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APPROVALS DATE ID/SIG.COMMENTS OWNTJT BT'ILDER T'EI,CARATIOII
<br />I tcEby ofinm undcr Fmhy ol pcrjury rh I m cicmpr lDm rhc Conrkkr6 l-i(I.F taw frtr llE aolh*ins rcf,v,n lS( 70.11.5
<br />BuriEs! rn Prcr.shn C.ne) Ary Cn, nr Ctu , shih EqliE! . Fmi ro (r'n{rEi. rl'€. itqlmt - d.nlish o. EFr lny
<br />firru. Fi, lo n! isudr. .k Eqlhr ilE {rlalr ror trh Fnn to fiL r ntBd rl.l..nr rh.l lt o, rrE a lirn-rt nuNrlll
<br />kl rlE In'rn$n! oltE ConrErc ! LFcnErl bw (CluFd 9- Con@tint *rh s.dion 7IxI) ol lrivhion I o, tlt Butift$ .nd
<br />Por€shnr Cdc ) or thrr h.or sh. i1.rcr?r th.nrn' rndrh.ba\hrdlh.rllc8cn.rcq,lion An, liolsrk n or sda,n 70l l 3hylny
<br />rnt icanr tu . Fmi {hif,k rlE rt lli.rnr lo r civil t.Mll y of d fr,E rh.n fivc huntcd doll$ (S5(x})
<br />-1.
<br />,r orF of rlE FiFnr- tr n, .i{,hr&3 *irh 1116 .! rlEi w'L 6n+..di4 will & rlE xri dd llt rrr!ft ir d
<br />id<d.d c olIcEd fd {L (Sd 7(x4, 8uliHt md Pmf6.hnr cod. TIE C.ntdri Li.r u* {t*. mr rmry lo x oqF ol
<br />rlE IrmIEny whr hild.or iqmr rrtEr.8l *ho.16sh k hidElt or h.r*lf o. rlmuah hir or h.r own.[Pb]s.
<br />pbvl|d lhd iuh inFsEmnE n rl hi.d.dndtu for Blc lt l$EE, rlE l!l}lin8 or fltmEEIl ir ild within otu )Er
<br />otdrtpkrir {E o|Gr Bui8cr }i[ lrw E hnln ottmvi! u. rErJ.dn 'd hiu u intftE
<br />'lE FoFry ftxllEF FEof
<br />I. r\ o* mr of ihc pR,lx ny. !n crcluntrly conhd n8 sith li.cn\cd (rnrldoN i, .o {tu.r r hc nn,tlr (Sc.. 71ll.1. llunm$
<br />lrn Pn,kadn (-,'d. Th. Cr'.ircttr \ l .i(n\c ll* d{rr nn lplly i(, nn Dertr ul tlr,IEny sho hu rlJc ot impm vcr rhtr..n,
<br />rnd *h) .oddr tu lNhnmFt* hn(.odr&1onn liu<rl plr\ud ro th (i,drr(r'1 I i.nt L:D)
<br />J rn' r(nrli !,Llr, \(rn{
<br />lrrlr
<br />llaf,{[x5:(lllltrdsAll0li
<br />TESJ&IIII]d
<br />I hcrby 'ffiriu.dcr Fnalry ufIE u.yuB.frh.lolhsm3 dall .ri'ni
<br />-l
<br />hsE ldl eill minllin r C.nirrrr. .r Co.rnl b S.lr.INUE ror eorls cn,{Endion. I povid.d ftn by sdirn l7m of lh.
<br />ljtrn adJc. nr rlE Frf.lr!.tr. of rt ro fd which rh. Fmii ir irrnd
<br />-l
<br />h3\rlnd rrllmi r rn *ukcr' co.rFrror bo rnsururc. !r EIUmd by sftrhn lrlx) ol rhc l.lq Cndc. tu rlE Ffomft! or
<br />lh. worr L{whi(hrhtFnnil is isiu.n M,*. sr'onFns,rion 'ntunrn.c.aEin ml Flicy.!'nbc. &c:
<br />I\,l,ry N!uti r
<br />-l
<br />c.nilr ri.r itr rtE pcrformm. or'h. wo.k ro. wh.h rhix p.mir h its!.n. I {ull nn.mpk,y {ny pcMn in rny mnmr
<br />{ ds ro &om $bFt k' tlt wr6' o'r{EBnb. Lu nr Cdifomn. .rld rgft rhi ii I nDUh l*|*.m $tFr r0 rL
<br />mrt6' oqEnerbn rmvnioN of Sdirn]7(Dof rlE l,rn Cd.. I rlEll. fdhunh si{i} } h ll|r- Fori\nF
<br />WARNIN(; ljsilurc ro $uE workcE .u6p.ndion .ohEgc i\ unhwlnl. rnd \hrll subjel an.trpkr,tr lD Lnmirul p. tiI !trd
<br />.ivil lin.r uI' ro or hu Ed lh.uBnd ddh^ (SluJ.ln)), in rddnhn rn rlE .o of $qrn{rio. dam3.r !r tmrit.d lir th.
<br />s.crh. 1016 or rlE Ulr, (ii.- idcEr in dtlmy ! rF
<br />lrtr.: Apptoll
<br />r rr'rmri crrrinrr:rrri
<br />DECIISAI!]N
<br />I hdr$y rrm md.r FMhy .l F,i'r, rhrl I u lir.r.d u.r&r FBir of ( lqn( 9 (o.ltlftrng *dh kiB 7(u) I of Dartbn l
<br />oa rtE Bor6r.d Pnl6lbm cod., lrl my laffi ir in tull rore,rl.llal
<br />colsiltlrcflo l r'{DlN(: ]\(:riil'r'
<br />I lEr.5y lro !n&. FNlly ol Fryry $d rlE t. on(n!1i,n bdins 4s, ftr rlr arrf(mt.f llrhrl li, lhih rhn Fd ir
<br />n:rEd lsd lll97. Cit C r
<br />AITLIIAILIEOAf,AIIA!
<br />I h6dry ull,n und.r licdslry orF jury oft or rh. iolbwinS ddL,rlions
<br />l}mhion P.rnirs.AttErr$ Norifr.rir r.d.nl Rctlbri,$ (Tirk!{r, Pd6)
<br />-R.quiE{
<br />l.trsolMriruliI
<br />_l..nilytlBrrhclcn.rrl,cllulJro \,t*,r(ling r\tr{!^ rcntrrnlnr( tr,i ippll.rn. k' rhA pn'r'.r
<br />-l
<br />diry fid I IEE En ihn .pf,linlnn 8r {r!. rh.r rL d.r oroidbn a .ffi I rs- t, o.r?ly *hh .ll Chy r.d Coldt
<br />onirEq.rn Srrc ll*! ELru! ro h,iUin! oBrirlirtr !n hdrrly.utbraE FFR tIiH of rhi( Cny.d Coun!, ro..rd '{r'. rtr
<br />rbov. m.ri.Ed pblEny t insF.ibn pEFm
<br />,llplicenl.. A*.rtSiAmluF
<br />Site-Work ..-?(*)..
<br />Underground 7,3 o./6 r 1.4*s,,.t,tX,/ ;71^L l) .- r_r/'
<br />Pole Bases t.dl-Lzla*L ht ,i,ll
<br />Liqht Standards aD
<br />Spas, Pool, Fountains -t-Siqns (monumenl)
<br />Life Salety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bondino / Groundino / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinos (Hard & Solfit Bouqh
<br />Ceilings (T-Bar Rough)
<br />Rough
<br />Service Meter
<br />FINAL
<br />Notes, Remarks, Etc
<br />ELECTRICAL.INSPECTOR RECORD
<br />Ltlrc CLs
<br />-
<br />Meter Release
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