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DATE ID/SIG.OWNER AUILDEf, DSLCARATION
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<br />Bains i.d Profdion Cod.): Any Cir, or Cou'ny wni.h rclut6 . Ff,it ro o,utucr. drd. ihprola donolbh or l9.n D,
<br />rM@ Ftu ro nr illlec. .to Eqr6 rlE .pplt.r! tu ech pad to liL . r't,'.d rimr tld lr or nE L Icda.{ F&rl
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<br />lpplic.Dr tur r Fhn $bjerr lh. lppli.dl lo . .ivil p@Iy oa mt mr. tho fiv. tun&.d dolhr I lr0o)
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<br />inad d ofra.d tu $l (S<.704a. Bci6 .td Prol6bc Co&: Th C.,txi( r Lilg try &6 d +rly lo x ow of
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<br />st) l
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<br />&d who olrrxlr fd 3Eh F.j.<rt rirh . Codrko(r) ltd!.d FErEr h rlr (t' r*loa3 l-t.G Le)
<br />l rn cr.trrll unds Ssri{,n
<br />$oaf,t8s-(!&urdtauq!
<br />PEC|JAAIIg!
<br />I h@b, aftun ui&r pqulry of pdtury orc ot fi. fouo* hs d..ld.ra1B
<br />-l
<br />htE an will rirl.h. CsritE.l. otconhr to S.lH@ aG md6 oiFliion. & FlviLd h. by Sdrio. 17m of rh.
<br />L.tor C.de ar tlE Ffm of lt Hxt lbr stth fic Fnn i iqEd
<br />I hrvc ,nd witl tui .in *ortd co'iFo.rh( idus.. a (quirld by S<ri6n l70o of rlE t bor ( od.. tor fi. FfolM. oa
<br />rh. sorl for vhi.h rhn Fnn ii iBEd- M, worla orFBaiotr iBum( c.riF ad Flicy.untE ml
<br />(.,Eid Ll@\1 Ing,
<br />v.f1-ueE(&3\,.,,,,- ' \6 - \- \"1
<br />I ccn'ryrnlt in rhc p6iorn1m. of th. rork aor which rhir p.rmir i! isucd. I ihrllnor dpby a.y rrs,n i. !n, nMn6
<br />e d lo b.<$mc .ubjftt lo !h. wortdl mmFd ion l.E of C.liloma. Md +rd rhd if I Jbuld tEom. $bi4l to ll'.
<br />qort6' mmp.Mrio. Fovili.B oas6lbr l rm or th. Ldor Cod., I J!ll. fo.lli$ rh omply u'ilh llD* FDrtio6
<br />W RNING: F.ilw ro sG *!rtd eiFsiion cotsrs. i unLtrtul lid lrull $bc<r d dnghF ro sinid Frrir !i
<br />.i!il frd up ro oE hundr.d rho@.d doll6 (t100.000).
<br />'n
<br />rdd'rior ro $. con of .onp.@rinn, drrugd a trotid.d for th.
<br />Sdri(r 11076ofrficl!&rr(i .,(r6616daro@yif6
<br />I hq.ty lrtun und6 F.dl, of pcjuy rhn I M li.a!.d und6 Fsl irion ofcnll'lo e (onmnios wilh S.clio6 T(xxr) of Divi3io. l
<br />oi lh. Burind ed PmfdioN ( o&, 3rd my lice i! in lull fo,.. ad cfi6l
<br />."*.* . C2o
<br />-,.'-1J-\:?-EL .1\99?e
<br />CONSTIUCTTOii LENDIM: .:EIlrV
<br />I hdrby dfr urdd Frly of Fi6y rhi tha. i . o'rirudin la'diB .rd, fo. lh. Fft.luE olrlE s.r tu "ni.t thi FEi i
<br />ite.d (S... 1097. Civ. C.).
<br />Irrdd'3 Ne.:
<br />ATIIICAtrLDIIIJAAIIO!
<br />I h.d, .ftm uid( F rly oaFjuy on. of rh. follo*ir8 .L(lo.tion.:
<br />Dqftlilion Pmir3.A.h6ld Norific.rion F.dq.l Rcsrl ioN ('I nl. 40. Pan6)
<br />R.quii.d l-ara of llodicniE
<br />I c6dry thr tlE &dq.l qllriiE E rdiq .b.sor lq@vn c d .rdt U. b rti Fttl.
<br />-,1 .6i& rhr I h.vc ud rhi! lpplkllion rd tr.r. rh! th. .bovc infomnio! i! con(l. I !8Ic lo onplr elh .ll Ciry !f,d coEry
<br />ordi,46 &d s'rrc l$! Elri€ ro boildilc c rn h-d,y .dhorie ,.FBndi!6 o f rLhn cnt .nd cDu.\ k\ 6ra lpod tlE
<br />o."'?l: tll
<br />!t rc nE'hn n p..Fr, for iEF(ion
<br />Aeprl..nt or Ardl skmtur.
<br />Permhe n.'n. ( pnrr l: K *1./.t-.=te{
<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 / Groundinq / UFER
<br />Transformers
<br />To rquerng
<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 />Service Meter
<br />FINAL ?/x/t " ,M tf\t{4u <(
<br />Remarks, Etc
<br />-t
<br />ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS COMMENTS
<br />r,.", .3-\-(l
<br />I I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />Notes,
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