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APPROVALS DATE ID/SIG. <br />Site-Work <br />Underground <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Life Safety i Low Voltaqe <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bonding / Groundinq / UFER c 7 ta ,5 c-'t,N )* C..2 <br />Transformers I <br />Torqueino <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Solfit Rouoh <br />Ceilinqs (T-Bar Rouoh) <br />Meter Release <br />rl <br />Rouqh /,J ts B*n-bt <br />Service Meter e ;l Itll bv ) C-'t t * y9<4 <br />MFINALE 0 ,Uflra+' <br />Notes, Remarks, Etc.I ltl <br />OWNDR AUILOFI DELCARATIoN <br />I hrrcby afllrm und.r p.mlly oI iErrury rtar I an crcmfl ln)n lh. a)nrsr^ l.f,cn{c li* n, !!c tollo}o3 rcLq,i (sd ?0.11 J <br />Eusi'rcs ond Proltsion C{d.r: A.y Ciry or Counry uhih rcquito\ , Fnh ro ..n{B.r. !trd. in{'!i'w. {h;nnh r En{ii uny <br />nd.ruE, rhr r. irs issumc. lls Equrcs lh. !!/k!nr lor iu.h Frnril x' filt ! si8rd iur.mnl rh{r lt or \hc i licca*d po^kn! <br />ro rhc !ovnio.\ of rhc C.nrrscrolr l-i...{d L} (Chxprcr 9. Conft^_in8 wirh S(!tr,n 7lI$ of l)ivisi,n 1 of rh. llu!rc( 0nd <br />ft.f.\\ion. Cdltl .i rhar h. or rh. ( cxcm rh.rcfromand rh. hsln tor rh. rlb3dl crcmDri,n An,vi'krn,norSsrirn70ll5lry'ny <br />+|l!.rnrlor.lx.nrirrubFcklhc.I)Plicanrloscirilp.ngl'yolmrmElnufiv.hundrcdd{nEr(S5{x)l <br />_1. sr owftr of tlE r.orEny. or nr, .n! oFr wirh *ra6 I rh.n ok ornqEn$rion, *ill d' th. w6t trn dE il lE i! n,t <br />ddrh orofid.n tDr ek lse.7oJ4, Busimrs d PrDf6sionr c-d.: TIE aonrrloir Li..{ u$&Eirorqipl!t,eorm.ol <br />llE Fqdy who ttrilds or tlpmB t,Entr sn wb dE sn w him.lf or lE ela nr !hn,o!h hk 6 h.r osn .rf)hyei. <br />Ilnxncd rhsr rui in{rc\ftdr ft br iddtd.d tr.iftlui fs sk li h{rE. rh. h.ildir8 rr iqn,EBd t {'ld *lhl' ix Fr <br />ofrnnpLri)tr tlE OqEr BuitLr rit, h.E llE t!,tL. ol FDtuE tlEl,Eo, rlE dd r, tliB or in!,oE nE F ldy n, r F,IiEol <br />_1. rr owF.arlr I'rTdr. m.rchr*il, $drdi.8 wnn larnrd $.rdo6 !o drn{dd rL F,rd (S( ?t*1. Bu\iEsr <br />lnl Pm6sih(rt : Thc Contrrlors Lic.ne Ir dcs ml !ml, io .n oqtr or roF , f,h) h0.[\or 'nD,!,v6 rh.rn,n. <br />0l--".-i@a/ <br />d *ho 6ddr fd trh FoFr tnh r Ct Mon() liln{d prFud h <br />'lE <br />Codr <br />-l <br />rmerrn udcrSNri <br />ul!u&ura-\ <br />I h.r.ht .finn und.r t MIry ol JI'lr folh*in3 d.cl&1ion\ <br />-l <br />h.w !d aill mi .b. C.nifrn. orc.nsr 16 sdr-l@rc [r wt6' onFrdiotr ri Fovii.n for b, S.daon ]7[) of rlE <br />tltEr Code ld llE Ffm of lh *ct tor *tth llE Fnn ir isGd <br />_l h.n,nd * l Ninbin *6 .n .oqxmr-rn imunk?, r EquiFd hy S(rrn.l?(n.l llE LlIr Cd.. ror rlt Frrrfu or <br />r,E h.t nr *hah rhn Fmn ir Gerd My vdt6 6,rFdi,n h{rrR ffir !n llliy tudB e <br />-l <br />(drry <br />'h.! <br />in rtE FrfotER of rlE torl tq *hi.h lhn Fnn t i.rd. I rhrll mr .q*ry ..y FRr in rny .MEr <br />r, {s tr ttsm r!6F o itE Bdr6 6,F.db. b*3 ol cllifom!. r'n.aR thd if I lhruld lEsw rrbj.rl iorh <br />*0116 orr.ns.rbn Fnvirkrni or sdbn 17fi) ot rlr bbo. Cdr.. I ndl fdhunh o"pb rfi rlt,- Fn*ili'nr <br />.i!il fim( up ro or h!.nEd th.uqd dolbr( (3 ).If,f,)r. rn.dlni.n to rh cori ol c..!iMn <br />SNrrn ill76 nl rtr trtFr C{id.. hrc.c{ .Ai <br />I heDtry r! lirn ud.r FnrhrofFrlur,I n lictrrd u.d.r Fovri)n olc}lprd 9lc'nn <br />of tlE BuriEs 8rd PDf.sion\ Cqlc- nd my li.cnE n in tull loc rn .r-_r <br />coxsrBuculruJADt!!,iltiElcr <br />I h.Eby ofrm ud.r I{ulryof FrJtrry rhlr rh.r. n a 6.{Mirn k.dir8 r8cry ror llE Frfmlr orrl. krk nn eikh rhn Fni ! <br />n.ud(se. J097. civ c ). <br />ATILICAI{TDIII.ABAIION <br />! hcr$y umm undc, Fnahy ofFrjury onc ofrhc {olk,ui"s drch'arn,n\ <br />D.mriridr Pcirnir+Ashcstos Nolilicarion FcdcrulRcgularior (-lirl. .lo. l'd6) <br />Rcqurcd hrrcrnf Norifi.ilkn <br />ld.rrltlul.[i,,],eg (l$! islr{!\ (r,i*rlr. tr.r,'t,t,lkrhl. i, rhA |x,[(r <br />rhd rhc rbvc irlor rrn,n N.utr!(!grlr.t,.o'nply srrh rll( irrnd (i,utrry <br />ivc\ olrhi\ (-iry,Rl (irtrrt r,.rro ur)n rrtrdr Il*\r.hr ak,bu,lJ 4/,1z1-rl <br />f 0e)+(-'Zr a L:,r-A <br />ELECTRICAL-INSPECTOR RECORD <br />COMMENTS <br />Lrnnc''( AJdr$