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ELECTHICAL.INSPECTOR RECORD
<br />APPROVALS ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Lile SaIety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Groundinq / UFER
<br />Translormers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough
<br />Service Meter /)
<br />FINAL a firlll{n,l&!t )tl'"r'- -F) t'(/Notes, Remarks, Etc
<br />oWNl. N trIlt!-DFI DEI-('AT TION
<br />I hcdby rmrm u.dd Fn.hy of perjury thlr I !m cr.mlrr fiom rhc C.nrBron t-k nk trq ror rrE irllowin8 rc$'n (S.{ oll.t
<br />Auri6i .'n Profcsi'n Cd.) Any Cir, or Cdnry rh(i Ertoi6 . Fnn ro oNr.u.l. ir6- itrltolt. &mlnh d r.Fir r,,
<br />(ruduc. Irir ri, fi i$uaR. dtu Eq!t.1rh. q'pladt ntr such Fmir x, iib ! lasftn dn.m.r rhi lE or rlE is licctrs<l tl!@d
<br />lo lrE rmvishnr olrtE Co.rrrlort t,iansn L,* lchllrs 9. G,nllrE in8 *ilh S.crh ,0(1, of Divirio, .l of lh. Burift$ lnJ
<br />Profc$i'nr Cod.) or rhr lE n th. i\ .rc'r?r rtrr.fiom.,ri !h. b.rn for th. llt8cd cr.'q'rhn Anyti,hrionolSdinT0-r1.5 hy..y
<br />rnrli.&.i lu r p.mir iohj(k th. applicr n' rcivilpcMllyofftn nna ltln l-rv. hr.dr.n dollds ( $Jur)
<br />-1.
<br />!. owE {f lh. pmFny, or fty.mploFcl *irh w!8.r 6r ih.n s'l conpcnrd bn. *ill & llt *. i.dtrEintuaml
<br />ids'd.d d otu rd qL l sft 70,14. Au.ir( .,td Prof.$bns Cod.: T& Comrld c LinE L* d... tEl .t'tly ro rn o*tr o,
<br />rrE Fotd, vh, txibr or inF)B llEoG rn *b dE ch kn hin<lf or lE.ell.r lrmuSh his d lE own cnpktF6.
<br />lrovid.d lhd luch itrqmEmnk d B, ir.nLd orol'EEd tor el Il t6sE. fi. tuildins or ry.nEr i.s g,E snhin om Fr
<br />ofonpLrin rlE orE Euilk,iU h.E dE h!d.n of FvilB llli lrddE dn r{ l[i! c dtmE IE FoFry fctuF peof
<br />-1.
<br />N owmr olrlr FrHy. !n.r.luriv.l, rndralinS rnh lirnkn sdrr16 ro @nrM llr FF (Ss ,()44, BBitB
<br />rnd h&sshncod.: Thc Conrulor'! Lic.n* Lrw d.E! d +,)ly ro an o*..r n l r,oFn y uho huildr or idnroE lh.r.on,
<br />..d *tp nnrdh td trh FDFr f,i'h. Coddrro lEa<i rrFrr lorltCoi.-ld r ti.ns l,vr
<br />I .ncrcmpr udd S(|b.. B & PC r,trrh^ rcuqnr
<br />lur86Eer.:gruflNsArlalI'ECL qAI{IN
<br />I h.rch, offirn lnder Fnlllyol I'. jury om nfrlE tult,ui.g Jrtl,rirk,ns:
<br />I h r r i Rrl einrlin ! (tniarur. of Conccnr ro Sclf lrso,c t, worlar ompctrqnon. us Pmvid.d for by Sdrirn lTtD or lh.
<br />l,lr (ixL. rd rh Fr(ffi ol rft ucl l *hihllE tEnir i\ ns.rl
<br />I h!v. tnd *ill Einr.in wo,kcn compcn{.rbn inuorc, &r FqliEn hy Sdbn llm ot llf t$or Gd., fttr !h. Frfollrwc of
<br />rh. rfil rd whth rhir Fmn ir i!*d My dl6i LlnFnetbn an.uN ffir .d Frlty nunbci e:
<br />, enrryrnll in llE Frforrore ollic work i(tr wiih rhir !.rhrir h is\Ed. I $!ll nor tnpk,y iny Fno. in dny mrnrcr
<br />$ as ro h(ar 3uhjNr h rtE * t6 6rtrn€li'. Lwr ol (difomk. lrxl lsr lhi i,I +$uld hc.oE roblc.r lo llE
<br />H,d6r comFneri,n Im!'rx,ns of Sdirn l7mnrrh. t:h, On . I {dl- lonh*nh $n{ y w h rlbt F.rnh6
<br />$ARNI:i(; I'r,lrrc n, Qurr u.rkeN conD.tr\rtr'. c.rc,itc '\ unb*lul. rnrl \htrll nrhl(tr n. cnlPl(,\!r t, (r'mrul Ftuir\.'xl
<br />.ivil li'r\ up ro onc hundril rhou\r'rl d.ll \ r1l(xr.(l[)r. r rl(lirion ro rhr .o{ of.o \qn\rr( . ! u3.\ !\ Pn)vi{td ntrrhr::t1#4 inr.rc{afrl onr\'\ fe\
<br />ull!.lu_La)-uurll)B
<br />IIT!:LAB^IION
<br />I h.Nb, rrtrr unhr IEEi, ol F ry lLtr Fovtir. of Ch.|,s 9 l(,llirEina siri k hn 7Cm) of Divli.n l
<br />,n rh.llu\nN\ md Pxnc\trtrtrCo,|(. xRlrry la.tr.e n fl lL'llf, (.:nlrrlrrr
<br />L
<br />L(
<br />,dn{Numrra to/+l-g q
<br />.ilq ))-vttltt-
<br />I ltrhy rffirn und.r FMlry of Jrijury llur I ir r on{ 1i,n k.dm! r8.r, lnr rhc l..lornuNc of rh. $nrk f.r u hth thn Fmn n
<br />AITLICAdLI'AIIAIAIII]N
<br />I hrdry dfm undcr Fnrlly ol pc'jury ot oa rh. [.!lt,*in8 ddLrdnns
<br />I)cmrlitk,. P.rnxr A\tEsl.r Norificlri)n ftd.Gl R.Buhron\lT k tO. P!n6l
<br />-R.quiEd
<br />l.rrd o( l*rifr'dim
<br />_l Nnir, rh.i rh. t d.El FllhlrrN r8anm3 rilE$r rnrul rE r, lpdilnk ro rh,. pmFl
<br />> r.d,,r, +,, r rllf,,r,r,. rmri. tr1rnrr.rr' ,rt.'hr
<br />,{,l rks rrilvrcrr". mllhE tn hu'!nn!.,,n{turx'n fi'h.
<br />.,t""cN,,;\rrn(Fnyr,".
<br />.0,,n-,-"Xn-'* D\0491'
<br />! inft,rrEli)n is cocl l.rrEroom
<br />rlb, uLri- EF.<draB of thii c
<br />-
<br />Ihl.I
<br />v
<br />217L v
<br />-""'-- D tbv^"\P.dili &,.{t t.t,r/I\]c1t"y1 utv
<br />DATE
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