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ELECTRICAL-INSPECTOR RECORD
<br />DATE tD/stG.
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rouqh lt-u.?o a,Mta6 LW
<br />Service Meter tlzttt7l Dm4t Mt6
<br />Notes, Remarks, Etc
<br />OWITER AUILDER DEI,GAR TION
<br />I h4by arm undd p6,lly ol pdjuy lll! I d qdpl ioo lh. Corlr!.1o6 l,koe l,w fot lh. fouoei,r8 r@r (SE.70l l.a
<br />Bulilld rn Prcaarbn Co&) Any Cny or Coudy whth r.qliq . Fhi lo @dru.1 .n6, i,rFort &mlah or lrp.n &y
<br />nt.ru.. Fi, ro i! isllle.lo ESri6 rh. Tdmr for sh Fin to nL..{rFd rioHr rnrlEor!Eirlrcd.d F,.!r
<br />b rh. FovirirN of 0E Contr&td r Lid..d tlw (Cn !{c 9. Comftir8 snh Salior ?00O of DvBion I ol ilE BsnB Ed
<br />PmlsaoN Codc) o. rh.l h. or !h. n a@pl thE.from &d lh. bdir for lhc dkcd ddFioi. Any violdiof, ols.dioD 7031 .5 by qry
<br />qglicel for a FEir rubjEr! rh. rr'plic. lo . civil p.qty of @r mr.lh& fiv. fiur&.d &'lla (tt00)
<br />l.sow.frh.FoFry.mEydphr6wirh*.s6arh.r5kc6hp@iFawil&ih.wt.d0E!rt!d@.d,l
<br />iddrd.d or 6fi6od for slc (SE 704.1. Buind &d Prcfsiod Cod.r TnG coft&loii Lic@ t w &6 nol qrly lo e ow ot
<br />th. I'oFly *rn bd& o. imFoE tlEatr nd who &E tun wrt hiB.ll or hgIlf or thh!3h hir ot lE om 6ploy.6.
<br />Fovid.d lh.l uh TTFDEEIr c mr da(lrd dofidd for delt no@.lL hrild,r d iS.*qd it bltdhh ffi )r
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<br />,, soM<6f rhr
<br />'roFry,
<br />e dcluivcly c.nlrcrhB wirh li.6Bcl co.ta.to6 b onrNd lh. Foj.rl (Sd ?044.46!6
<br />.,n E$tsir co&: Tn Co'nrxbir Ltcc Lr*' &6 @r .rply rc d o*od oaFoFly rho bu'ldr or i-prct6 lhG6tr
<br />ud wt[ otu-$ tor *h Fois *nh . Coffio(r) l.dE d gr!.rn ro dE Contrid t LrqE r,w).
<br />I &n .xcniPr unlo Sdlion
<br />rof,f!8slcollfllsaIlo!
<br />DECIAXAIP!
<br />I hncby alfm uidd pdnty of psjury on. oflhc folloqirs dclfalioa
<br />I h.E id vilt rinr.i!. Cdi6.rc otco6an lo SGlf-lE@ fd $rrt6 otrp@lrb( - Fvild ro. b, seri..17m of t
<br />L.tor Codc fd rli pdftrffi ofr[. sfi fq *tin r Fnil ir isrd.
<br />I h.v. od will mrinlsin wortf, .omD.d.rio. icu4.. s r.qund by Sctio. 17OO of lhc L.!or Cod., f th. Ffol11@. oa
<br />ln. sorl tm *,hit rhb pdnn n isld My wort6 .onp@dion 6urk. ffir !d polty ndbd a.:
<br />I (drt rh.r D th. Ffotlre. of rh. *. forshrhlhBFnnuen!Ilrllrmtdqlo,dyF$ninoyndE
<br />e arobdom$bj.{rrorlrK 6'omDslr.ion hBolcrliaom'r lrl rgEthd itl nsuE b.coe subrel lollt
<br />wo d' compc$alion prcvilioN oas..lion 1?00 ofih. l,bor Cod.. I dEll. fonhwnt conply wnh thoE FEvbioN..
<br />$ARNINC !!ilG ro su. uqt6' onp.dn. o\6.s. ir unLqtul. !d rlull ubj.tl e .,rlphrg b cmir.l Frrir arl
<br />ro oc hun<l..d rho@d &lls (llm,ooo). n sddni.n lo tlE con of ottFisr'o.. drrD86 a Fo\il.d fo, tlE
<br />bor Cod.. inr661 dd lnonry tti2p
<br />lrl:( l-\R,\IloN
<br />I h@by rlrrm !n.td p@lty o f psjury thol I m licds.d undd Fovsion of chtpld 9 (comacinS wnt S€clior 7000) oi Divilion l
<br />of rh. BNilB.d ProadioM Codc. rd sy laog 6 in luU for dl.lTcr
<br />'E-
<br />{,r [2 "
<br />I h@by .fm uidd Fdry ol Fjury rhr rhs. i . cotdructbn lodiiS .g@y for th. prfo,rrry. ollhc wr tu *tich thb FniI b
<br />is.d (sd l@7. c,v c)
<br />t ,iq t Nec
<br />Lo (i Ad.lrs
<br />AII].IIANI.DECIJAAIIO!
<br />I h.{ry .ifim u.da Fuhy of pGjury oE of rh. folh* trs d<Lmod
<br />l).iolnio. P@irs-A*dro! Norificatio. F.d6!l R.sul.t'o.r (Tirlc 40, Pd6)
<br />- R.quird L,.rtd of lldi6.rb.
<br />-l cdit rhd d. f.d6.l r.Suldb6 ,lgdin3 Bt6to! llmv.l d ml .lpli.tuc lo tbi Flrcl.
<br />I cdirythr I h&,Ed rhit qplt rbo.irr.lhl0Ert w bt)nnrbi h@tr(r.I *rc lo ooply *in dl Cn, ud Cou,,ty
<br />oil!ffi6.Dd Sid. us Elr!{ lo bildi,s.odtudiic in
<br />.luE molioEl rroFly ror
<br />,\ppllcrnr or x.nr slSnarure
<br />Dr'
<br />l::4;e.*
<br />Rev 08'07-2015
<br />APPROVALS COMMENTS
<br />FINAL
<br />.I,.&Pa torthir rlen
<br />4ts1ts)
<br />Pmlt( Er.(rrlrrl, b".)o*i'
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