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ELECTRICAL-INSPECTOR RECORD
<br />DATE ID/SIG.COMMENTS OItNER AUILDER Df, I-CATATION
<br />I h6.b, !r@ urdd pdity of Fjurl lhd I h smpl from lh. ( tl r..loR Lk.@ lrw for rh. follo*irB r.&i (Sc 701 I 5
<br />Buirs !'d Prcfsio. Cod.): An, Cir, or Counry Bh'ch rcgund . tEnir ro onrrud. rhc. imFore daElbh or lF.n &y
<br />ltocl@ Fior ro irs t l[k.. .L r.qniE rh. @9lkmi for o.h Fnn ro nk r r8ncd na.l6t lnn lt or cE a liccd ptmd
<br />'o
<br />lh. Foviri.E oa tlE Conrrld'r Lkf,rd lrs (O!.Bq 9, (onrffiins
<br />"nh Sdirr 7000 olDivnion I of tlE BuitK Dd
<br />Prof6ioB Cod.) o! lhll lE n rlE ir.rmi rh6.lio6.rd thc bdu for thc.lks.d crdFio. Any vi()Ltion of S.crbn 70115 by.ny
<br />.pplk.d aor . Fnn sbj(li llE pplicul to . civil FMhy of kn mr. rh," 6\. ho.drd &tlrn ( t5m)
<br />f f,,-""*olrr"r,oporr,orm!mplo)G*ih*.a66rhd$komp.iunn.trl&'dE{dIdnrhffimirbr
<br />iddrLd or offd.d ae $L (S< 70.1.{. B6i6 Dd P.or6hc (i}d. Tii(td(ori litM t e dGmr?ptro&orEof
<br />rh. FoFry $tn h,il6 o. urT.o\6llEec rd s ho d.d sn $.lt hiMll or ha*lf or itmu3h hi. d lE o$r mpk'lc
<br />p.oriLl rh.r ru.h impmrffi R Nr -ioicdororH tn BL lf. t *-q, rlE hildiry or irs6E1a i'nldsihmG rrofonplrb( llE O*E &,rld *ill h\c Eh,rldr olFui'B d.lEr JE dil d hild d irFt\r !n FrFq 6rtlE FrF&ol
<br />1.6.*EofrlEFsFiy,ma.h!n.l)..fl6tna{nhltou.dcoil,*t6toodnKtrlEF.jrt(Sc'r04{.&!ltr
<br />dd Proisii Co<t : Tl. CoElrxloi! l,icN L.* dE mr {,'N t, s o$rd olt'opa!)- e ho bqildr or impm16 rhn6n.
<br />ed sho coffi3 r sn F.j.(r $nh r C.dr*ro(!) lad!.d Frglrn ro rh. C6d.r1m r Laoe tr* )
<br />I m.(mpr un& sdio.. ll .( l'( ntr rhtr '.artr,,""* Y-111L1,,,0 O 2 C ra tL/4 4>$oRkl [\'( ot\tPt'Ns \ lt()N
<br />./q
<br />DEOJAAIIA!
<br />I h6cby lrm und6 F,ulry of Flrry o.. of rh. folk,r'rs d.(h,.lioru
<br />I h.!.,i*ill dlintlin ! Cdinc cotcotrhrloS.l Nurcn,r\ul6 comFro.rion.s Fovid.dforbySdrionlr00ofrh.trhr Codc. ao. lhc psfommc of thc *o* for shi.h lh. Fmit i! isu.J
<br />I hav. a.d will mdnlain world- comFld ion inrur.n.c. a rc<lutr.n by s*t io. 1700 of lh. ldor Cod.. for thc pafotucc of
<br />lhc vork fo. which lhn p.mit i! isu.d. My worlqr' .ompoBdion iniuroce .eid dd policy nunbd e.:
<br />/Dl.dit rh.r m rh. From.mc orllr tro,t ro, qhrh lhir Fmir ir i"!a].1rh.ll mr mrloy sr Fsn in uy Dffi
<br />s 6lo baom sbFl ro llE srlal onFMion L*. dfc.lilor,r. ,!n +G thi il I ilFuld li(oc auh lo llr
<br />sorl6' enpqElrbn FivLhB ofs.rlio. 1700 of rh. ttt . (iic. I 3h!ll. fdhe nh @mplt $nh ibs Fo!i!i)N
<br />'rlARN[\C: Failur.16 su. "otld' @dpdaiio. mr6.n. s onL*a!I, dj $all $b].fl e dtrplo]E lo ainiMl poEli! .Dd
<br />cilil fh6 up io oN hod.d lhoren<l &rllB (lloo.ur), in ddhhn ro tlE co! .t.onp.diotr rlrtrES6 B prlLil.d tu rlE
<br />Sfrrion 1076.lth. bb.r C.d.. id6d ud ih'rE'
<br />n".)-7- lf n*r,-^.t
<br />Drcr riaTtoN
<br />I @y .Ifm u!d6 Fltty of Fr,ry lh. I e li.sE d ud6 Frraioi ol(1u96 c (m,ltllsi€ *nh Serb. ?fr[) of Dn i.io. 1
<br />of rhc BciIB rDd Prct6ioB Co&. rn mt li.@ 6 h tull fod nd .fifi
<br />CONSIIUCTION L'{nlT(; ACENCT'
<br />I Hy .Irm urid Full, of Fjury rhn rh6. ir . oinrudioi ld'dil3 .3dy for rh. Fforue otrhc sorl for xlich rhi! Fhil ir
<br />isu.d (sc 1097. civ. c.)
<br />I4dd i Ndq
<br />l6d6 ! AddN:
<br />dIIIICAIIIrIO,Af,AUA!
<br />I h.dy dtrm uidd IE all, of pdjory o( of rhc lollowins &cbrt ions
<br />D.molirion Pmn!'Aib6los Nolifi.lrion F.ds.l R.8uLtio.s { lnE {0. Pd6)
<br />R.quir.d Ldra 6f i.roi6crio.
<br />-l
<br />csriry lh, lh. fcrL6l rcgublioB EgEdinS 6b6b rm\ !l &. n6r rrpli.bk lo rhi! p@r.d.
<br />af2l (d rft thd I h&. .ad rh. .ppl.rt 'o. in r!r. rhd rhc ih'\. i.fomd io. a mrrr. I .sG ro omply Bhh rll Ciry ard Couirybdiffi6 rd srrr. t $r GhrE ro bo'id6s (oldrudntr tn lE.b, ruth.riz. EFeirdir6 oiini Cny Ed Cou,ny ro a 6 l4o. dE
<br />.ho!. mdrioo.d pmpcry for iBt crion
<br />,rppfic..r o..\16l SknrI"r. F
<br />.7-t 6
<br />e^:n*^r^,O;A,&4&1r/1O
<br />'/4
<br />tdrL Z4/D
<br />Site-Work
<br />Unde rground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<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 />nValls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rouoh
<br />Ceilings (T-Bar Rough)
<br />Meter Release ?b/ l/4 t '/rk-/h /o-
<br />Rough >/ot ltel An6rl*IO,
<br />Service Meter I
<br />FINAL zh/rt ?TID|T /€
<br />Notes
<br />APPROVALS
<br />Remarks, Etc.
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