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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNEI BI'ILDET DAICAB TION
<br />I rEr.hy {nnm !ftld FElry ('l FrJUry rhlr t o cxcr{'r ts6 rhc Gn rdon Licns lle fttr t,E rotlo*ing i.&,ri (S.. ,t11.5
<br />Itusincss nd lh"csion Cdc): Any Ciry o, C6u y shth r.quiEs ! IrnDr ro .onerucr 1116, iq,roE, &mlnfi or Enon !n)
<br />\rtudurc, r|nn r,, i'r isluaftc, rls, ft.luic rhc oltli.r.r lor ruch Frmil Io lih! si8rcd nfttunl rhd lIor sh. i\ lisn{d pssrnr
<br />ro tlE rm,rnion! or rlE Cootrsntr r Lt.nEn L!* (Ch.fl( 9. CommkinS wirh SN'ion ,(rxr ot Diviri.n 3 ofllE BlriEas.nd
<br />hor.$ionr Cod.) or rhrr lE or rlE n.knpr tEr.fion..d tlE t$i ror rr nks.n.r.qibn Any vblrrhnorsdr,.?0]l5byiy
<br />{'plic. lor r Fn srhF.ls thc 4rlr.nl lo ! qvil pcmiy o, fr mt rh.n fir. hundr.d dolld.lltD)
<br />_1. r\ o*w orrh. rhFny. ,n nr.'r$t,Fs with v$ur r. rrEtr slc onlEnsDn, wil d. tlr qnk rd lll rurk t
<br />int.nrdr .r oflcEd for eh 1sd.7ur4. Busiftss and Pn'lcsions Cod.: TlE G,nrra.rofl Lt.n* Iiw dd3 n atpl, k, ,n owBr of
<br />rhcnmFny *lrr hni s or in{x,Es rlEotr lrl wh df,r \uh srk him$ll nr h.^.lf o' rhmuah hh or lEr own.tPloy.cr,
<br />porit d rh.r ssh inlrcEnErt E &r hlcn l.n ( o,tu ror eh ll h,kE, rh. t[ rhS c iqn,Edrl i $Ll wirhin m Fu
<br />o,.!q,lxi,n. rlr o$mr au[r. *'ll hrE trr hnr,.. of F,v g,El lEd llE dn rn hliu d !(nft t F.tdy ft, tlt F,F*or
<br />L r\.trr{.olrh.rtupcnJ_. rtrrcr.lu\tr.1!.ontr..nt { h l'(rtr{d .o r(r\ !) connrucr rtr t,.}tr rSN 7llr,1 llun'r$
<br />arki lh)rar\r (ixl. lh.C.ntrs.kr'\l.rctr\cLrsrl,,$nor{Ilyroon.sNroltropcny*hohu'kl\ornnfi(*r\rho.on,
<br />itrd $h...drx.!\hnsuc[,r].r\*iihaConrm.n(\)li.c'r*dpu^urirr'rhr(idfu.ttr'\l-$tr€li!)
<br />D.r. ()emr
<br />\tttRl(t lts c'(LllPf\saT(rN
<br />Ir[lta.B4llu!
<br />I h.rchy il ll r nr unlq Nmk y ol J{rury onu ol rtu nnl,,*n,S ,lrrhrtuon\
<br />I h,E .,rd ! ill 'Binrcin . C.n irrrc oa CotrEnt ro S.lf lBuE ror hdt6 drqEndio.. &r In)rij6l aor by Sal ir .UlI) or rl.
<br />tlhc Cod.. fLr rh. Ffolire ol tlr rqt for whrh th. ,sor i3 is\!.n.
<br />_l h!rc r,rt pill mirrrin wo*6 comFnrliofl insurtu.. a equiEd bt sdrsn l7m olrlE l,tu CcL. for tlE F loffi ol
<br />rh. work lot whi(h rhn Fmit ir n$.d M y sGlst mnlEni,ro. insuM. ffa. !i polay nunba m:
<br />_l.cnity rhlr r rh. rxrformft. of rhc rort for shf,h rhh lrmtr r F(61. I sh,ll mi.ryLy rny Fmn r tny 'Mtr$N!obcNE hr.rl lo lhc so*sr' lr,qEnerb, hwrorcaliromb. lnd !8m rhlrifI stnuld tEuE ruhj.{r rorrx
<br />w Lyl .onr.n\d ion pDvhion\ nf S6.'t ion 1700 oa ihc lihtr cod.. I rhlll, nr hwirh omply uirh rhM pn,visio.l
<br />WARIIING IrtuE t. sw *skcR' sn{Ens.lion otmtc Li unh}tuI. anl rhrrl sbF r. dnl'loF lo aiminn Fulia.rd
<br />.ivir fmr uF to oE hundrd rlFuun &lb^ (3loo,0oo,.
<br />'n
<br />AnsL4rqr.9t t...4curon. d.,E€!r .r Prcvn.n for tlE
<br />\df 6. {176 or rrr r,rrr C!d. .rft. U'd tuv ! fdr -z:-7 -.'./ --"
<br />".,,, \2f Kf 2a Y*,^,, I fu Z-Z:------' | ,[{srn cuNTRlcTl)tz
<br />DECITBAIX]X
<br />I LEby lrrm !id.r FMxy or Frrory th,r I am lirn d ud.r Flvtion of Ch.prs 9lsoftainS *nh sdb.7flD) olDivnbn 3
<br />or llr BwiEr rn Pd.$b.r Co&. i-d my lis( ir in tull fora arl clt(l
<br />sK loL
<br />,.r.)2 UZQ.-n*,.tZ
<br />grtluf,l]lalal.[UDftG.Alildla
<br />I lmb, .rrm u,!ds rEBIly ol Frrur, rhi UE n . on{ru.in. bdinS .8!fty ttr llE FfdflE. ol rlr "qt anr *h.h lnii Frni ir
<br />is .rt (s&. llDr. cir. c ).
<br />l. lcfl AdJrc$
<br />APPLICANT DECL NAION
<br />I horby rtrm uBlc. Fndry of FUUry oE of rlE folh*in3 d.rl,r.r i,nr
<br />tcmlirion P.rmik Aiti{or N.'ili$ri,n Fcrlcml R.8!l,riJns (TnLlo, P.n6)
<br />_RcquiEd ldlcrof f{otirkarhn
<br />-l
<br />ccniay rtd rrr fdlnl aslLtnB Eldi.s r*stn Emrrrl N R{ $lttl,t ro lhit !rcr.d
<br />_l cdifyrhai I tus Eld rhr nrrlri iprffirr !,E to oq y sirh.I Cnt rn Coun'y
<br />iEr ol fin Ciry !,n C.hry ro .nrs lFn dE
<br />^,, V/lUzob
<br />urdmmcl a,rl Srsrc liasalarir8 n)"r -"1ry4"f4 h:
<br />rlx{.
<br />'mnr
<br />i(nr{l f' o|tn y lor
<br />l.,?]
<br />Yta
<br />Underground
<br />Pole Bases
<br />Liqht Standards
<br />Spas, Pool, Founlains
<br />Siqns (monument)
<br />Lite Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />-r/
<br />Bonding / Groundinq / UFER a r'Hr/tu (m4 ru&
<br />Transformers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Boof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinos (Hard & Soffit Bouqh
<br />Ceilings (T-Bar Flough)
<br />MeterlRelease 1,/_tq(T)[/ /r'L7/d/trrJl/rt zngy
<br />Rough
<br />Service [/eter J,1 '-,--.3
<br />FINAL 7/W/d arq,/r,Wvt
<br />Notes, Remarks, Etc.
<br />Rov On-07-2015
<br />Site-Work
<br />Under Slab / Floor
<br />6
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