|
APPROVALS DATE ID/SIG.COMMENTS OWNER BUITJER DELCARATION
<br />I lEq dlm o&la F.dr, of Fjury rhd I m d@rr 6Dr th. Conrrrt6 Li.!& t fo, rh. hllr*irg rB,. tS6 7ol I J
<br />Bua.a &d Prcfahn Co&): A.y Cny or C@fly *htrh r.qui6 . pdnit ro odru.l. .h6. inProve &mlilh or lc.i &t
<br />m<ru.. Fnr lo irt illff., .lo E+iG rlE epltor lor e.t Fntu ro fik r sigxd rntul lhi lE or tlE b lkd6.d puttrdt
<br />ro th. FDvtbd oa{E Conrr*rd ! Lic!6.d Ir* (clI,is 9. Coffiing wih S..rio. 7000 of Diriion ! of lh. t}!in6 ud
<br />PDfdiodCo&)or{l.llEqtEirq.r9llhdtfion!nrn bdi! for llEdh.dsdrlbn AnyvioLrnnols.<lb^TOll5tye,
<br />.ppli.d for. Fhi rt crr rlE tDpliod ro . dyil p.6ty old mErh.n liv. hd& &llr. (l5m)
<br />l. - oeE oa6c FoFiy. d oy anphtG wn[ *.86 - lh.n rb orpdErbn. {i! & llr \dt id r,E inaic i mr
<br />i'rord.d 6orad ftr rl. (Sr 70a,r. &!i6rd Prlrdird Cod.:It Coft-rdrti@tr$&6d+Plylo&osEof
<br />tb. FoFry stD b i d il!.ot6 Ea.n *ho r,6 rh s litrE tfo.lE*lfor ltEugh hit r hd os, aidorB
<br />p.ovltcd rli rtdr .qD€Gu E !D. lrcd.d d ollqld irr d. l[ ltrc!. fi. bildir d i,rysdd ir nld *ihir N )r
<br />oldrplain dr (xu Bqitb will lrw rlr hd@ of Fwg rl! lE d JE dn d hl,ld d iisror tL FlFq tu ir F,FE ol
<br />- l. - NE of rh. FDF!y. 6 .r.h!ndy .onr.lins s nh k6!.d conrxlN to .odfud dE Fi{ (56. 7olr. 06'B
<br />.,n hltrn Co<,.: Tt. Co.rdoii Lkm L.w &'6 mt .Cply ro e orrE ofp.oFl) u'ho hliklt or dFor6 rhcon.
<br />ed rho cod.*t! for s.h F$illr *irh. Corrtlo(r,li(6.d p{6rar rc thcCoffitr.! Lile t^l
<br />I D.rmF un L! S6lhn D & P( fq rhn rce'n
<br />1!Of,SEA5:(A!ltE!tAr.&!
<br />DECIAAAIIA!
<br />I hs.by lmrm und6 p.nllty of Fju.y otu oflh. follo$ins delsltiod
<br />Ih.!., kill m.int.in . ( cni,ic r.r('onst ro Slla'lNur. for q orkd conFBdion, B Imvidld for hys6!ii,n:1700 otrh.
<br />t bor ( od., lor rh. Ffome. of rt wo.I for whi.hth.p@il i! isu.d.
<br />- l h.* dnd will hli,rin sorld $mpcnrlion isunmc. a rqunqi by sciio, l70o of rh. tihor co&, lor th. n€ folfucc or
<br />rhc Ert for whth lh! Ffrir i! is,.d My srld s.rFBdion ie.occ csi.r dd Flty numbc r.:
<br />I.dt'0tlld i! rlE Flolrl@. ollE $orl lor ehth fiir Fnn ir isr.( I slEll mr mpbt er_ F$n in m, ie6
<br />$ E lo h.6m $bj.<l to rlE "sr6' oEFErbn l&r of C.litomil rd *6 lhr. il I slDuld tEo@ ot .d
<br />'o
<br />tE
<br />*!rt6 omFs.rbn Frvi.b6 orscrid :170l) ofrr btor Co<lq I ,rdl fodh$nh smdy $nh rlE Fn\ irbN
<br />\TARNING: F.ilur. ro se Nrld erFsi(n s\es. 6 utrh*tu|. ,nd ih.ll !bJ..r a opkrt- h omiul Frlit.!d
<br />cnil fi6 !p ro G hu'xH rho@d &lld (11(I).(l)0).
<br />'n
<br />rddnion ro E .on of conpcdior &rur6 B rold.d for llE
<br />S..lFn 1076ofrh.t bor (od., nl-.i i.d dturE rf6 fo,sk /a'-
<br />uclltELc9Nraa(]llf,
<br />TECTA8AI,&!
<br />I bqd,y .,Im ur& Frty of Fjory rhn I m li.qlr.d und.r F.vilir of Cll'plq 9 (mmins s nh S((an 7({)0) of Dn i!b. l
<br />ot rlE Bui.B .nd ltoldioo Cnd.. d 6y li..@ i! ii tull LN .,n dfd.
<br />,*,^".,,f {e. s '-72"
<br />(a!$a!g&!IElulNc-&GEN(v
<br />I hRby .mrm und6 Fndlty o f psjury rhd rn6c is ! $nnrud ion L ins aBdcy lor rh. dfome. ol rn. $ork h. shirh rhir tEhir i!
<br />iru.d(s( 1097. ci! c )
<br />AITIII;ABLTECIJAAIIAB
<br />I Hy iiE ur& pa.i, of pGjui, oG ol rt tolbwirlB d6lrrbN:
<br />Daelhio. Pmnr^lbdo. uorifrrhn F.dnl R.subri'o (ThL 40. Pdr6)
<br />-R.qriEd
<br />LarE of tlorifr.d
<br />I .ority lnd rh. ,in r.l i.sut r io6 (Xrd'n8 6Lror r.fr\ rl !. ml .r?lt.bL ro lhir Fol.d
<br />I .airy d I hD. qd rhil elirir .n rd. rhr dE rloE inao liir i' corrl I lsE ro dnd, *nh .I ('dt .nd co{d,
<br />ddi@ .,'d Sld. r,s Elir ro h{iBitra o'itu ibtr .n h.!tr rrlbriE rqerriG of rhi Cirt .d Cooit 16 o{E l+on rl.
<br />.toE !Erb..d FoDany fs trrpciic A,FG
<br />^prrd or ^frr q5.,.n: -l tz,! '12" n"
<br />P.dlrn r..lprlr0l
<br />Site-Work
<br />Underground
<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 />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough
<br />I I I
<br />FINAL hth w wt*{
<br />Notes, Remarks, Elc
<br />ELECTRICAL-INSPECTOR RECORO
<br />I
<br />I
<br />I
<br />I
<br />Service Meter
|