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ELECTRICAL-INSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS OWNER BUIIJ'ER DEL('AR TION I nqd, afm undd Fshy of psjury thti I h qcmpt ton rhc ConrsroB Licce lro for lh. lollo*iis ca'o (S(.Tl l.5 Bui,6 od Prcbbn Cod.): Ary Cny or Cddy $nth EquiE r Fnn ro Nruod. .116, imp..lc damlilh M le.! ,y nruduc Fix 'o itr illlrE, .16 Fqri s rlE @li!n for *h Frn lo 6L . 3rgfld fid6r rti lE or rlE i lkB.d F.irr to tlE FrbioB ol dr Coirrrroir Lic$.d L.w (ClEFd 9, ( omtri.g *hh S..rion 70n0 ol Divilirn I of th. Buir6 !d PmfdioE Co.h) or rh.r h. or rhc i. dmp rhd.from dd rh. b.ii! for lhc .lh.d qop'i6i, Any lioLrion of Scrio. 701 I 5 t'y d, .pPlic.nl tor r prDil rubjcb th. !ppli.&r ro . .iril pdhy of mt mr. rha lir. hundr.d &lla (Sro0) I. B @6 of rli pioDdry, d ny mpb,6 rnh w.e6 d lh.t $lG onqNrio( s1! d. r {qI dd dE ln(rE i r'r i'nci.d c ofrdql a6.lc (Se 704.1. ButiB -d ADfdioB Cod? Tn Co,'irrors Lt.e ts,.106 mr +ply b u o$E of rh.FnFty vho hikl or itr!.ov6 tlEoG drd *ho .b6 3(h s!* hn4.lf ot h*lao. rheush hi! or ha otr n 6nployd, Foli(H lh.r uch inF.ffi c rbl idd!.Ld dlEld for -lc lf, lDw6s. ttl hili,rs M,iprclEEn ii $U wihi.... )arolcnpki^ E o$G B{ilt wil hE tlE hrddr ofFlri'tg rh. lE tr JE dii d hild d inp.or. fi. FtrFy fr'.llE F,FE ol l. a ow of rh. FoFiy, e.r.haiv.ly.nnfidi.g sirh licd.d m (16roconrrud rll Foj.n tS( 7044.8crn6 ]i EDftsion cod.: Thc Co.reroat Licd.liw d.6 nor !tFl,!o oo*nd.lprcFny sho build! or ihphr6 rhn<'n, Dd *tb @nEl' lm Mh p.ordr trnt. C6nr-lo(r) lt6E d F6er lo rh. Codr-toit l-i(o* l,q ) I @ .rdfl uid( Sdion D.i.:__ Onnn: * oRxrrls, (:oi-FJis iidi IECIjEAIIA! I ha.tr .lrm u&ld pa.Xr olFju, oc of rhc folb*ins d.<hrniE: Ihav.&dwill im6in r Cclifi.dr of coNot ro S.lf-lBur. for mrkd comFnsr ion. E! provid.d tff hy Sdion 17(xJ oarh. li&r Coda for thc Fforlje. of rh. {ql tor s,hkh rh. parn ir is.d I h.v. ud will mi rir u 0116 .omF6.rirn Inl,ltrc. s r.quir.d h S..lion 1700 .f rh. t b.r Co&, for th. p6folM. ol 1,. wr* fd whth lnir Fnn i. isfd My wrh6 onFiiion iEutuc 6ir in Fky nunb6 r.: , cdirythll in lhc Ffoll@c. of thc work for which thir Fnir i3 isru.d.l *!aU nol aploy.ny p6on in any mmnd $ e lo bdiB rubjer lo th. wond NmFB.rion lr$ olcllifoml &d i8E rhd if I druld b.com rbrdr lo rlE en6 onFddion Flvirird ol S.di,. 1700 of th. Lrtrn ( odc I {.11. fdhwnh o,rplt with thor plar itioB. WARNINC: Fnbt. lo cft $ut6' @mF!.lion mv6!J. it unL$ful. .nd.t!ll rubj.{l o mpLF b aiminrl pdtrli..d civil lind up to on. hundrcd rho!.!id &lld (S100,000), in lddirion ro rh. cort ofcomF.Lrion. dml8d u Fovid.d lor thc SElpn 10?6 ofrh. trtd Co& int6d nn lolB . ad; ---'^**",,{ 7( z,- (q u(E$tDlqEI3AgAS ) DEitt AR flON -.,.I h6!ty .ffm untb FrXy of pqjury lhd I m li.6rcd undq Flt bb. of (lugd e (sm,n6&'Ds * nh S(lnn 7000 ) ol Dilirion 3 of dE AGIIE rd amfdbB ( 6& nd6vli.@iri.tullftld'd.IYd ..",-"".(;:y CONSTRUCTIOII LFADING ACEITCT' I ha{iy tffm undd F.rIy .f Fjuy $d rha b . {rstu.lhn lading rydy lor rh. Flollmc. otllr sort tur e hict rha Fnl ir ir&.d (sa. 1097. cir. c.). A}PLICANT DEICI-/IRATION I lE*y.&D undd p@.hy of Frury oc of r folh*ins &ldioNl D.noliio. Pmtu-Alb6r6 Norific.lion F.dall R.guhionr (1nb 40. Pd6) icqui,ld L.rra ot Norificdion I .qriry lhi $. Ha.l r.ruLlioN cgd'n* 6h6rm rm\ rl o. mr q,pltrbh to rh6 FoF I cslit th.l I lw. rod rhi! appl(lrion &d !r!tclhd rhc.tnv. infonnrrion it con..r., !3ra ro N'npl, wih rllcnyrnd ( ounry ordruG sd Std. l^ r r.hirB r. b{ildinE .odrucliotr rn h(.5y llllls r.F.6dn6 ol'hn cily.nd (bu.'y lo dr6 lFn dE *or. mr6n d pfuFr) ro drqgla p,v* Z-)- eppoonr o. rrar strortn /\ ,/ -2 zlrl+2. Site-Work Unde rground Pole Bases Li ht Standards S S Pool Fountains Signs (monument) Life Safety /Low Voltage Fire Alarm / Dam pers Communications Cable Building Under Slab / Floor Bondin / Groundi / UFER Transformers To rquerng Sub-Panels Air Conditioners Roof To E ui ment Facto Wired Unit Walls (Rough) Ceilings (Hard & Soffit Rouqh Meter Release Rough Service Meter lt I 'I FINAL 4ltolrt }vhtl Notes, Remarks Etc I I I Walls (Conduit) I Ceilings (T-Bar Rouqh)I I )t-