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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS OATE tD/stG.COMMENTS
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Life Salety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab i Floor I t
<br />Bonding / Grounding / UFER brFr I
<br />Transformers
<br />Torqueing L
<br />Sub-Panels
<br />Air Conditioners I o
<br />Roof Top Equipment /LI,?A ?\Dfr4r6 I
<br />Faclory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilinqs (Hard & Soffit Rouoh
<br />Ceilinqs (T-Bar Rouqh)rl
<br />Itrleter Release vwr
<br />Rouqh
<br />Service lvleter I
<br />FINAL 1)7,C '?)bRw -t
<br />Notes, Remarks, Etc.
<br />owNEt Sutlrux DEt-cAtarl(,
<br />I hcrct, lmrm unds pculry of Fqury Uul I m crcryn n m EGfindor'Lms tle ror rtE rou.euB udn lsdm]l.5
<br />Bu\in.$ !d Prcac$i'n C.dc) Ary Cny 6r cord, whrh Eqlrs r Ftu lo orrrucr, .Xd. nrpmE, &mlnt or EIEn rtry(mlr. Fu b n. rssum.. d$ r.1uircr rt alplt.nr for sEt !.mn k, nh ! lsEd s|'rcrfl rhr ,E o. rlE ir lio.nerl pulsd
<br />t, rh. pmvNiod orrrf, Cdnuddt Lt..r.d h* (Ch.trcr 9, Comftrcrnt *ilh S6lbn 70oO oa Divirion I ofrlt BuriEsr.nd
<br />PreLihn' CdL) tr rh{ lr tr rhc t .xcmpr rhcElrom &d rtr tslis lor rlE ,llcs.d .rcqri{. Any vi6hr nofsda,n701I5bysy
<br />lppli.unr fttr o pcrmir rubFrs rl* .mlainr ro r.iril FEhy ot a m)E rho fivc h!.dr.d dolLrs ( SJm)
<br />_1, rs (l{M of ttr FDFny, or ot.rpLrFs wirh *rg.s ar lh.t eh..nttnt.lbn, ,iI &, ,! *t t ad ttE sME t d
<br />m.drl or.iYcEd fo. st (Ss ?(}1,,, BuriEs .nd ProrBbnr cod.: TIE Conlr.clois Li.oc ll* &Er nn .p0ly k' o o*ffi of
<br />rh. lDFny *ho h t! q iqmE tlEE( nd who dd.. o<r! mn himrlr or lErEIr or lhmud his s h.r om.q,loF.s,
<br />porB.n ini *n i.lrDvtldr a rcl iddrLd orotrcl rtr st lL hoEw, lll hlill,E c itrFMl n sld wilhin oe Ftr
<br />ol oq,klion. riE OwE Ad!.r wil hlrc rlE hrd.n of Fovi,B rld L c {r dil rx hiitd o, iqeE 0x FqHy ror oE F,Fe or
<br />-1,
<br />6 uwftr or rh. pioFny. m.rclu$vcly.otrr.&1hs snh lirtr<n co ftlm ro on{rulr rh. |,or(l 156. 7oa. a8c{
<br />anl li]f.{sih Codc: Thc Co.k(!oi. Lt.nE U* &{. mr !p0lyro r.o*mr.lptup.dy who builds or in[.owr lh.Nn.
<br />md *rb $detl tu ruh FF1. wnh i Conhdonr,lia.{d !u^Mr k'tlECo mttr\ lin€ ue)
<br />_l trn.r.flp' und.r Sctioi_. B & P C lor lh rcN'tr
<br />l).1. _ _ O*..r_wonxriiiolrprrsrtol
<br />DECLASAU$
<br />I krchy sltuh unkr FrX,of tiijory oft of rtx follo$in8 del&ri.'nr:
<br />lh!\cr {,llnlnnrr r(cnili.rr.ol(inknrL,Srliln\urrn,{orLcr'..,Iir$rnn.r\pnrvdc,lntrtySc(ri,nlrlr)olrh
<br />r clrlc. lor rlr F trmB! of rlE wnt lM uhah rh. Fmlt i. ssucd
<br />h:r. r'xl r,llnr rtrr work.rs
<br />Bnrk i(tr whkh rhr!rDir 's N!
<br />onqrnr.rir nruarcc. rs E1]uircd ty SEr io. 1700 Dr rlE lnbor Co&. for thc Frrnffi ol.sir lrl Fli.y numb.r ft
<br />_*,". /44/= ,
<br />_1..d'ryrhlr in'h. p.rro.mNc ollrrwo tu whahrhir lrynil i.nrEn. ! !h!ll ml cnplo, a.t F6on in nny lME
<br />w tr k' trranr suhirr ro rlf *orts sqErurion lals orcllitornir. unll8E rhd ir I rhrld tEom iut'ill lo llE
<br />$o.t.r .orr{Enrari)npolnn n ol S.1ahn :1700 ol rh. t bd C,d.,I \tull. fonhrilh(rt y uilh lh'c pmvtiunr
<br />WARNTNG: Fi,lotu n, sm *ortc^ .o'np.nsron . kra*e is unh*lul. .'ld shlll rubFr an mptrrlr ro oi,rinal FBllir {d
<br />.N,l lin.\ ut t, on. hunlrcd Itr,uslrd .Lrua (tlUl.{XD). i. rJdnbn !) th. con ol coqrnstion. d.ugr! $ Fovirl.i ,or rtt
<br />IECIdSAIIgB
<br />I lEEby !fitrm uadcr pcMlry ot lEillry l,ur I m liccnrd un&r tn,riri,n or Ch.,rd , irsmmftins *nh Salion ,UD) of Dirnior :]
<br />af tlE Bustrs .rn Pmr(rinr Codc, .,n my ltcns is in tull foc ud efl(i
<br />C-ta 2zoaa tt /tq"+S.Aft//4 /2(
<br />Ilrrcby uflrm unLr FMhrofpc4ryrhd rtrrc s. connrudnn lc ing!3cr:/f(rh.F i,lrEce ofrh.krtldwhrhrhisFmn (
<br />hrucd (se _1097. cir. c ).
<br />L.nds r N,m
<br />-
<br />ItnJcr\ Ad.lns
<br />APPLIC NT DTCLAT TI(IN
<br />I hsrt'y llfm ut'dd lEnah' of p.rrury oft of rhc rolb*in8 dcckr{i.inr
<br />IXfrniFtr Pcrmih Arhnur Norifr.rii,n F-dLr.l R.Bubrhnr (TnL40, Pd6)
<br />_Rcq!i6d L rof MrifEdm
<br />_l.drry rh3r rh. li{..r| E8ohti'h EBdJin3 rslt{olEtrrv!|orc nr qplicabk ti' lhn pol.cr
<br />I (drryrhd I havc rc!'l rln\ umlE un turc rhd rlE d$$ inaormri,n i\ ctu!. I rsN ro.omily enh rI Cn, lid Couty
<br />'.rft.(annSrar. tr*,{ EI{irE k irE cofl{rud nn. lti h.c$y 'ur
<br />htr't rcpd !rv.c ol th6 Cny..d Countylo.nls ulnn llE
<br />*c nrnrn d lj(,tidr- fitr r!
<br />\plli.n r Dr rxrnl siln l ,,,//4/z I
<br />RFV 08.n7-2014
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