ELECTRIGAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS O\YNER BUIt'ER DEII'ARATION
<br />I hct{,y .lrm un& p6.ly of Fru.y lhr I - aoIB nrr ih. Gdd6 LilE L$ for tlE folloMB l@n (s<701I t
<br />Bs'.s .d Profeibn Cod.)r An' Cny or Cqrr' whth Equi6 . Fnt ro or(tkl. ![6. irp.DE damlith or Epqi oy
<br />nrudre Fi,r ro irs (u@c., .L. r.qon6 rh. @plicur for such Frnit h 6lc. liso.d nddd rhd li or rh. i! li.d!.d lluerir
<br />lo rlE Foyiliod of tlE Coilr*rtr'' l-ic6!.d t * (CtuFa 9, CoMtrin8 snh SErion ,000 of Divirion ! oa rh. Bcind .nd
<br />lmfdbN a6d.) or $d lE d rh. . ddlF $dt'M rn llE b-6 aor rlE .lk*.d ddprhn Ary v6hb. or Sarion 7l,ll.5 br !I}
<br />tpplMnl 6r . rErDit !ubj..tJ llE .Iflicanl ro . dvil F nrofNl mr.rh., n!. hundr.n doll,rs tl500)
<br />I
<br />l. a orE of llE P.oFny. or mr mpblc { nh *.96 - rlEn nl. onFsiotr *ill Lh dE srrt -d dE rMG n d
<br />iddrid d olIa.d for !.h ( sa.7or.l, BdiI6 nd Piofdi,B Co&: TIE ConrslG r l.trou ls 66 nor rDly ro o osF or
<br />thc FFty *lF hlil<l or inq!6lhsEn. nd who (h6 $ch h.t himr.lf or h4lf .r fimueh hir ot hd o*n nplor.6,
<br />F$riLd rh, rkh inlF$tnlrfu cd idd'.,.d or oIH 6r.t l[ hon6q. th. biBnB or uFflqEi it Fld *inn,q rrof.orpkio( tlEo\rE Blilla sil brdEhiboaFoE* ilr ltm$cdn d hlld c lqhEtt FDFty 6r r,.F rEor
<br />L B ou6 otrh. Frrdy. d .rclBiEly .orrfl.1iry rnfi ka!.n codtuoB ro mdNd tlE FrF (Sc 7014. Bdlind
<br />!,n Fokin Co&: Tn (oddor'rLk.elru dd er @l) ro ooyc orFnFrt *t L{'ld.or inprord rnndm..nd stro o,tddi f( 3u.h Foiclr vnh ! ColnE lo(r) licas.d pllRu!,n lo tlE aor ..dois Laru L.u )
<br />I !r .rdF und, s<ur
<br />D.l. O*o.r
<br />$oru(r6;aoMPrns^TroN
<br />DECIJAAIIq!
<br />I ha.br. .mrm o.dd F.rr, oaFlu, r. nrc of rlE folh*ms &dr.rnN:
<br />l h.vcdnsill,Mmr.i..Cdifi.d.of (i'1hr roS.lrll]!cfttrno d q,nFadkro. a Fo\rd.d a.rhvSdrion rTu).ftlE
<br />Ilhr Co&. f rh. Ffd'rm. of rh. *oA rr trnih rhc p6sir . (u.d
<br />I h.!r !.d qill m.intlin sorld c(mpdll ion iNur.n.., a r.qoir.il b, s6r io. 1700 of rh. Lrtbr cod.. lor rh. pafonnr(. of
<br />rh. qlrl lff *hth lhE rEmii b is,.d My rorld NnFsbn iBuft. ryl' rn Fli.y.umts m:
<br />X.(ditrhd i.(h.Fror@r.of rh.worl ror wh(hrhirFnn '! i$u.d,l rhall nor oploya.yFcon in inymann6
<br />ro b...G bjd n, lh. wultd' conrEr.lhn hs..lc.liaomn. Md laE ri.l if I 3huld iE oft subj(r l,' ltr
<br />u..t6 onIEdi.n FririlN of s.crion 1700 of ihc l.hr Co<l. l tdl. fonfi*nh smd, s nh rEE Flvilpd
<br />\'lARNlNc l;.'lutc lo R@ *.rlm' co.rFBnlion cor6r*c ir unla{ful. ind ihall 3ubrdl ollo}s kr cnniol Fruli.s MJ
<br />rlhugnd &rllc {tloo.uro). h sdjnrr lo of comFBxon, dau*6 * prcvkl.d tor lh.
<br />.&. miFd &d.rorEy s fc
<br />I hd.r,y aJttrn unds p6dty o f psjury lhal I m licat d undd Frvnion of Ch+la 9 {romndcins with sdion 7000) of l)ivLi.n ll
<br />or lh. BaiB dd PNldiiE Cod., an mv lk@ ir h tuI aoc in.fidr
<br />vop/fib 'z-1/{
<br />I hq!b, rfm uids Frty of Fiury ftr tlE! ii . @rdMir knnS .S;.y ror lh. Ffoffi olrlE *mt 6r whth rhi Fnn i!
<br />isucd (Sr 1097. Civ C.)
<br />ArtI,r(aELDECtdaAI]A!
<br />I h.!t'y .trmn !.ds pd.l, or pdjury oE ol rh. rolb*i.s d4Lrdi'n!:
<br />D.mlnio. Pontu'&bdoi Nolificrion F.dsrl R.auLl ioN (Tnl. 40, Prn6)
<br />R.qur.d Ldld ot t*iifdir
<br />I .d! ily I hd rh. r.ddll r.sulal irN r.s6dins Nb6los rmoril ,. nor r{'pli(.l'k to thir lroja:l
<br />I c.iif, thd I hn. rad rhi.r?li.ditrn &i r.r. rhd 6. ibo( 'ifi'niii.n B.orcci. I.{rdto conpl} }ith.,lC(} lid ( ounl}
<br />.'dtrn (6 and sr.t. ljss Flding tu tn'ildinS (or{ru.i
<br />!bo\. mlion d l'npcly lor
<br />Appli(.nt or ,{rdr Siln{rr.
<br />wlY?-.laae
<br />^.^:,;/iil;"
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life S /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Bu ilding
<br />Bondin / Grounding / UFER
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top E uipment
<br />Walls (Con duit)
<br />Ceilin Hard & Soffit RouS h
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough
<br />Service Meter
<br />FINAL -l/?/D '- \6 .e|H 6X
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<br />I
<br />I I
<br />I ILight Standards
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<br />I
<br />Under Slab / Floor I
<br />Transformers
<br />I ITorqueinq
<br />I
<br />I
<br />I
<br />IFactory Wired Unit I
<br />Walls (Rouoh)I
<br />I
<br />II
<br />I
<br />I
<br />I
<br />l.,lotes, Remarks, Etc.
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