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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER AUILDEI DEI'ARATTON
<br />I hdrt, lllm urns FrXy of pajuy tltd I m qdpt tor rhc Codr-l6' Lie Le fo. lh. folbwq ra$t (Sd.701 L5
<br />B$inB ard Prct*Dn Co<l.): Ary Cny or Cdrrt ehich r.quB r Fni lo @inrud. dr6, !t'F!v.. dk"DlLh or E .n ay
<br />ndduq p(Dr to ft i.sutr., alo r.qi6 ir 4rltot fo. qn Fnn ro nh. rtn d idffir lhd lE or !r. i lic.6.d 16.&r
<br />ro rh. FrvirioN of tlE Co rehir Lror.d lr* ((l!iFd 9. Coffiing with Satioi 7000 of Divition I of $. Aui.q xd
<br />PDa*nc Cod.) d thr lE or rlE ir datrPl tha.fron 6d th. b.sii lor tL rlh.d qdprbn Art vioLrbn of ki.n ?011.5 b! ey
<br />agplt&l ror . p6.i *bjd$ rh. rtpli..,u lo . oril p.Blly ot mr morc ll$ fiv. huftH &Ue {1100).
<br />l. B ow otrtE p.!Fly, or d, anplotG *irn Mgq 6 th.n hk omFEran. wi! & tlE *oA d'd UE nDd@ ir @l
<br />indrLd d o,Is.d lor sl. (sc.70,4-4, B$i'B sd PD.6.ioN Co&: Tk codr-ld! Liae le dG @r rpply ro D olrG of
<br />rh. Fpqry *lr hi$ or irt nE IIEEE,r.t *ho &E sh mtt hirelf or lE*lf or rrough hs q lE oM dploya
<br />pmvid.d !h.r !u.h inpl!ffi n ml nai.d * ofiscd for rl. lt howe. dE hr niA @ i.tro16E ir $U winii oE )d
<br />of cotrFldi.E t& ()*E BuilL will h.E tll hldar of F!{B tl! lE or CE tld ml hild or mrrlE ln. FoFty br $. F F3.of
<br />L s os€ .illE FtrFry. u €rclsivcly conl,lclms *nh licd!.d 6il'*r@ ro o'Encl 0E ,micl (Sc. 7044, 86!6
<br />.!n Eok in Co& Th. Coarrxloir Lic.e ljw do6.or .!'9ly ro - o{c of F.Fl, sho buildr or inprovd tldotr
<br />od *no @dds fm $rh Fj.lir wirh. ConrEto(r lto!.d palan lo rhc Con .croi3 Lil& ta)
<br />I dn.r.mpr undcr SdDn
<br />lloaf,EagsaMfEdsarlq!
<br />DEC!.AAAIIQX
<br />I hs.b ,nm un& Fux' olFJu, oa of E folbwuu d.(lr 66
<br />I ha,. sld *,tl ru,nr@ d Cdrrkd. of CoE:t b S.ll-ltEc for srld .ooFldrol! s r@vii.d ror bt selbD ]?OO olllE
<br />lrlor C.de for th. Ffol:l$c of th. mrt lor *tfth tlE Fhn i istd
<br />I hlrr md vill tuinllin woit6 @nFu.r6i iBlllua ! Eqlind b, Sclib ]r00 of tlE L.bor Cod.. lor tlE Ffollrr. of
<br />rh. *qr ro E!{h rhrJE i' t qrq
<br />cm,6 Kdwod
<br />My *orld .obp.Mro. rBurm. ffir en polay nuobd a.
<br />F,E <--
<br />^,r'\\
<br />\(nrr, ' Fgi^,Eltlql (',"-, '-l--!- ? L-
<br />I cfiit thd in ilE Ffollrffi. ollh. worl fo, vhich thi! Fnll n ns.d. I rhrll mi dplot e' F$. h uy n:.|E
<br />$ a ro bcorc 3utixr ro rlE st6 omFdioi h$ of( drfomi& sd $r [In irl shuld b6offi subJ<r lo 'lt*oltd' ..sFGdbn lmethB olsdbn lT0O of lh. t lor Codo l thll. lonh, h @f,plr *nh rl$s Fovilioa..
<br />WARNING F!itu,. to sE $sI6' ompssbn o!6ss. n uhwtul. ed lhtll rubjd e dpbF to ainin l Fdb !d
<br />.irrl 106 up r. o.. hondrcd
<br />'h.B.nd
<br />&116 (t100,000). in !dd't ro rh. .on of .on:p.eron, d,h!86 6 Folil.d for llE
<br />sdri.n 1076 of$. Idbr C.dc inr66 dd dtoflE J fc..1-j o -?L
<br />DECIjAAIIQ!
<br />, h@by alIm unds ,a6hy ol FJu, th, I @ t<dE d u.dd FDvirin of clrF6 9 {conlrffius wnh Sdbn 7000) oa Divirion l
<br />ot rL BuiB !d PmfBirM Cod., dd oy liccM i! b tull aor !d cltar.
<br />P- c tt:.lozqGq(l
<br />?:3a.(a {l
<br />(]0ltrauc1l0l[l,fdDllclcElI:I
<br />I halt'y .rm urds Fdty of raJury thn rh@ B . s'rstu<rbn ldldi,B {d, for llr FIollM. otlh. srt tor *t!i(h lh6 p.nn a
<br />e!.d (S<. 1047, Civ. C.)
<br />l.B!q r Nftl
<br />aPPLtC nT nrcr AllaTloN
<br />I hcrby .ftu undd ,orlry of pdjury on. of !h. following dclrdioB
<br />Dqmldon Pdtu- lb6ror Noiin.ri b. F.dd.lR.SuhlioN (TirL 40. P!n6)
<br />R.qoi.d Ldrd of N.rif'.rin
<br />I coriry rhd $. feldrl Esulll ioB r.grJin8 sbGros ,mr rl e ml eplirbL b rhir prcid
<br />- - I cd'ry rhrt I heuqi lhi! @ltd ion ai 3t.r. th, lh. .trv. inlomdion i! .orq]l. I rlra lo codpry lah tll Ciy md Co6ry
<br />ordrMc6 ed Sral. l!*: clrrtrr8 ro boiu cod!.lio,\ Dd IE b, ruthori,. rcpr6!fuilc or lhir City F Couly to 616 upon ilE
<br />rtr\ c n,6hon.d pn,l.n) r(n n1Eton
<br />Appllc.nl or Ag€nt Slgn.ture'x
<br />r-rr- -r. tp.loO, ts "rr"" V\:'?O
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bondinq / Groundino / 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 />Ceilinqs (T-Bar Rouqh)
<br />lvleter Release /-/22/lLC 7 ,,
<br />Rouqh
<br />Service Meter
<br />FINAL /-/z-7/r/-c -2
<br />Notes, Remarks, Etc
<br />,---------___--<7
<br />Rev.08-07.2011
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