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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE COMMENTS OWNER BUILDEI DELC.IMTII.)N
<br />I ltEny rtId uid.r FAly 6f F.!r, rhd I d dcn+| lmm rrE Coffi6 LirE l,* lor th. folt m! ,Wn (Sd.?o]l J
<br />alsinc* .,ld Protision Cd.): a.y Ciry or Coun'y qhth EtuiFs a Fnl nr conntod. drd, inwoE. dcmlirh nr EFn ry
<br />rrtucrw. prir r. irr i$@.. rla r.nlirs tlr qipli.ar ror rx.h Fmir io liL . rBmd .l!r.Enr th.l lE or stE ! li..trrd pu$$l
<br />x, llE rn'rarions ol dE Conrrru s Lianecd L.s lchfld 9, ConmEi.S *nh sftrb. ?m or Divirirn -l ol E auliEs ai
<br />Pr,,csi,nt Cod.) o. rhli lE o. sh. is .rcnpr rlermn .nd rh. b.sir Lr E rlk8.d cr.mFx,n. Ary vilLlbn ol S..1ion 701 I .5 by .ny
<br />lppliclnr tu r Frmi rubitB ttE rppliclnt lo ! civil p.mlty of ml EE lhq fivc hundEd dolk r lltlD)
<br />L r .wF of rrE FoFny. r nr.q oF! *dh *!gd a En st Ntrp.nr.li,n. wil!drllE wat rn 0. rnxrE i! El
<br />inl.ndsi or oiIcEd fi, Mh (Sd.7044. BlriE s and Pr.fBrionr Cod.: Th. Conoeror'3 Lic.nE Lv drEt nor tpply lo an owmt of
<br />ft popsty who tlillt or irprs tltGn rnd *ho &E ui k& hireltor lE.Blror 0lDugh hir ls oen.rlpbysr.
<br />pmvitdl rhr skh itr'Fow t e m' ddnd o offtld (jr .l l( bw. tlE hrildiB 6 inFEGlr i rU wrhin ft F,
<br />o(oq,hhn. tlE O*ar BlitL! wil hlr rlE hrttn of FDvig t ur lEd nE dil br t{ild d inp,6E 0E FtFr, for E F,Fror
<br />-1.
<br />r\owE of rh. FoFny. Dcx.tu{kl, cod'ding wnh litndl cotudouro onrrud E FDr&1(Sc ?o,rt. Burcar
<br />and PDIL$ihCodc: Thc Co rrrol s Lic.nsc Lr* dc, mr !!?ly to !n owlq ol prepcn y who builds or imtn,Es ltuR,n.
<br />md *llo mlllBk fo,.kh Fqr'lr wirh r Conrdorlr) larrudl p
<br />;|,"-"ffiq ,,""..><
<br />urrl. &[r]r
<br />I h.nhy xllt'n unncr p.mlryofItrjuryoM ofrh. n'lL'sinS dc.llrarx,n\
<br />Rlll(: Fllur. n) rru,c rort.^ .r {^-i\rrtrnr .o\rrr$ r u lJ}suhJ..r 0n ml,loFr lo aimirul Ffllir dnd
<br />!in.r up ro oft hu.dEd rhouend dollr* (Sl(x).ool)), in oddni Eneln n. d.m8.s !\ proli.Ld to, rh.
<br />:::1"ryLry;q
<br />I h@by .rtrm uftLr F.,lr, or Friuy rhd I m [en$d u..,.. Fovtbn or ClEI,ld I (onEtrins *irh S6rio, 7(m) of Di.nbn :]
<br />.l th. Auiies &rd P6f.r!i.N Codr, r,n mt lt.oe is in tull r6E rn .ffd
<br />crJlsrBlg[lN.ualt tcl{illgr
<br />I lrEby rirm unl.r Fu!, or Fri4 rh.r rhdr i! . @oinatDn hdb! .3.Ey ld dE FlolrlEm ol llE rui lor *hin ltit Fmt ir
<br />kru.d Iss. 109r, civ. c.)
<br />AIII.ICAI{LDE{JIAAIIO!
<br />I ha&y rrm undcr trMhy or FrrJry oE of tlE folh*in8 dc. Lnli'ni
<br />Dcmlirion P.rn r+Asb.sos Norifrdnrn ltdcdl R.8uLrirff tTirL rlo. PDn6)
<br />-R.quird
<br />L.rr.r oa tlorifr.ri{
<br />?,ffi iffi;;ilffi ;/###ffi;r,y;:".x'.:,'ii.*::'#"*
<br />H::Hffi <rL%hr,*' f/ z ft".'
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Lioht Standards
<br />Spas, Pool, Fountains
<br />Sions (monument)
<br />Lile Salety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor (
<br />Bondinq / Groundino / UFER .{?7h.(rMn
<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 />Ceilinqs (Hard & Soflit Rouqh
<br />Ceilinqs (T-Bar Rouqh)lt
<br />lvleter Release tl ulvL vrq*,
<br />Rough It
<br />Service Meter t+1rl7l bktE,
<br />FINAL 4 tzlz,t bA]P&4 I
<br />Notes, Remarks, Etc I
<br />ID/SIG.
<br />_l h!!. rn $illminrrin. Cdif.rr. o,Ci,n{nr ro s.lr lnsrE ror k,.kn dnFns,b...! FsvrLd for b, S<lior lrmo,dr
<br />L5bor Co{c, aor th. nsformtc ofrlE *ort for whih rlE Frmit i! krocd
<br />-,
<br />h.E ldi siu Ninrrin eori6 coritEN.rh. iN6Ec. r rcqlieti b, Sera.n l7@ orrh. trbor Cod.. for rlE Fndrrc of
<br />rlE h n, whi.h rtu! Fmir ir is$cd M, worl6 6np.nsrio. iniom cfir rn polay nunb.r rc:
<br />PoLicyNumbq- Erpiair.-
<br />-I
<br />d,ry lhr in rlI pdforrE or tlE so ror vnih thi Fshn n ircd- I th.ll tul ctrt)l6, Dy F$n in my NE
<br />b G ro bc.!r tubjEr ro 'lr
<br />uoll6 on{Ens.rhn hsx ofc.lifoBa., !d rlrE rhrl ifl th.uld heoB subFl lo llE
<br />worl6.oqrerionprevirioB6fSBrionSTmofrlrUhrCod..lrhllro.$wnh6nplywnhthosFovirioN..
<br />l.nddl .{.1&Es.
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