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ELECTBICAL-INSPECTOR RECOBD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNEf, IUII'EX T'AI.CANATIoN
<br />I LEby !lfm, u ld p.Nlry ol Flrry fi.r I .n.r.nF fom rlE coftrd litE Lru tor th. tulloein3 Ers lse.70ll.5
<br />tlusirc$ rxl Pr.LNiiotr Codr): Aiy Ciry Dr C.unty whth rcquitr . pqnir ro c.ii .t, rllo, improvc. d.mli.h or E!.n d,
<br />rhdE, rrr ro irs tsu.E?. l'd EquiE! rh. rnDlid l$ ruh Fhd ro 6L. rSEd eidEd rhd h. or cr B li..rql prB.tr
<br />h rlE po$i.B oa rh. C.ddor'' l.ft.s.d l:s (Clq{.r 9, Col!ffiEi.3 wnh Sdi.n TUI| o, D,viti)r I .f rh. aBiEs ed I
<br />Ptur.sirN c(x,.r d
<br />'h.r
<br />h. m rh. i!.E,rpr rh.Efrlm Ii lh. b6tr n r tlE alkr.d.r.n+Do. AntvELtbnotsdb!70.rl.5byrn,
<br />0pplicod lor d p.nnit ubJ.ct ttE applic!.l lo 0 .iv il ll.ull y ol mt mr. lhcn livr hldrcd dolldn (t5ul).
<br />_l-6orrrorrh.Irqiny.nnr.n?h!rsrthr.!66 En nL mnpdEatun. will di dr wrt rn tl. cNc a d
<br />i .nlal ( oOa.J nr {L (S<,Hrl. Bu.iEi\ rtul PrcLsioB CcL, TIE C.dErqr Li.os L.r do.r d rr9l, ro d o*E ot
<br />rh. FnlEdy vl$ h{ildr or in{rou IEla otd wlb dM Mtt *ut h,nrFlf or lr*r o lEuth hn or lEr o*n.mplorer.
<br />F.tnl.d Or ruh if,pr.Erdr e d ieln d noflLr.d lix cl. It lre, l,t hl&n|a d lr$hwftd ir sld *iine )raolonpHiE ttl o*Er Bliua vill hE uE &nLr ofDrovr{ d{ h. ( {r Jil d toi! q itr+bE rll FtF, 6. rh F,po€ of
<br />-1.
<br />& owar or dE Ftqrr. mr.r.luri!.! .odrdinS *{h lh.trrJ odfut6 b .!dMr rlE p.oj.d (S<, 1}r4. Buias
<br />!n Pir,&!*.c(rk: TM Co mkr.r Li..nk f.* der d qDly b urwE ofFi'Fdy rlE brild! or a,lpoE rlElt@
<br />.nd vlr) .. mBIo,tu.hFoj.{ll*xh.G'dBrdri) larr&dpuudro{rCt,'rdd'rLt Ml,})
<br />_l m,.r.nlln !'rl.i S(totr- B &PC nrrklr.ivrr
<br />D.t.
<br />-
<br />t!oa&:Elgl!lu:!t nlt!
<br />DICLAR{TION
<br />I h.r.by rfrnorundcr Fndtv.frE)uryurc ufrlr l,nksiry i..h.arN
<br />_l havc ant *'ll ntr'nirin r C.n ic . olcons.nrro S.lil'L\ur. tu *Drtdr !l,nlb$uro..01 I'n)vrdal tu hy S..rion 17fir ol r
<br />lltu, Cixlc.Iorrh. Frl,{nftc L'lrh. *trk li,r phich rh l.n r i\ ir$.{l
<br />_l h'r r l sill nud.r *o*.R .ontrN.r$n hsur.E.. rr E1ur.J by sfrroi 37@ of tu lrbor Cod., lq rtE Fnim. o,
<br />!,E *qL ro. rl'th rt8 tsn'n r i*!.d M, ro.t.a cohFr{tn in$e. mr rn! tblE, .untE e:
<br />e ,Nudb.i-trpiEs
<br />c.nifyrl hrlrt{ntru*.o,rlf,*o,kfitreh'chrl tpcrm r s$.d.I null lrn .q)l,y rny I'er,,tr uy nu,nct
<br />ro b.anm sul*rr r. rh. s 6 omFdm L*r otc.lrlomn. .d .!G rhd if I ibuld b.om lrb,et lo rt
<br />*ort.G (nlp.n\rtnrll(,!truBorS..rDtr ITUOorrlr ljhtr LroJ.,l $xll, fdhw(h(npl] *Ihrhos pruv6i,tr\
<br />WAkNIN(;: f.'llr to scm *dlcr on+.nrak n covog. t uhbrlul. dri rh.ll rublan u cnitloy.. to ciniul FrtE Ud(pil fmr op t'.'E tu,nErl thiue'n d.U (llm.u,ro ,n ro rll $c or corm.Mtion. d..q.t a Dovn.d fn rlE
<br />DD(:I.ANATloN
<br />Ih.Eby.,lrnuftLrltnlhyufp.rjuryrharIrhlic.nsttr.lcrEovB'ono,Ch4rd0(.oDnreir!wlhS.crDn'1000)offrN6rn1
<br />.I rh. Bor'rcs\.nd I'mf. on\ (-od.. r1 lnv |f,.!r n in lull foru lri cll(r
<br />Llo
<br />IOIIiIBII:IIIN.LENDIIC.AGIN!:I
<br />I trEb, .mrm u'ld.r FMlry or p.rtry th{ rha. i' . 6.{Mh. Lndi.3 l8my fo. $. F.fclllre ol rhc srl 6' *l'ih rhir Fmil i!
<br />iro.J (s6, 10e7. cn. C.).
<br />aE!.tcaNr.pEcl,A8a1]oN
<br />I lr'.6y.nim!toi., FDhy orFrjo., od of E tolll,wn!dc.ltr{ioM'
<br />D.D,ni.n PrnfieArlr{$ t{ortr.rrM Fed. l it.8uLrrD (Tnk.$, P86,
<br />Rcqut.d Lucr nf t{iifElih
<br />-l
<br />c.nni hx 'L lcdcr.l rcslLritN Frirdin! t r.in r.m\i d rn +pla.bk r. rht FnFr
<br />_l c.nily rlu I lEv.
<br />'
<br />$d rln! rpdKinn {rl *nc rlu( rlr rtnvc rnfurrrtr'n tcon.d I rs'e (, mnDly unh lll Cny . County
<br />..dinrmcs rnil Shrc lj*rrrbrinC n' |{rldin8 cor{rucri)n. md h.r.by rurhniu rts..m.Li!c! olrnBCny.nd C u.ry h.nrcr !r.r rh.W-
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Salety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding i UFER
<br />Translormers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rouqh
<br />Ceilinqs (T-Bar Rouqh)
<br />lrleter Release
<br />Rough
<br />Service lvleter
<br />/2h/7hfu,.FINAL v&4,ri )
<br />Notes, Remarks, Etc ( - /(.'
<br />Rev. 08 07 201{
<br />tpf tltz
<br />!h^? ,6rx,Bri DmD.d!
<br />^"' 7ho/Pto
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