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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS ID/SIG.COMMENTS OWNER BUTLDER DEI,CARATION
<br />I hq.b, .frm uid,E F|lly of Fjury rh! I m Gr6!p nom th. Co rlclor' Lic.M L.w lor lh. follovins ra$n (Sc.70l L
<br />B6i6 rd Prcfdbn Co<b): Aly Cny or Couny rfitn r.qui6 . FEa ro o'rntud. .!6. lrp.oG .ld[tn d lE.t ay
<br />i,uctue Fixro iG islee.to '!qli6 rlt +plter tu Mh FEn lo frb . 3is,rd ,r.,rE[ rhr lEd'I. a liuE d F!$r
<br />ro rh. FovirioN ol r,E ConlrErdi Lienr.d trp (Ch4G 9. colmmin, wnh Scrhtr TOOO ofDivnEn I ottlE B6ir& xd
<br />Protdiotrr Cod.) or rhrl lr or rhc i! ddlr lhdcnom ed lh€ bEir tor rhc.ll.s.d cidFbr. Any viohion ofSelbn 701!.5 by &y
<br />rlpliot lor i Fnn 3ubi(r th. Oplicd to . ov pdny of rcr mc $x fiv. hlndld &'lLri ($m)
<br />f,Z!/. - .* "r,* p."e.,y. or ny ddor6 enh w'36 s th.r ik ohFE toE qrr 6 trE *!it .d rli !m.!c . tur
<br />nnod.d or oflqcd tor el. (Sc.70.14. tu3ilB Dd P,!faio( Cod.: Trlc Conlrclol3 Lk.M tl* d.6 mt .!?ly lo & ow or
<br />th. FoFiy efio hlill or in!.oE lrE@G srd who dG uh N,t hitr.lf or lE*lfor ltEu$ hB d hd om oiplo'6,
<br />FoviLdltd sh irq.lgtEt Gd noi.d rolEr.d ftrrt ll horE, E hlildls a rF$sEr iFBw dlr)d
<br />oa6d+ldb( lll (r$G tuil& wil hE dE hda of Fovi.g lhi lE d tE dn d hild d urp.on dE FlFty fr. itE FrDc of
<br />l. aowofth.FrF y. D crcluiv.ly codrd iry *nh Lcd!.d.onrlrloR to o'drucr llE FoJd lS( 7O{4. BUU6
<br />dd Piokn Co<l.:It conrsoar Lt.@ L.r'&,6 @r pply to o orc olFoFr! *ho t il&.r impror6 lt6on.
<br />rd who @ffir for $ch FoFr wnn . Condo(r ltd!.d Fjl:@ b rlE Co drd , Lkae L.*l
<br />I en cr.mpl un.l6 SdrnrX5/*lz" r ? *$
<br />DECLA TTA1TON
<br />I hs.by .mrn u.dd Fdly of p6ju.y o* ofih. followi,S d.claltioB
<br />I hrE rn will uituh . Cdifrn. otcoMr b Sdf-lr[. lM wt6t .eFqtd\ a Fotii.d hr by Sdion 17m ofrh
<br />t bor C6dc. aor $. Ffollrre of th. hrt for *ti.h th. Fnir i! is!.d
<br />I hlw.d *ill ruirhin Erkd comp.cnio. iNrtrc. D r.{un d b} Sdnn l7m of rra hb.r ( o&, f.r th. Ff.llrlsc ol
<br />rh. wl [n *hah rhir Fhn n &r.d My *gtd' onFBrDn u.uft. ..lE nn Flt, numb6 e:
<br />fu"axyta t^F-wt *.orfi. wort ror *hkh rnir Fsn ir isu.4 I rtull mr arplo, &y pden in ey . 6
<br />s d ro b..om. rubicl lo rh. wort6 enpqBorion L"! of C.lifomi4 &id lsG rhd it LFuE b{om. lobjct io lh.
<br />mrt6' omFsdior F$virioB of SElion 3700 of llE Ldor Code I iEll. ldhwnh coniply wirh Oo. FnilioB
<br />\'IARIING: frilur. id sd. *orkd 6"t .MKrn frr'a4.
<br />civil lin.! trp b o.. hundrcd tnourmd dolld (t10,00o), in
<br />sdrio. 10?6 ofrh. hL, coJc i.rdd di.norF r lG
<br />ir unla$tu|. ud JEll rubF s aphF b cinel Fdlb. d
<br />.Jdibn ro rh. idlri tn'taE &!r a r.D d.d for rh.
<br />I hdrt y .tfm unds pa.ly of Fjury rh, I @ Iicq!.d un& Fvbion of ch.9r6 9 (onrliEEir8 rnfi Salion 7000) of Divisio, I
<br />of llE BsiE-d hll6nB Co&. rn hy lac L h tuU for rn .,L.1
<br />colllaltcrolrEuDMlcllcr
<br />I hattly.rm u.<kr FrhyoaFjuryrhr i,E a r @dndbn ladn'B t3fty ror llE Ff(tlrlrld of Oc wt t'r rnah inn Fhi !
<br />s$.dlsa :ro)7. civ c.).
<br />L!nd'! AddB
<br />-
<br />_l .qrif, rhn rh. Ldarl r.suldioB eSEdii8 ab<tm 6nd al e mt lPpli..bk to th! pmj..l.
<br />n lran'r, ,a , *.,-,nb lpplrdnn rn rdc rhr rlE rbo,c
<br />'nromdion
<br />!(6.d.I qscroomdr$nt.llchylrl counq_
<br />ddmN6 Dd srn. L.B r.hus lo hrrduucoljrudDn rid hq.h) lulhsrr.nt6ddtr6 of rhs c
<br />'.d
<br />counr, !o arc upon rlE
<br />.b.\. m6r i.n.rl pmpd, for irupdrnn ptrprs li
<br />-^ppr.o,c^r-!sr,irr. - ?q-/-* -"-2/$,/2er7
<br />pm,,ftnrn.,pr,n,,: PFUap fuc<r.t<r< 6-'
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />ns (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 />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilin gs (Hard & Soffit Roush
<br />Ceilings (T-Bar Rough)
<br />Meler Release 5. /.1- t9
<br />Rough
<br />Service Meter 5- tq- tq
<br />FINAL o
<br />Notes, Remarks Etc
<br />DATE
<br />Air Conditioners
<br />Cui':-
<br />I ic.@ Nutubd
<br />AIIIJCAILTIOJf,AI]A!
<br />Ihdryan'mund6 pa.ly ofpojuiy on olthc followins d<hr.rior:
<br />l).mlhion PcInlAlbdor Nolificabn F.dsrl R.aultlioB {Tnb 40. P.n6)
<br />-Rcqrir.d
<br />t llaof &iiftrir
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