <br />Underqround <br />Pole Bases <br />Lioht Standards <br />Spas, Pool, Fountains <br />Siqns (monument) <br />Life Safety /Low Voltaqe <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bondinq / Groundinq / UFER <br />Transformers <br />Torqueino <br />Sub-Panels <br />Air Conditioners <br />Bool Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rouqh) <br />Ceilinqs (Hard & Solfit Rouoh <br />Ceilinos (T-Bar Rouqh) <br />lLtrf rltll -lu7a4 9W-ao.z%f r@Ivleter Release Tlrtlts <br />e"qeb 412'2' fce <br />Rouoh <br />Service lVleter <br />"9 {t-r7t&1FINALb/,<l|t\ <br />Notes, Remarks, Etc <br />()lYNtiR lllrtLt)t.:R lrl,il,(1R,t l loN <br />I hcicby atnirn undcr pcaalry (r rcriury lhal I m .icfrpt fsm lhc Coortrck's Lkcnsc L!{ ror thc lollo'ins rcasn (S( 70'l l 5 <br />Busincss dnd Prolesion C.dc): Any Cily ot Counry which rcquir\ a Fmnl to .onsrto.r' ons. imllrovc, d''mlth or rclrn 8nv <br />{nEturc. prirr lo ik issu.n.c, lho r.qun$ rhc ,lllicrnl fu cu.fi pemir b lilc ! \ised qr cmnt Ihal la or stu is liccn{d Nrua <br />lo lh. pmlisions.' lhc coDrlactor.s l-ienscd Ljs tchill$ 9. co6n.n.nlB Bilh seclio. 70ot} ol Divisioo ]] ollIE ltUlincs\ dnd <br />Prclcsions Cod.) ot lh.t hcorsh. ncrc.rpr rhcrcfromlnd rhc btr\h r.rrhcollcacd.r.nnion Anvvidorio'olSNlionT0ll5bvn'v <br />arplic{nr fd{ll.mil subjccIs lhc 4pl,crnl lo rcivil Pcnrllyortrol !no.c rnm liv. hundrcd dolld*($5ur) <br />L as ow.cr of lhc lln,lfny. or my cmnloyccs *irh *agcs !s rhct $k .ulFns.rion- ,iU do rh. work and lh' sME h fr' <br />intnd.d or offdcd rd q1c {3a 7{}r4. susirrcss atrd Pnfc$tun\ Gdd Tlt Conrr{ck \ Liccnsc Lov docs .oi rpPl, lo !0 owncr of <br />Ihc potedy wtx) ttrilds or iinoB rncmn. and wb {nB {.h <br />"ork <br />himicll or hcrcltor rh,onghhis.r hcr o*n emplores' <br />,ro'idcd th .u.h impbrcrftnIs e mr inrcrdcd oroffcErd fo. $lc lll bwcv.r. rhc tlildinr or nr{mlcnEnl t $ld *i(hir one ,e!r <br />of con$hlion. llE Ot.( auiu.r sill hlvc rtc hordcn o, ProlinB rtd lr or shc dil nor build or irnpow rnc lstxiv fo. rh' purlr'$ of <br />-l..sowncrol <br />rhc pmt)cny. sncx.lxsilcly..nkrcrins sirh liccn\.tl conlndon u.on(rucllh. trcjcd (s( ?044- B!'i'r{( <br />,nd Pn)fc$irCodc: fhcContuctor'sLicctr\cL!*doc\iorrttrlytorno*ncroltrfl)Ilcrlv*hol,uildsori,npnrcsrhcr'on. <br />.nd who conka.rs ror sucn rnjccrs wnh . G, nckln s) liccn{d Pr\u.trr lo rhe Conk,.rtr s LNnt ljw) <br />I d .xcmrr utrdcr Sccrnrn-, <br />I herchy afirm undcr p€nllrydrPc.ruryorc ofrhc folbwinC ddl.mlions <br />-l <br />hrrc ud will nuinluin u Ccdiarorc oa Cotrsnr h scl nsurciorwortcG. nr.solion. a\ rolidcdlorbvSccrionl?(xrofrhc <br />Llbor Cod., ror lhc tsformmcd .{ rhc vork ior which rbc p(mir h issucd <br />-l hdvc and will mainldin workcn compcns n,n in.urrncc. as rcqlted hy SNtion lT0Oofrhc tjbor Codc- foi Ihc !'rfonuncc of <br />rh. *ork i whichlhisp*mir is Gsucd. Mywo.kcN smpcnsltinn insntuk. c{nicr a8l p.lkv nunrhc! m: <br />WARNING: F. lurc ro ccurc sorrcn .urcnnrlii,n.o\crr!c i{ trnhqiul. nid \hill suhicci m onnkiv'r lo ciniml |tnrhics Md <br />.ivil fincs xp ro oN hunnrcd rhoxsrnd dollrrs (Sl(X),(Xl( <br />Sc.rnnr 1076.fthc Lrtxr Grle. i crc(ari! Dr'f,y \ lit\ <br />conr.nsdrion, namus$ rs !rcrntd for rhc <br />I hcrchyalfiflnundcr pcnrlryofPctjurylnd I th li.!n{n u.dcrytolisi.n olchlPter 9 (crn'rn.i.8 <br />ol !h. Ausi.cs and l']olcsrbns Codc. and my li.dn* is in tull (.N llxl .lTNr <br />C(INSTRI](I'I'IoN LENI}INC A(:FNCY <br />lhctohyrfirnrundcrpcnahr.rp.rjuryrhlheEir,.on{ruclhtrlcndincr!cm}lorliepcinnmmcolthcs'rklorwhichlhisp'rn'ili! <br />issucd (Scc lm7, Civ. C). <br />AITLLCANLDICLAEAIIOX <br />I hs.ty lJfmr undcr pcmlry orFrjuryotrc oirnc f(nhwiD! Jcclaroli,ns <br />Dcnnnirion Pcnnirs Ast*slos Norificartun F.dcral Rcsullrii,r\ (lillc'{). Pin6) <br />Itc(rirc(l I.(crol N.rill. lit <br />t cdrfyihll lhc lcJcrtr]rc!ul ri.n\ rcSrrding r\tt{tr rcnmvrlrr. nor r|Dlic.hlc t, rhi' Frlc.i <br />l.cnllvthrr Ilr\c rctl1l,i\ r0|l'.3rtrnr rnl{on i\..rcct.l!!rert..mplywirh!llCiry <br />ordinrNcs rnd s1rr0l r{\ rcldirE r, huil <br />nlx)v. rNi, rd |xin 'r) for irst'ccr <br />/\pDliunl nr A*(nl Si{ t ,.&r 0rAo /2 <br />Policy Numl,cr:-Erdres <br />- <br />-l <br />ccniti rhdr in rhc tcr{ortun.. ofrh. work lor which rhh Frmil is tstcd. I sh,ll.ol emplov anv rcBon in a'vrdrot <br />$ .s b tEom slblcci b lhc rorkcd ompenrd i.n lovs of Crlifodia and aBrcc thlt il I should tEom sui'd h ltr <br />workss comrcn\arion nrovisions ofsecln,n lTmoflhc Lltnr Cod. l rhdl. fonh*nh.umrlv wilh Iho* p&ri*iotrs" <br />Sr.ri(!r rllx)r,)l I) ri\irr r