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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE tD/stG.COMMENTS OWNER BUILDER DEIJCAR TION
<br />I h6.nr a,lid undc Fnahy of pdjlry rhal I m .rmpt 6om th. Contr&1ot Uc.e k* fot fi. followmS lg$. (S<.ml ! ,
<br />B6ioB !.d Prol6ior Cod.): Af,y Cny or Coudy which r.qun6 r Fnril to odoc!, .h6. imFov., dsnolth or rqai ey
<br />slnrluq Fiorlo il3 soe., rLlo r.qun6 0E 4pli(mt aor ruch Fmir b lil.. t'c..d nflc6r lhr lEor JE i li.aE d plE.rl
<br />ro rhc FovilioB or 0. ConrEtoir Li..u.d bw (Chaprd 9. Commr! w(h serion ?000 ol Divi.ion I of thc Bui.g ed
<br />ftoleioB Cod.) o $ar lE or dE n 66fl th6.&on &d th. b.rk ror lh. dl.3d qdFioo Any riold 6n of S.sion ?011.5 by 6y
<br />.pplic.ht for. Fmir sublcr3rh. rppliclr ro:.ivil p<u!,of rct @G$d ftrc hondrcddoll&(1500)
<br />l. s MFolrlE FoFry, tr hy qnpblc wih *as6 6 rh.n $k srqddion. wi[ do tlt{ot ai rlE nnarE b rcl
<br />inldrd.d or ora.d lor !.L (S( 70,14, A6inB od Ptoft.sios Cod.: Th. Co'nrsrd r LilE L.{'d6 el.pPly lo u osc of
<br />th.FDp.ly wlb h & or inproElhd[ ad *'lio do6shm hi,Mltor t*lf or lhrcush hn or fi6 oM dPlorG
<br />Fovid.d th,r sh i,qrrqEi. e d i axLd doltctd 6. rb. l( ho6q. dE hrldlB c i,glEEI n $U withD on. )4,
<br />oa.o.Tkrio( th. Ownd Buildi eill h.r rh. hrnar ol FlvioS di lE or tr ilil ml hild or llrDE tlE FoFry f,, $. F,Fcol
<br />L s ownq offic pmpdy. m .xdciv.ly.o ru.linB wnh ft6&d cotu&loBlo coNtrud tlE F!i..t {56. 70!t4. &AuB
<br />!n P&ksnnCod.: Th. Co turoai Lic6!. L.f, do6 nor rp9,yro oMqofForEly who build, or anprold lhd@..
<br />&d who co'n6.l3 rd 3(h FDj.dr wnn r Co rsro(s) lk.E d ptr$lr brh.co r.crol3 LrcaE bw)
<br />I D .!.dp und< s<r nn
<br />lof,trff,llollfl8sallo!
<br />DESJAAIIO!
<br />I 6y .rm un&r Ful'y of tE ury oE of lh. follo*ir8 d.cLr.lioB
<br />I hA. srd w'll minrlin ! C.n ifrar. ofconhr ro sclf-lBur. aor rc.k* compnaal ion. a pfuid.d fot by Sdlion I700 oal,E
<br />tibor Codc for lh. pdfolrl&c olinc *o tu snah llE par l B iBud
<br />I h,!. md qill mrif,rar *0116 comDsll ioo rtuuBftc. s r.qun.d by sdrion l?00 of lhc lrbo, Cod., for rh. pdlomuc. of
<br />ln. "orl lor whkh lti Ddmil ir isld My qukd codp.Ndiot iNurmc .eir ald polty nuobd &.:
<br />- I ccniry rh!| i. rh. pdro.r@c. ol rh. work aor which lnie pahil i3 isucd. I 3lall &l anphy Dy p6et ir my mdfu
<br />r sro b@m sibjd lo tlE *ort6'.onFE rion laB ofcalifodi!. dtgclhd if t r,buld bcodc subJel lo fic
<br />wrl6' enrFMtion povilioB of Sarion l70o ot thc t bor Codc I slEll, fonhvifi N'npl, wnh rho- FoviioG.
<br />$aRNlNG: tril@ k1 suc worl6' Fnpcnsrxon ov6.*G s u.lawtul. and 3hdl lubjd d oployG lo $nif,d FEtis.d
<br />civil fiB up lo oe hud6l rhoue.d doll@ (t100.000), 'r rddnbn lo th. co, or.onp.Nlio.. d.m86 a Prcridcd lor llE
<br />S(r6tr 10'o ollh. khr Code 'nr-.i lBl d'on.,'s lc
<br />ucEArl:LcotrrxAcrof,
<br />DEf'I-/TRATION
<br />I h6.b, lrtrm und6 Fnaliy of pdjury lhd Ln liGs.d ddd Fllition 6actnpl6 I {.of,ffiins *nh Selon 7m0) ol Divnirn l
<br />of $. uGins ed PmfdioNCod., ud mylE.@ a i, tulllor..md.fid.
<br />CQIIIAISIqIIEID&GIGEMIIleb,.ttm undq FEiyof Frjuryda th-. i!. oi!tuctioE lddiie !goc, fo.lh.Ffolrll,tr otut s l *'lEhfii'Fni b
<br />nru.d {Sa. 109?, Civ C )
<br />lrrdd 3N.m
<br />APPIICANI DTCI-ARATION
<br />I hd6y !trm undd pallry of Frju.y om o I rh. touowing dd l6alioB
<br />D.mohion Pm,ils-AstBro! Norificdion f_.d.r.l Rcgrlalio (Tirl. 40. Pdn6)
<br />Rcquncd lrlr6 of Notifr cahn
<br />I .orit rhat rh. fqlarl rcg rlim rcSrdins sb6lo! romrd &. nol applklbL to rhls pmi:r
<br />I csrii rhd ! he. rad rhn @D[otio. ad srdc rn r rh. .torr irtomdion s cordr LrIc lo .6ndy wnh lll Cny ud Colily
<br />odiffi.d &d Stll. rrws rchrins ro hiildiis .o[{tucrio.! !i hd.by rh.rtt cFerdit6otlhnCny..d Comly!o ols ul[trdE
<br />oholr morioncd popGty tu ii$.dioi prDd6
<br />Appli.rnl or p(rl Siltr.ture
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Slandards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />tl
<br />Bonding / Grounding / UFER ,LJ u Drfrt -t
<br />Transformers I
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment lot ,-u"2 w YY*<'7
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />Meter Release tLit >tr$t 7
<br />Rough
<br />Service Meter
<br />FINAL la 7;t Dr+6-)
<br />Notes, Remarks, Etc.I
<br />Rev.08-07-2015
<br />Under Slab / Floor
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