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ELECTRTCAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS (IWNI.I' IT'[D}]R DEI,CAI'ATION
<br />I tEEby llImr und.r p.'rrt of Friory rhd I an .r.nu nuD rh. cl,rreb^ tI.M L* lur th. lollo*i4 Een ls< ?031.5
<br />Busin.ss aii Pnri*iJn C.dc): ny Cny or Coudy whth rcquiEs . Fnir h c..nrud, rlrs. ir{,rove. &mlis} or R?rn my
<br />nrdur, ri,ib ns ksudr., sLv' Equirs lhc annliu lo. ruch !'.d oft.litEdst{.mnr rhltlEo.$cilic.Bal lu$dr
<br />ro rh. Ftrvi$i.ns.t rhc Conl.eror'i l,t.n*d hv (chaAc.9. cDhmming wirh S.ction 7ux) of Divisbn ] olfic Bsims.nd
<br />Prufdlions Cod.) or rh! h. or str is.r.n!i 6s.li!maJ nE bats tor tlE dkS.d .r.lIpri.n Any tiltLriotrofs6lbn,01L5 b) s,
<br />applicmr ror 0IEnnil subj(h (hc dppli.rnr ro. ci!ilP.nnhyornor m..lhrn liv. hundEd dollrh (t500).
<br />tl.!2. * **, ..r '* ""-.'. "r my c'nprnyFr * (h *.Bs 6 ,h.n sh mnpcnstioi. wirr do oEFurnL.l or oficE.l lor qL lsd.7o44. BueEs *J Pbf.$i.m Cod.: TIE Cod'&rDrs Lic.rE bw d@s not .pply ro r o*rcr or
<br />rhr rn,Fny slr, b{ikh n inllruEs rlm[ a&l wl$ dB sh *)rt hitu.[ ot lE ellor lkou3,] hi! 6 her oM.n{'loF.r,
<br />poviled tlEi such iDlYormdrd mi mrcrlddl.r.Ilcnn hr sL. l[ ho*.tr, tlE toildinS .r nryrowcnt knldw ri.oE ]td
<br />oIconpUioq iE OwEr Build.r will h.w rh.b!rL,olp.oriU u h. or slE did mr hri! G inpo!. llE pDFry fc llE purPos of
<br />l. rs o*rr of $. popdy. !m .rcltrsirly .ldrucrina *ith lic.i*l .onk&roR b &r{ruct rlE p$j.c( (S.c 7Ol'4. BusiBs
<br />!,n PilfNio Cod. t h. Contnctn'r L&ns. uv d*. tur .tDly ro u owrw oI pnFny *ho boild! or inDDv.r rlEr.on.
<br />.nd 'ho onreds ror such proi.k wilh r C(dkrrrls) licctrsd ru6ud lo 'h. Codrd.fs Li.cM bw)
<br />_1m,.r.mni urdd S(tn
<br />(!+u z\u*',1 a
<br />DECLAEAIqN
<br />I h. rcby atirn u ndc' !.nrX! ol pojury Dn. ol r hc inlhr og dcc lsd ions
<br />-IlB*aidwill
<br />6rr{in ! C.n rfi..r. of CnM ro S.lilNUE tor *or}.i. con{r,sdion, 6 nmvided ,.r hy Satiotr 1700 of rlt
<br />tltu Codc. lor rhc Frlorlr4c of rb. *oIt ld whi.h rh. Pmni{ is ir5u.d.
<br />_l lDve and *ill arnrah *orlr.is conltlsdrr.n nsurarc.. r\ EquiEd hy $d i(,n 17m of rh. ljbor Cod.. n, ih. FromBrt. or
<br />$. $.rk io, wtrh rl,t rxrnii r issd. M, worldJ comp.Eiton intum.uiq nl lolicr.u,,h.L *.:
<br />Polrcy Nun6.r:-lirpits
<br />.LFrl..i'8 rhrr mrrr trrrd ur. rl
<br />'
<br />hu * urk fur ah'ch rhn p.rnir t issu€d, I sh8ll mt .mpby sy lusn in my ronn.I
<br />-r ^ r. hcm'r.uhi.d 16rhc r nAca' (nnDcsd
<br />'ntr hw\ or('rrromu, inJ.Arc rhr I lh.ud b.r^m \ubj.rr hrlr
<br />$ortoi on,,.nsarion provnDrs of SdlDn 1700 o, rh. Llbor Cod.. I slull. funfi*irh oiply wirh rtDs l,rcvisioN
<br />WAI{NING, Failur. b s-ur. *orl.n comr.niurion cov.agc i\ unla*Iul. md sh:ll subi.cr an .rnploycr ro ominul FMhis ud
<br />uvrl tuEs un b oE htr' rd ilrusa*] dolln (tlo0.tl)ij). r addirDn to rlf .oi ol cotr{Ersiion, dlnsA.s s pDvid.J in rtE
<br />(1i1..idcrN da ore'r_ \ lir\
<br />tt /tt/zr,",.(
<br />DEEIABAIIO!!
<br />I lEEhylfrrDu er p.alry ol p.rjury rh.r I an! lienEJ und.r FovnDn oi Ch.ps iJ (conmNing *irr, Slirn 7000) o{ DivNon l
<br />of (he Busi*ss d*l Ptuf.x\iotr\ Co!.. .rrl my lrc.n{ ir in full IorE lnd clTc(
<br />CONSTRUC"lION LENDINC AGENCY
<br />I hcftby.nlrmundcr p(nrhyofr.ruryrhd lhsc i! i.oniru.rhn kndii8 a8.ky r.r rhc Pc.L'rurc..rth. *ork rhi rhthrhk p.mii i.
<br />nsu.d ls.c. loe?, ( n. C.).
<br />AICUCT,ULDEELAA{I9!
<br />I tfttryrlnnundcr l].n ry or p.r ju.y om ot rhc i,llowin8 &cl arins:
<br />D.mn ion P.rnnk- s1lio! N(nfi. x)n F.dcral R+uhrbns ollc 4l).l'd6)
<br />R.qurcd l-.n.'.1 N.ni.nron
<br />45-;
<br />rlythr lhc kdr.lrc!uhi()n\ r(lrdins Atr(,xr.irtrrl c D.r rr,tLrrhL hrhn tolar
<br />rhrr I luvc,r&lrhnumlicario rl rliul'c uhr{ nfonrlnfl i! co,rcr , rSrcro.ongly wirh r[ cntand c.unty
<br />Sra'c lj*s rchriq ro boildins ,rl h.rhy luh.rnc rcnrc*nuriver oithis City ind Cou y 6.nrcr up.,n 0E
<br />/o ,.)
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Sions (monument)
<br />Lile Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor I
<br />Bondinq / Groundino / UFER ICffi/K d,ut/,k vat
<br />Transformers
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Faclory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rouqh)
<br />Ivt€ler Release
<br />aI91a"'td/21Da U-.r"lr (6 4'
<br />Rough
<br />Service [/eter
<br />FINAL lq4/dt.W-rtl/ai :zd
<br />Notes, Remarks, Etc
<br />Rev. 0B 07 201
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