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APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Sions (monument)
<br />Life Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bondino / Groundinq / UFER
<br />Translormers
<br />Torqueino
<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 Rouoh)
<br />Meter Release
<br />Rouqh
<br />Service Meler EO
<br />Notes, Remarks, Etc
<br />I lil\4rrY
<br />O$hIEI SUTI.DEI DELCARATION
<br />I h.rcny .ffirm un&t p€turry ot F.rlry rhlr I m crcfrfl f$n rlE ((hlrEnn l,i.n* he nrr lh. followins EaYr lSdlO]LJ
<br />tturircs !d Pml6\h. Cd.): a.y ciry or Counry lhth r.auiB a rErd ro 6h{n*1, 1116, irqtot. dcmikh or EFn .nv
<br />\hdm, Ehl ro irs h.uftc. d$ EauiEr rtE qrpliMr for rkh Fmi kr fih r srSEd ndrctunr rhd rE.t rrE ir liarsn pu.s l
<br />h rlE rrorni,n! o, rlt Conrrloar Li..nEd tr* ((.hrpld 9, Commtin! wirh s.ttb. ?{ID of Di*bn 3 otdE suriRs rnd
<br />horcsoNCod.,orrhrthorllEt.x.rynllrrciionrndrlEtrirldrrErlk8.d.k$I,lnn.4.,lilLri{orSd6n?011.5l"lny
<br />rfi'li.rnr rM . Frmir .ubFts rh. lmlkDr ro . ciril F lry or not m,E rhr nvc huidrcd {k l8 (!5m).
<br />-1,
<br />r wE. ortlE FoFny. d ny.npt yR3 *nt *ls6.r llEb nk 6n cnr.li4 *i! dr rli kri !,nl,E r.rie k ml
<br />ifl6d doficr.d fr sk lsc.7ot.. BlriBi rnd Pr.t ii,N CnL Tlr (ltdErmt lit^* t,w rrE m'.FPly lo u 0\6 or
<br />rlE DlnrEly *ts h,iltr s inproB dr@ rd wlD r,.s ut srt tiEtf d t-trf or rtmulh hii q ts o*n.ri?bFi
<br />pnlriLd.hd tuh inprcEmd3 E dr dsi.d qolldEl (r rk ll lrw, tlr t!ild!t! d idthEffi ir $B eani! oE )s
<br />ofqnr rira th. O*F Bu k wil lrE lll b!d.n oa Fou!ts tld L d t|t dn d hr! d irFlE ItE FoFry &. ttE F{rE of
<br />-1.
<br />s mE otrh. Frp.dy. u.r.tuliEl, s rrrhs *irh litn<J.rdrloF k' Ntrdnd rlE FDFd (sd ?0,{.1, Bolis
<br />rn h!6<si. Cd.: Tt Cor tn i Lk..€ hw dmr mr q?ly lo u o*tt or FtFn, wln lloildi u ihphE. tt{6c
<br />rnd rb sdd. fd trh FoF.r3 rnh . C!'rrx!{nlr, lis<d Fllud b tlr Cofir1m.t lrtr ti*r
<br />_l m.rcmpr u.d.r Scrbn
<br />\a ()RxeL$ c(rr\tpF\saTl{r|t
<br />DIO.ASAIIO!
<br />I h.rchy lmm unds lrMll, ol tEjory otu or rrr rolh{ing &thr.linn
<br />-l
<br />h.vc in eill @inhi. r Cdifrrt. of CotrEnl lo Sclf ln\ur aor trtks $mIE.!.|b.. I pDvd.d tu by S..tion 1700 of rl!
<br />Iihtr Gnc. nf, rlE Dcrf@. orlh. mlr ror which lhc lBmil ir iocn
<br />Ih!\c nnd willtrrinrrir ro crs c.mncnuin,n i.\ ranc.. xs r.1]nrcJ hy S(i ii'n .17(r, or rrE I itrtr codc, artr lhc PcrfqEt. or
<br />rh. *ork rorwhi.hlhis p.nnil is kscd Mytrork$ .omFn{ri in\urakr.ni.r (n pliLy non'lxr dc
<br />)t iNet 1 .\
<br />l..nily rhat ir th. Irrli,rmN ofrhc work f(tr rh(h rh* Frnrir N r$u.d. I \inll no! rmPk,y lny Fnon i" !.y oMn.r
<br />$ ,\ b tx{rm \ubj.{r &, rh. vo.k6' comFnrol ion l!r{ ol Coliturni( D t rseihul rlI !lr)!U rtmtu ruh].d hrhc
<br />wo*c( ron{rMibn pmrsbns of Sdion l7u) of lh. l ikn C{xL. l \lIll n'nhw h u{,ly *irh rh't pmlisionr
<br />WAf,NING !i,hm b rcuc uorlcF cimpcnsiion.orcr!!. '\ u b*lul. !ft] rh.ll \ohlc.r 16.mPkrfr Io simiul FMhi\ rnd
<br />riril lln.s u! ro om hu,ind thous.nd dnll6 lsl(x),(,(iD, 'n
<br />rdd nn h lh. con of.odF.sho., d!m36.\ proli]cri rd rh.
<br />Sr.rk lO16 ofrh. ulnr CoL. inrcrn and o.my'\fft\
<br />lpgllalaa
<br />I lEEty lltrn ldd FMxy or p.dur! thll I s lienr.d un&t Ftrtraon oa CrrPrd 9 {oltmins *nh sd Dn ?ur, ol Dnisit l
<br />or rrE BuriBr.d Pmf6riN Co<L-..d o, la.n* ! i. tull roN rn.ll(l
<br />t{.)vrlq..,1
<br />-i OL
<br />FEB co\sll{l ( t,\ I t\rrr\(r.\(}\( \
<br />I h.Ehy rrrm und.r FEhy nt rriry rrbt rlEE i. . onrMin k db! .s.By f rh.Fixlrcof ll8 lsl br rtah rhis Fni k
<br />tr&i ts& .1097, civ. c.).
<br />ATELIIAILIIESI.ASAITOB
<br />I hdlrry rfnr und.r Fnrlty of p.rjury nro of rhc firt'*inB d<hnr ii.t
<br />D.m,hion Pclnih A3ber.s Norific.rion F.ncr.t Rc3uhliN (1irlc4), Pnn6)
<br />-RcquiEd
<br />l.ir( of llolifi carrn
<br />I (cdilrrhnrrhcledrralrcgul.ri(,o\ Egsding !\ttqo\ rcnr)r,l nr. tr rrPfhcrht n, rhi\ Pn*.r
<br />rrd'rvihl Ih ! rciJrhi\rrnlir n,n xl{rrcrhri rlr ltrr irn.rn!(t)onr(r lr!N't'L'trnt'l!_ s hrll(iryr J
<br />odimr.smd sr.r. llws ELlirB robuiBing
<br />.h,v. rc.rioftn lroFdy for iffFdioo tEFr
<br />rcl]..{nhrtrc\ orrhi\ ( iry lnn Counrr ro cn
<br />.\ppli(nnl or \A6l SiBtunum X
<br />r'"."it,"*-,",n;nr,, X *<r',L\4.o.,
<br />,,.FEB O?'"'tn\t
<br />I
<br />ELECTRICAL.INSPECTOR RECORD
<br />,B
<br />FINAL EXrt'--
<br />qLY -^.A1
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