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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS ID/SIG,COMMENTS OlryNT.R BUN,l)Ei DEI.('ANATION
<br />I hcrchy afirm u.dcr p.dlry o, FrIrry rhar I dm.r.n! rft'm rh. G,nrEd.n l,irnxr lxlt rrr !h.lolL*itr8 rcai,n ! Se.?0.11.1
<br />BrnBr ,d Prof.\iir (_d.) Ary Ciry or CN ! whth EquiE* r IEhh ro 6dd. .lrd. irq'mE. d.tulih ol FF d.,
<br />.tru<turc- Fitr h ns irM.. !L$ rc1utur rtr +nla.nr i(tr ish Fml h nh ! rismd {.lcE rhlr lI dr.h. ir Lc..ql PuMnr
<br />k, rhc Imrlisr,nr or E Contm.(,i Lic.n€n LB (Cnrtrd e. Ormrh.-i.r wirh smrn. 7(u) o, Divisi.i I orrh Bunfts tnd
<br />Pn{c!(nnr Cnd. r or thd E m rh. is .r.r! rh.rcfroNnd llr t-iii ft, rh. rlk8.i ct q'lhn A.,lnLrnnofsdio.?oll:lhyiny
<br />arrlicrnr lor a F nir {bj(k rh. amlk.n! ro r .ivil !.n, I y o{ not mrc th0n nt hu lEd dollsr (!5(xJ)
<br />-1.
<br />r! ouEr of rh. I'0Fnt. or my crpkrlt\ *nh e.r6 rs tlIir r)L (,n{Eflelio( will d, rrr *ql drj rtE {Er@ n n
<br />idcnLJ or u,T.Ed for $k ( Sr )O+1. Burirc$ rnd ln'fcs*rnr C.dc TIF C.drkt.r'r l-k..€ tlr &rx mi ipfly k, !n or rct ol
<br />rh. FId, $lr' hill. or tqnr6 rtNr inl wh' &B uh w't hin{lf o, h.rslf nr rrmlai hi! r }s o*n.r{'by6.
<br />pDvidcn rh{r ruch in,pskftnh m d inr.toi.d or rcr.d for aE It kircw- rlE huildmr Dr ntmEmnl t $H *irhin onc )tr
<br />orrnqrhrih. rtl ()s6 au!!.r rill h.E rlE hd.tr ol ForlE rhc lEr{ri,d d r Ui, ir4m* 0E FoFny t, rlt Fl4r{ or
<br />I. !i o,tr.of rlrc Flrny. $r.r.luriEly(odBrr! rirh lt.n<r $.rdnF h on.ltul rlt rmiTr (ss 7tr{1. BurEr
<br />! h'fFtin Co,.le Thc (i'nrndof r Li...rc t,aw dmr not imly lo !n oercr ol PmFdy sho huiHr or imlmki rh.rdrn
<br />.nd *tn odrdr fir ixh ImFk *irh ! (i, Blorla licnrd pu^ud b rlr ('o.lirlm \ Li.os L,tl
<br />F:-i#;)t1
<br />tll:lLl&ulal
<br />I lxrcty rfiirm undcr ncmlry or F,l]h. ur orrlE (lnl
<br />-l
<br />hrrr.!n wil! mllll.h. C.nifo!.orCon(nr k! S.ll-|.w. fr, rvl ..rrENtirtr, !r F,vid.n fo, hy sal-,n :17{n of rhc
<br />ti$r Cndc. frrrh. pcrlnrruK frh.hrlfitr*hihrlrnth h^arJ
<br />/r+'68 !d *,ll m'nrln *nrr.^' .urr{Em.r $n ,nrur.rc. .! Equircd h, SRri,.lTtl) ot rh. tihot Cod.. for rtt Ftiyfrr..l
<br />ih. w,rt l,{ whxh rh^Fmn! rt Fsucl M} *orts mnt{nrrhn 'n\ursr.rffir rn FlEy nun*E e
<br />c^,*, <.1,-a-4-t'
<br />a,ri"yr,.u, J D oooO 2J<f I
<br />r rrr(. !l 1,t,"
<br />-l..nifyrh.r
<br />inrh. n ra.r@tuc ol rh. rort f(tr*hrhrhrFrmir i\ i\181. I dull r{ .f,pL,y tny Fre. inlny m.rcr
<br />$ 'rtrbc<rm t'Fr !i,rh. e"ri6a co.rr.nrol ion bw\ ofcllilornn..nd r3mrhr ilI rh.ull tEcoE hJccrhrh.
<br />uo*d( tuqrnqri{ I'nssioN of Sdin l'7(x)ol'tE 1llfl Crl..l {Ell n'nh*nh m,r?ly wnhlbr I,Itrirnnr
<br />WARNIN(; l'.rlurc n) BU,c {ork.^ crnrp.n\sri,trr.orcfu!.,\ utrlrrlul. .trxl \hrll \uh}ar an dlllk,rr h lrmrnrl Ftr'hr\ rnd
<br />iril llftr uI' b oE hurl'ld rLrn.d d.lhrt (!l(n.flX,). in linn nr rll o{ ot.onttN'ion. d.,q.3.r F !i.rl ror rlE'l)':l.id(. tr cre{ rldrnry'\ lt.\
<br />I appllunll)6,,.
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<br />ull]jKu&:
<br />I hcr$y lmm unds FnrlryorF.]!t, rhtr I am l€ns.d !M.r Frvnion ot(]Ilnls 9lommftin3 *irh Sd,n Tom) orl)i!i\ion -l
<br />or llE Burtr.r .nd Pmr.iihnt Cod.- .d ny lidr it o tu|, tom ,,n dfdr
<br />b
<br />f-* t,/t,.>(
<br />I trr',rlt !i&r Ftulry or Frlry lhr E t. oNlM.n ldq.8ftt to, rrE Frrtm orllr ert in *hkh rhk Fnt k
<br />n!u.d (sc.1097.civ. c )t.d.irN.m.-
<br />ADPLIC NTDE(I A[TTIITN
<br />I hsrt, armn utol$ p.nnh, of p.rJurt om ol thc Llhsitr3 ddlorlrh,n{
<br />Dcml,rrn Pcrmnl A rnor t*nrff,'r.n tu rrl Reubrhn. rTi!klO. Prn6r
<br />-R.n!iBt
<br />lrl.r ol litifft rrn
<br />l.cdrlt rhnrth.lcdcr.lEtulllioo\ ES'nIng r\lino\ rcnr)vrl rrc norrpnltihlc r. rhN !n,F]
<br />l.cn'ryrhxt lhrlr r. l rh'!rt1l,l(rrnr nl$ rcrhnrrh ihrer l'nm ntrtr.on&r lrg'rrk,ro rfl!sirhtrll(-irvrRl(,n r
<br />dnrrdc$Jxt Srric l;*rRLnlt r.t r in3 con{elirr rd hci.h'riE rcF.€rr.fits ofrhii ctr, rrn Cou yb016uF,nrlt
<br />Jhrc nrnri,nE,l pn'p.'ry in i'rpc.ri)
<br />\pplimtri trr \!cnl \ixn trrr I ,->r',7
<br />-,o_1 Pa_-.a yA(--
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Lite Satety i Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Soflit Rouoh
<br />Ceilings (T-Bar Rough)
<br />lr,4eter Release
<br />Rouqh l/6.+?(rd
<br />Servrce lvleter t -t '^
<br />FINAL -7 1t\v 4llc{t,t)
<br />Notes, Remarks, Etc
<br />)
<br />DATE
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<br />Lrtci' Adnc$
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