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ELECTRICAL.INSPECTOB RECORD
<br />APPHOVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lile Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rouqh)
<br />Ivleler Release
<br />Rough
<br />Service lvleter PiT!
<br />FINAL a ztlibr 'YA\*1
<br />Notes, Remarks, Elc.
<br />OWNER BU!LDER DELC RATION
<br />I hcrcl,y aflirn undcr Fnahy {,f pcrjtry rhar I !n crcnfl arom rhc C.ntlcntrr Licc,* L.! fo. rhc follo*in8 ,ca{o (Se,7oll 5
<br />Busincs and Pi(f.iaiotr Codc) Atry City or Coury which r.quircs a Ermil lo onsrto.r. slro. iqmlq d.mlish or Ep,n ey
<br />strudurc. prior to ils issurncc. aho rcquneslhc applkrnr for suchlcrnril lo filca signed r .mnl rhd trcor shc is liccnsed pursuul
<br />b th. ln,virions ofrhe Conkrbls Lic.nscd IjN (Chaplcr 9. CommcRnrs rilh Sccrion 7000 of Dilki.n I .f rhc Busin.s and
<br />PoL ssio ns cod.) or th,t h.or shc iscrcnyt Ihcrcflorlnd rhc bnsis lorthcallcgcdc&mprion Any violdionotSccliotr 7011.5 hy any
<br />4A#ffi *ffiilffi ;ffi ffi ffi
<br />"*il*;r#:Tr.,",rh€ l],rrf,ny *ho tuilds o. inl{}ovc! rli.dn. and who dds su.h M, hnbsclf or nfi$lf or lhrcush hi or hcr own cntlo)ecs.
<br />provided r h0! xlch inlpr.rcnEnts lrc trol inicdql ot offcrcd ld elc l( howcvcr, rtr hxildinE or ini|)brcnE.r k slt eirhfi onc Fa
<br />or.orphrbn, rtr o*n.r Build.r pill h.rc thc hirdcn ol pmvi,s lhar lE or shc dil nor b ild or inPmh rh. l,oFny fot rhc ourlns oa
<br />l..suwftrorih. nrorcny. aflcxclusivclyconrrctirs wilh liccnscd c.ntack,^ ro coi{ru.!
<br />'h. ftul-{! (scc.70.14.8u\inc\r
<br />r.d Proacsi,n Codc: Thc Contnctr'\ Li...sc Las d(rcs nor rpply b M own$ of proncny *ho huil{k or nnpiov.s rhcrcotr.
<br />oDd qho contrich lor such projcds wirh!Co, rucrn(,liccnscd pursurdr t,rhcConlr.crors Li.c.scLaq)
<br />I hcrchy nilnmnnncr |Enllry.ip.rjuryonc ol rlr roll.si',s
<br />Ih.vcdJrlwillnDintairrCcnificdcofCon$niroscltlosurclin*orl.n (nlP.nsaron..s pmvidcd for hySdn,n.1700 orrhc
<br />bborCod., rdrh. p..lornrnccof lhc w.rtfor whichlhc lnni n issucd
<br />I hrvc and will ndnrain workcrr compcnsalior nNurhDce. !s rcqdircdhysftrbnlTlDoirhcL or C.dc- {or ihc p.rrannrtuc or
<br />rhc wort fn ehichlhhrcrnril is isucd My workcr' ompcnsation in\uaftc oricrud toli.y nun$.! {c:
<br />La,jL',*, r*..",..,tu*..i,h.q.,l ,o, wh,.h,h^,ri,n A A+icd r.tu,nr,-FV.\*r"* *r.ni.'r" tro cF cnn'FrsJ,inn hB.olcehr.min. r rsrcrhJr,r r
<br />rtr oy rtry tf,rn,r ir ry nutrNr
<br />!lr,uld lrcotrr suh]ccr t)rhc
<br />vork.rs.onDctrsriionpmvisionsolSLrrion:lT0Oolrhcl-'tnrCodc,lshrll.tnhsnh.omtrywllhlhosrrovhion\
<br />WAnNNG I'rilurc Io ccu.c sorkcn'con{rr\alion ovcG8c h unhq r r'.i,f,fr turlr'.i xn,l
<br />maEc\ a\ pioridcd for rhc
<br />I hdrcby dftm undd lcmlry .l ,,.lury th.t I 0D In n{n ulldct pmvision of Chrprr 9 (.onrftftin! *irh Sd
<br />oa lhe Busincs ud Prclcsn ns Cod.. .Jrl ny li..n\. is in tull fora ml cft.cl
<br />CONEIBI]CII!}NIENDTTTC.&GEICI
<br />I hedby ultt u.df Fmlry of Frjury lhol lhcE is ! con(rclion l€ndins asc.c, lor rh. pdrolr11mc of $. *o* fot *hich rhh F.nril is
<br />hsu€d (Sec. :10s7, Ci!.C.)
<br />Lrndcls Nrnr
<br />-
<br />AIfIIIANLDECLTX{U T
<br />I rmby rJlhn und.r Fnalry ofFrjury oN otth. folbwnr8 delmlionc
<br />Dcnnlirion Pcrnik Ash8ros Norific.rion Fcdcml Rcsuldions (Tirlc40. Pan6)
<br />Rcquircd lrrrdrof Nolifi catio.
<br />l.cnfyrhdr rhcltdcmlEgul.lionsrcErdinei\tEtus rcmval arc nn! apdi.$1. ro fiir pmjdl.
<br />nh,r. inrormlio. is corccr I oBre ro ontly wirh all Cily {nd Counly"hx**it havc rcntr[i\ a0 i.nn)n]nd (rrd rhar
<br />rlc I-rws rldir! k, h'il,li',a con{'xcrtl hcrchy rurhoirc rupNctrl.tiv.s oflIis Cir
<br />ptuFny tu iNDc.rirnr N4rscs
<br />Applirnr o. Affnr Siamrure
<br />Pumllft nan. ( prin0:
<br />"dl';;l'b
<br />Transformers
<br />I
<br />Lic \c Cl s: Li.crrc Nunrttr:
<br />-
<br />Irrl, ( onrmtlur
<br />Lrndq r Addrc*
<br />4,.,
<br />=
<br />I
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<br />It-
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