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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS O\T'IER
<br />'UU,DER
<br />DEII'ARATION .
<br />I hatby.rm u.&r FrIt.lpcluy lhr I a aaqt hn fi. (ndfum Li@ l^ tor llE folb*iry ItJ.(SE70!I5
<br />Bunn63 Ed hofdion Cod.) Any Cily or County *hi:h r.quiE I Fni lo 6irru( .tc. iiFrovo dtmlitt ot li?.n by
<br />eru<ru.q rar ro rl' i.u&E. .lo ..quic fic Apltar for 3ucn Fni ro 6lc ! 38..d srndd thd tr or !h. ir licd.d lrux
<br />lo lh. F.viri,N of rlE Cotrrtrroir Lk N.d L.w (Cn Fs 9, Conffiin8 qnh Scrion 7000 of Oirih. I of In BBir ud
<br />Profdhd Codc) or rhd lE d rL ir qdF thE.Eod ad rh. b.ris for th. ru.*.d .rm! ion. Aoy viohron ofsdtb, 701 I J by dy
<br />.r?l(er for ! pdEir 3ubr.n! rh. lpplic&r ro . .ivil Frny of mr mE rha li\. huiN &llr. (1500)
<br />l. s o{E .l lh. FoFny. s mv GtrphrE vnt s!s6 6 llEn $k NnqardDn. srtl & tlt sqt dd llE snxlc i! hl
<br />inrdvLd .r6lIncd for $1. (sd 7044. BBIB ed ProlBioa (.& T1E ( ndr..ioli ti.E l^ &6 d ppl, to a ow ol
<br />llE FoFy *ho tlith o. itrFlr6llEsq .n $b dE rdr wn hinElt or lE*lr or lreueh hi. d h6.m mplq6.
<br />prcvid.d tld .uch imFD\6ds e ml inlad.d or ol[nl 6r nL lt hos6c. tlE tlildilB or iqrwaEr it sld *inh w )d
<br />ol@+lr& rlE O*c B.laBd viit h.E rlr Udd! ofForlg rL h. d llr dil mr hrild n in$.oE Ur FoFry h. tlE Frpos oa
<br />L a o*na ofrh. rrDpdy, m.r.lai(ly codrdi.g *irh li.dBd co rd.6ro6tu EFoj.< (Sa ,04.1, t}!B
<br />a EoEEirCod. li. ('o r-roit LkN L* &6 ml.ptlrh doe.6ofprcpdrysho bril& or irpovd rfi(@..
<br />ed wno c.6brrr fd iu.h Fnjau wnh ! (b.brl6(, l.dud F,s{r b rh. Codrxl( r Lkd& ll$)
<br />lm.r.m[ un.kr srrion
<br />D.t. or..r
<br />\r oRr(ER-i'()rrPENSAirON
<br />INGIJAAIIO!
<br />I h6.tr.firm und6 len.hr oltEjuD on.ofrh. aollos6F dchri'nrB
<br />I hav. lrl *rll n.fl.in a ('6riicd. of (_oMr ro s.lf lBur.for\ottd comFMrion. B Frvid.d tor hyS*rion 1700oath.
<br />tdir Cdc for lh. Fftu. oflh. uvl for *nrh rlt Fnn a isu.d.
<br />I hr!..nd q ill Mi.hi. *0116- comFMio. iere., a GNilil by sdhn lrm of
<br />'h.
<br />trhr ( o&. for rh. Ffollffi. of
<br />rhc mrl for whkh rh! Fmn is isu.d. M, *0116 .dmpqeion iNormc cffiir ad rolly nunbc r.
<br />QD S"r.r"t-tf.rjl'\t: Lo1!t,[""1",t
<br />I cdiay th.t in lhc p<fomx. of th. vort fo. *tth thn Fmn ir is.d. I llull tul snphy oy F$o in my nEE
<br />$ a lo b<!rc .utir1 lo rh. *sr6 .on E!di,. h6 of Clr'fomir, md rgc lhd if I 3lblld b.(orc rubr.l lo lh.
<br />sort d' composn ion pFviii.N of s.dion 1700 oaln. t bd Cod., I Jsll, fodh*nh c,md, shh rlrE F.vLioB
<br />$ARNlt{C hhr. ro ssc h,I6 envEgrn.o\6.sc i, unhtrrut. &d,tult lub.cl m dptF kr ainm,l Futi6 md
<br />$vil lind up !o or. nund,.d lhoMd doll6 (il
<br />S.din !076 of rlE | .trr C.&. rdc{ od nlqr4
<br />). m add'rn,n t, rh. coi ol romFMro( ddEra $ r.id.n f( rh.
<br />-q- --]l
<br />DTGIIAAIO!
<br />I hd.St amrm unda ,E nr, of Fjury lhn I m lic@.d oii.r Fo\ Li,n of chrd( e (on:lmiDa snh Sclion 700) of DNEirn l
<br />oa rh. BduB r.d tmf66d Cod.. &d oy k.e a in tull foE.tt.ILcr
<br />I 1'ro)11
<br />l\-\-\1
<br />I h6rl,r rllir r un,lc Byrlrr ofrElur_a rld rho. r r.onrrudnn hnh4 4e' L! rh. Fr.nnffi. !f rlE trorl ny \hEh rh6 Fm( 6
<br />,r\uallS( rl)97.( '\ ( l
<br />AITUCAXIDS:IJSAIIA!
<br />I ''Ps .Itnn ondd pd.nt or Fjlrt oe of rh. folh$ing ddl{di'd:
<br />DaNlirion Pm r.arhdlo! Noxficarion F.dad Rcgul.r ioN (TirL 40, Prn6)
<br />R.q!n.d tllrd ol Norifrrtion
<br />I cdiay rh,r rh. lildal ..XrlnrioB (gadi,8 arh6r.r rm\aldr. i.' rptl(obk ro rhL tnl.rr
<br />I.difyrhdItuv.nd$Lrprli..rhn,n{!r.rhdth.!b.v.i.btuhntcondI58rctoohpl!uiltrll(ay&dCouly
<br />mdinft6 !d srd.l^: EldirB N llilth8 sifudioa .,n hd.by.dl$rt. r.FMndir6 ofrhh (-i', dnd Counlylo dls uFn llt
<br />c,!a,(. {'c1eJ^
<br />uJrl,,
<br />Site-Work
<br />Underground
<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 />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 (Rough)
<br />Ceilings (Hard & Soffit Rouoh
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough
<br />Service Meter I t
<br />Notes,rks
<br />0/-
<br />Lrl
<br />Under Slab / Floor
<br />F|NAL lLlttill flA ua{
<br />/z/7'//7 /',,t. n[utua
<br />'z-+-
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