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ELECTRICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS <br />Site-Work <br />Underground <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Life Safety /Low Voltage <br />Fire Alarm / Dampers <br />Building <br />Under Slab / Floor <br />Bonding / Groundinq / UFER <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 />Ceilings (Hard & Soffit Rouqh <br />Ceilings (T-Bar Rouoh) <br />Meter Release <br />Rough 0pr lsrar.,r Lat r DL Mc Q€bn -Le-e <br />Service NIeter W/et Af ?mo- ad t )p lg'ro WtleWl ( <br />Notes Remarks, Etc <br />0 <br />U <br />-+ <br />OlVNER BUTLDER DEL('AR TION <br />I hncby rlfm undd Frhy of Fjut} tni I o dmF 606 llt ( ocdoR Lire L.r for llE follo*ila r*)r (sE 701,1 5 <br />Blsins .,n Phashn Cod.) Any City or Counly whi.h r.qunB a Ffti ro roBttu.1. !hc. imFo!. d.mliih or RF'tr &y <br />rrrucluc, FF ro iri i$ue.. dro r.+t6 rtc .p9ladl for Nh Irnn ro fik r 3i8&d sltald lL h. or dt a lx6!.d Flrar <br />ro tlE Forbnc ofrh. Conrrsr( t l-tc.!ql Lw (O!,rq e, Comndins *iih sdi.n 7000 of Ditiiion I oflh. Auind ed <br />ftlfsio8 Cod.) or rhd lr o. !h< n nd/ th6c6om sd lh. hdir for th. alle.d Grdplioi. Any ioldion of s<ri'n 701 I t L! e, <br />rFplicant for ! p.mtr subjElr lh. .n,licad lo . ciril pally of ml mi. lhs fivc hund.d d.ll4 (t5m) <br />l, s on n otrh. !mFr!. or ny .n htc w h w!!6 s rn i. $t ;mF.Mrion, will do rhc Nlt an dE .tn r@ ! frn <br />mt6!.!.d oror.Eil fm El.lsa.704r. BuiK ed ProfdirB Cod.: Tt (tmrrorLr.elrwdGd4?lyro-o$cof <br />rrr F$dD * rn hikb 6 ir!.ov6 tlE@tr en sth d€ rxn ro* hiNlf .r h6elf .r lhmu8h ht or h6 oq a.plorc, <br />provid.d th.r rlch imFs\ffi. e d n'td&d oroffEql6r sk.Il hov6'q.llE tlrldit{ or irFDEcr ir $ld titnii N tc <br />olotrpltioc rlE (xG edda $i! llr ih. h!&r olFu,B tL lE r ,E dd d lxiu r irss. rt FFrt tu {E F Fr. ol <br />l. a o$c orrh. Flvdr). m.rclcir.ly @nrdnB *nh lica&d.oftr(lm ro 6d.urr tlE Fojrr (sE ?04.1. Bl,3llB <br />.d Ptrf3lir cod.: Th. ( o.kkroir Lic6. Ldw dod mr .tpl, ro u otrn6 orprop.rly uho bu'ld! or isprcs rh6on. <br />6d sho onEls aor sch Flj.ritwnh. (!nr-lo(r) lro!.d pr6u&i rortEGtuxrd'i Lt@ brl. <br />I m(r€nrpr un'ier sNr{)n <br />D.l. (),r.r <br />woRxaR.( dMtENi r0N <br />DECIJIAIIA! <br />I ho.hy amrn undd poEhy of Fjur_ oE ofrh. folt6{ ine .L.hrltiod <br />I hrv.&d*ill mimah r Cdinc.r. olco.Kt b S.lf-lsuE for world snF.E riof,. s Fovid.d ror b, sEirun 1700 6f rh. <br />l.tF. Co&. for rlE psfolrlm. of lh. lrrr ad *nah rh. Fnn . ie.d <br />! h.!. md will mrif,bin {od6 comD.s.lion msurlmc, s r.quiEd try Sd ion 1700 of rtE Lrt{r c6d., for rh. Ffoll1e. ol <br />rlE *{rI fm rhih fiir Fmh i isld My *ul6 omFE ion iBurdc @ir ald Flty.untE r.: <br />tAcfco t/gt.a*cz-wLou312fl{L rf ,12-aa <br />l..niry'llrl ii'l'cFl.rr1e.of lhc wort lq *hi.hlhi! Fnn t Lruc{.l3h.ll nor 6ploy.ny pq$n iI lnyiund <br />s B lo tEcom. $biE rorlEm a ompdui.n h*r orcdilomq ad.sE lhi it I .tould t (ore $l*t <br />'o <br />llE <br />$ort6' mmFetbn F!\ iril6 ols.(ion 1700 oflh lior Code I {dL fonnrilh ornplt Nnh rn s F.vbioN <br />$AkNlN(; In'Luc r, kcr. \rork.6 $nr|rnsdk,. .o\otr!. 's rtrli$n'1. Md shr <br />cilrl n.6 up ro oc huftdr.d rh.urd dolla (tlm,(m). in.nddrn t rlE <br />sarirn 1016 ofrh. ttlDr Codq inlsd md altorrEy s fd <br />/e/Lt/ t s x_ <br />I hdtbl !{Iu m und6 Fdly ot psjury rhlt I o licaBl u.d( rhvnF ;ichirr6 q t.on,mncin* rir h sNrrn 700{))oA)ilton r <br />of rlE llulindr md Profshns (-,,dc. ed m, li.flk s in nrll tu . md .Itdr <br />l" <br />,,*..,r'.r /*" to[LD/ / 1 <br />+ <br />'',,'''* <br />I hdt!, arm ldd Fllry o I Fjury th.l lhq. ir i NnrtuCjion Lrdin! <br />islu.n (sc .!097, civ c.). <br />irhcpdfollMccof rhrK.k ror trhi.nrhi Ff,n( a <br />ATTU(AIIDECI.A8AIIA! <br />I hddv .6m und6 D.n.hy of pcrjury oft ot lfic fdlo$ins d6lmlx,ns: <br />D.molnion Pmhr-Arbdor Notificd ion F.d.r.l R.8uh ioN (Thl. t0. Pd6) <br />RRltrn.n kr6of nilnrakdrn <br />IG1'l\il r r hc li{sil <br />' <br />qruld tr)N r.!r d'nF alKt)1 <br />' <br />c'no\ rl ( nir itfh(.1)l. ro rhs t)'q(r <br />7*r*";n*l::t*t":";I{b.'c ro'x,n d n..Fnj L q<nn <br />apprl.rnr or ^rdrshrrue}( <br />Pcrmilc Mtr'. I prlrl l: ,< <br />n iscotrdr I a{re lo coha'l) u,th lll cd!dJ ( ounr! <br />r.rr6drdn6 otrh6 ( nyed coumr 16 ord ulDn rlt <br />',r.. /Zr/{, <br />,r.' y'a/,I <br />Communications Cable <br />FINAL <br />,rttxl4vl