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APPROVALS DATE ID/SIG.COMMENTS OWNEi BUILDER Df, I.('ARATION
<br />I hn r,y rltm ur& Frly ol Fjurv lhd I o cr.hpl noh rhc Codrdm LkGB L.r for rh. t lb$nE l@n (Sa7011.5
<br />B6i.6i rn Pmf*hn Co&) Ant ( ily 6r c.u,rt *tth r.quiE r Fmi ro coGitud, ird, inrroE domlth or rt,., n',
<br />3rrucrs.. Fsrro,r3 softe llo r.qun6 iE qnraer fo, *i Fdlo 6L. rBn d nrrdd rh6lEordrilk6t{ ldnar
<br />rort FovkioN ofrh. Co Gtd! Lkas.d t w (clrBd 9. ( omditS |ilh S6ritn 7000 ot Div!6.I of llE BuitB 6d
<br />PnfBEN cod.) oi t!1 h. or nE b dmpl thdcftoh rd lhc hdi lor rh..lLtcd ddFio. a.y \ i,l{irn ofstlirn 70!l 5 hvmv
<br />q,glk&l tor . pchn ublclt lhc .t,9li.oi ro ! civ il p. hyorml mo.. rhe fi* hund..d &llt! (t500)
<br />L s Nffi of lh( Eolqry. o, nt ndotc [ilh wlsd s lh.ir $1. omFdio(
<br />"iU
<br />d. tlE $nt nn dE iMR ir ml
<br />d6dci or ofrqld for sl. (sc 70a1. lt6il6 xJ P.otBhd CqL: rh. Contt.clois 1,ic6E lrs dod nor tF?lv lo i orc ol
<br />rh. FotEty *h. hril& m inFoE 0Eal! tt { ho dE nf,n trol hirulf or hotlf or rlmu8h hir or hd o{ nphtc
<br />Fovid.d rhrt sx.h inF.vsEn! e d rrod.d nolEtld tt rl. lf, lrre, ft b.tldru d uIFovsEI i! sld wiihin om )a
<br />or.or,pkrb( th. (\G auida *ilt h.E llE hrrh of ltori,{ fii lE or ilE dii mt hild s i4n * tn. FoFry fotl,EF rDeof
<br />l. sonEolrh. p.!rdly, @ocluiv.l, conlrldin8 *nh licdu.d co.lff.6lo oldntl llE F.j.{ (Sd ?044 ltBi6
<br />,!d FDldin Co& Th. Cont*loi! Licdr. Liw do6 iol lFply ro 4 osE o f ropsry $l'o h{ildr or ihP,or6 rhdo..
<br />.ft1 *lF onEl. l( u.h Foje$*nh t Coltfuonr licd!.d Flrsuirn lo llE(_or'lmn r LilE Lr9
<br />I m.rflfl u.<,n Sdi,n
<br />IaBIi[[!](AUU:N,I IIl)ti
<br />|)l:lr"raarlat
<br />I hqrty .flim urdi Fut, of Frury oE of llE fi,llovids &(lt lbdr
<br />I hs!..d uru @inr,in. cdifr.l. of coen lo sdfj6G tu sorr6 orF6rio( a Fbvid.d fot bv sdli..l7m otdf,
<br />L.hor Cod., for rlE ,6folrMc. of rn mrt 6r rtih llE Fni a litd
<br />I h.r..rd will minr.in worl6 conp.N.lirn iEff., 6 Equir.d bt Sd1.n l?m ol E IiE. Co&. fo.llt Ffoffi of
<br />rh. xa"I ld *t!ib thlM'l ! s/.d Mt {ort6' @nrdrDn iEffi. cdF ,n DoltY numbc Rcc fu[gqllir^*V ''h^s.-
<br />,,*,n,.0., 9 N!t4,444;LgQ EtA
<br />--.,,*,1
<br />.1. t?
<br />I cdiry lt'l r. rh. p6fo.M(. olilE m* tu s'hin lti! Fnn i isu.d. I tl lsldn loyeyF$.inlnvtund
<br />i 6 ro b.sm. 3uqd ro rh. edt6 rciFudnn lM of Crlifom* .Dd cc rha if I lrruld h..om. sbjcl lo t
<br />s$r!d conpdldionpmviioB ofsdriln l70Ooflh t hd (-ode I CEll. ,onhnnh @nply $nh lh- FolirioN
<br />\4ARNINO Firtur. ro sur. $.rt6' omFEdb. c.s6+. ( u.hwful. d nEll rubjd & dploF ro (min l FEIG di
<br />cilil fin6 up ro or hu.dr.n lhourod &1116 (ll00.oo0), r addir comt.Bro.. dffi.s6 a pro$d.d f.r th.
<br />frhc l.ahr cod., inrdd ud dlo.r9r! 16
<br />I
<br />DpcLaSarlQ!
<br />I hdtbr !n-"s undcr ,6ulry of Dajory lhd ! e licdsd lndd Forilion 6f (tupr6 9 (offiins rnn sdion 7000I of DnBh, l
<br />r;r/,;ff,
<br />Co&, ,i m, lk.M G in tull Lra dd.lYdr
<br />Lo zlct
<br />V-al<t-tv-4
<br />callraucflltrlldDllliaqEdlI
<br />I hchy lftm undd D. tyof D.rJuo_ thn tl'-. i!. mdruclion lddilB tsdy for lh. p6nirl11tr. of th. wrt loi \tEh lhi Fni it
<br />su.d (sc 1097.( iv c ).
<br />L.ndd r Ne.:
<br />Ldr<t6 i Ad&d:
<br />AITLICAILIECI.68AITTN
<br />Lryll r&o ords Fnrlr, of Fjwy on. of rh. folt winB d<hrdnn3
<br />DntulnFn PmiG^rhdd NotifKaion F.dd.l R.Sulxioa (Tnk 40, Plno)
<br />R.quir.d trrl6 of Noti6.di,
<br />I cd'ry rfi,l rh. r.ddrl r.8uli6c ..srdins stlnos @oral d. mt q,t'lklbk h rna! Fojd
<br />?fl (cr,6,hd r n.,r rcld !hi! appr'<'r
<br />ordlft6 ai Srd. L.(t Elditu r. bu
<br />abo\. MtioEd FoFry for iNp*rion
<br />i.aonnix,n i (tu I .rr to condy q'nh ,ll Cnt .d (-ounly
<br />dntori- r.F6dt n'6 of rhit Cir) !d ( ou.r
<br />Ap0lio.l o.
<br />^Bfll
<br />Sk.rlrr.=
<br />7>tlr Azras -
<br />,rr" r,.[rc
<br />"'l;'*"*
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rough)
<br />Ivleter Release
<br />Rough AlQl,t 4\\hb
<br />I
<br />FINAL il/q /ts,lLB<
<br />Noles, Remarks, Etc
<br />'(
<br />ELECTRICAL.INSPECTOR RECORD
<br />Service Meter
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