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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OITNTR BI'II-DER DEI-CARATION
<br />I hcEb, utirnr uldcr Fnulry of p.rju.y lhol I M.xcrryr linm rhc Conio.ioF Lirn* rie ri, rh. itrloeing rclsn (S(.70JLt
<br />gurirc( !n ftorc$i,n Cnd.) Any Ciry or Coo y *hrh E{!ir r Fd k' ftKNt, .lrs, i'ImE, &rulth EIw r,}
<br />irocror, Eior tr irs ir ak., d$ rcquir.! rhc pplicMt for.u.h Frmit ro lih! ri8md {orctunl lhat l*o, $c is liftncd pusu !
<br />ro tlE pn,vi\hm oI lll Co.trstr'1 L&nrd L.* (Cbfl.r 9, ConrmrinS *irh S&rbn 7uD of Divnion I of r,E BuiiE{ .d
<br />Porr\snrnr Cod.) or rhrr h.or sh. N.rcn r rrEEliom 0d rhc h$s tulhc llk3.rl crc,npri'n Any vi,hri'nofsdi,n 70ll , r'y My
<br />dF!,lkrnl ror r F.mi $nr{r rh lll'licrnt x, r civil pcmlry ot !,r ma rh,. fivc hudr.d dou{l ($0))
<br />-1.
<br />11 nsrcr of lhc ,,mFny. r, nr, .ryrlo)Es eilh u!8c! rr rh.t v,L dnnPdnqrion, wru d. 0r work . i ltE (ulm is ml
<br />lll dd orofi.'.d ld qL (SN 7(x,1, Blsidrs sd Plrf$rb.i clrl. TrE Codr&!r'3liuc L,* &E d +plr ro.n otff of
<br />th. pn{Eny uh,t!i&ori,{ ,8 rh.etr md wlr, aB *h s* hin€lr or hc*lror rhmuah hn o,lB own cn!,lor!.r,
<br />pnvi.llal rhar ikh ir{mEmdr e m' inEd.d orollcEl tu *L ll lDkw. tlt t{iufu or inFEft,r Lr -ld wirith,e F{
<br />ol oqrhm rlE OwF Builr( vil! hrr llr hdcfl of Im\ins r,t( lE or {E dit [n hiild d ,nFiE irF lftIn, nr E l[ Ib-or
<br />_l. 0r oww ol rrE FntEny. rh .rclurivcly .ontL-rins * h liensn .odrxlo6 kr $nitut rh Foj.s (s( ?o,l.l, Buws
<br />u.rl Ptr{E\im G €: 'I'h. Conk-ror'r Liccns. tre dos not anrly to rn o*E .l nropcny wh, build! ot inomEs rh.i.on.
<br />md *rn odN! lo uh FoFl\ *nh. Codn :rcir) larn .n rto^qn b rtr Coddtr\ IEE t,w).
<br />_l m.r.ntr uxhr sNrbn .B &PC brrhirr.ryrn
<br />D.r.
<br />-
<br />Ovrcr -W(lRr(l {S C( )iIPENSATIOn"
<br />DEIIJIAIIII!
<br />I h.rcby r,lkmlndcr FdhydllErjuryom orth finl'wiry &rUrcrions
<br />-l
<br />hlvr &d w ill ruimrin r C.nirtr{rc ol Cons h Sclf ln\uE nn workc^' conlcnul io.. os F$vid. ln hy Seii$ .tr00 ol rlr
<br />l,try (' r.. for r& Frfolrrmr 6a
<br />'rE
<br />*d( ror whrh rlE Fmi i( L(u.d
<br />Ih.vrrtuj*illtuinrrm*orkri.orp.n\rrkrn'h\urd.,!\rcqurBlhySdliul'rUrolrhcIrhtr(i'ilc,lnrrh(lcrlDrmm.of
<br />rlf, qorl,rlhrhrhn Frni ,\ t\xal Nt, $o*dr ('n\rn!rirn rn\lnnccMf,r uri Fnf,, nu'nhcr r.
<br />I ccnify rhd ir lh. Il.rforrorc. ofrhc rorl tu *hich rhr pcmir ir i\skn, I shrll.ur.t{,loy lny n ^on itr !try monMr
<br />q, a\ h trar,ni \ubFr ro rrr uo*di .otrlp.nsran b*snlcall(trou. !d laK
<br />'htrl
<br />irl rlnull h.{oft $bj..i ri, rlt
<br />f,od(6\'$n{E.vrirrori:iir.fS<ionlTmorthL{htrGxL.lnull,ldhqirh.!ipl}r[hrhospmvti,nl
<br />IIARNINC: lliluE ,o sE $qtcr' mm(E.sri,n 6wEs. t !n!.rtuI. {n rh.ll rhFl m drI'httr ro omiul Fnlir dd
<br />.iril n.cc up t,, om hundrcd rhrllond d.llas (tltD,Ixx)). in addnio. r. rh. co$ ol compcnqriotr- d.nEg.i ei povidcn ft rhc
<br />Scdion :ll)76 ol rlE L.ts Cod.. nncE{ rrn . (mr\ rdr
<br />D.l.: ArsXtul:
<br />r rr:srs6iirrrp.rr-niF
<br />DESIdAA.ITqN
<br />I h.i.h, rn n !.&r F lry oa Friury thi I.m lhnrcd undc. Fotitbn o(Chrgr( 9 {@nmfthB *ith Sdion 70(n) of Ditirhn I
<br />of thc Busi*sr .d Pt'..!!i,.r Cod., &d n, la..e is in tull foB! !n .fid.
<br />coNsTalkrTtott LfNDrNc a(iENCY
<br />I lErch, lfarm undc. rEnrlty ot Frjlry rhd rtm i! r .onslMlitn b'nin3 qwy for rh. ,Erf(rllrsc 6f rhc *orl ror rhi.h rhn Frni ir
<br />n.kJ tse. lo9'r, civ c )
<br />l.nd.r'r N!mi
<br />lxtrdci\ Addr.\\I
<br />AIILICANI.DIIIdEAIXI!
<br />I hodry irm lnldr Fnllry .r Frjuy .ft ul rhc r.lkrwin3 &{lq.lirn\:
<br />D.mlnirn Pcrmilr'ArtEslos tlorifrrion H.6l R.slErion\ (Tnk 40. Pnn6)
<br />RcquiEn kncr .r Nrirrarin
<br />_l rnitirhrr rtx f.&ral(8ohri)nr e8rJint !{E$! rcn)valuc to,lJ)plkahL b rhG !mfr!
<br />-l
<br />ccni,yrhur I luvc (ad rhtlppli. i,,n{i iar.rhlt rhc fi)vc inlhrnutirr is corccl Irarero(rmpl,}nhlllciryrndc.unry
<br />orJmNc( rxl Sr.rc ljx fthiuB ro builling c.netu1r4 ,rl hdcty rurlnru. rcFccnd ir.s of rhn C y rnl Cou.ry b 6rd !P. E
<br />dhN nr ioBi pmncny tu in\Frtntr IWFE{.
<br />r\Dt,li.rnr or.\x l SitDlur
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Sions (monument)
<br />Lite Salety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Bonding / Groundino / UFER 211,<7A b,k*/,
<br />Transformers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Flouqh)
<br />Ceilinos (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rough)
<br />Meter Release "l"t a Dk!4c
<br />Rough I
<br />Service lrileter 2)zq a Do*t 7
<br />FINAL ,)\<DA+''{q
<br />Notes, Remarks, Etc I
<br />Under Slab / Floor
<br />t,i(cnrcCh$-
<br />[------r------
<br />Rov On n7 2015
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