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ELECTRICAL.INSPECTOR RECORD
<br />APPBOVALS DATE ID/SIG.COMMENTS OWNER EUILDER DSLCATAI'ION
<br />I tftby rllrm und.r F lry of F.rury lh.l I h cr.Epl fmn rlt ConhrB L&nE l,* for rh. folltwin8 Er$. (sd 7011.5
<br />alnmrs an Prcr6sio. Cod.): A.y cny or Cddy rh-h r.quiB ! F.tu 'o
<br />oEet. rhE, iqnE. d.mlitt or EFn uy
<br />$d.tue pm. ro it! ksurRr. rlso r.qriRs rh. q'pltmr for skh Fflr ro fih r iisrd !urcd.! rh.r lI or JE n li(ulal tu$d
<br />x, lhc povjlioN ot tlE Conrh.roas Ltcn{d Lre lchrpr.r 9, Conmmi.B wilh Sdn'n ?mO of Divnion I ol llt Alsirn ed
<br />Pnrt s\bns Gdc ) r rh4 lr d lE n .r.rpr rlF.fmn dld rtE h.rir lor ltE iL8.d .r.qi,n. Any *,Lli,n of S..li,n 7011 5 by r.y
<br />.pplran lo Fmi subFr. rll .pplkr.r ro . civ F..lry or mr mE fi.r fiv. hurnErl dolLn ltt{D)
<br />_1, !s owcr ol rrE ptuFny. o, n, cnployEs virh wEsc. d rh.ir bk .oquMion, vil! .1, tlE wrl un dE srulu ir mt
<br />iddrLd c oficEn for rL (Sa.?Orr. BuriE ud ProLsbnt Cdc: TIE C.drlq r Lj.ur ljr &!t hl pply lo e owr .r
<br />rtE lrordry tr hd hil& d in!.oE rtfta !n rho dd. *n q* hirelf o. h.r*lf d GrcuAh hr r i.r os.rphyes-
<br />piovir.j rhrt rah inp.D\fr,& c n irddcd o. orH fd .L lf. hoffi, rlE hiiUirB o. inp.oEfd k $U wrhi. ffi )q.
<br />or $n{,Lrion, tlE Ovmr Buildd pil, i.w lh hnl.n of pmviry rlur lE or slE dii mr trill or itrFow ln. I'DFny 6, rtr ruFc or
<br />L as orftr of rlr pqEny. m .rclun(I, .odrdint *irh lnu.d .odrdrm lo onsM rlE FtrFd (Sc 7ota. Blll8s
<br />lrd PFf6in ('ad.: Th. Conts.r.as L-icns. tl* der mr +Flr ro dowm ortbFnywrb brildr or imtmv* rhdmn.
<br />und slF co E G for uci rm'Fdr rnh o Contruron O litred nuEMr r, rh. Conhclu\ Liccns lrw)
<br />-l
<br />hiE.,n qill minrli. r CcnifEltc of Cotr€n! to S.l uE for *o.h6r' @trp..sr ion. 6 Fovild lo. bys<rirnlTm urthc
<br />tllr, Con . lr rlE Ffm ol r w t rd whih llr Fd ir nrEd
<br />I hrvc lnd *,ll mimrin *orkch conJrnidn'n in$rift., !r Blui.d hy li.crrn 3 lm of thc L3ntr Aiic. to. lhc Frf(mE--. of
<br />rh. work tu rhrhlhislErmir i{ issBd Myworlc (rn{Ensulion insur!tr(c cMi:r ud ,l)lhy nlmh.r ac
<br />-l
<br />cdify rhlr in rlE lError8N of rlE *ori tu ytth thn F.mir i\ !1iu.n. I llrlll br.npbyd, Fnn in.ry nqE
<br />{, .i ro b.om rut'jtrr ro ltE mlt.6 snp.Mi}n Lw. of CrhfomE .rd rrE lhn it I rlsuld bc$m tuhrcl lo lh.
<br />*0.16 conJEneoon l,mvi.ions of scthn 3?morrhc L.tor aod..l shlll,lonhwirh ohpl, wnh thr r,mvnbN
<br />WARNINC: FsibE ro m Ert6t' oflp.nr.ri.,n oEnr. ir unhwtuL !d ltDll lohFr 6 dlproF b aini..l pdrit,n
<br />cilil 6N! up ro oE ,u'dttd lnougld doll&r (lloo.mo). in r.ldiii ro rh. 6r ol.onp.Mioc drnrSls a pmviLd for
<br />'lES6rk n 1076 of rlt ktnr Cod., inron lnd ariotuy! aes,
<br />lr.L: Applol:- t rc-r\stD c()rYrtlc.|t)t
<br />DEClalAIOB
<br />I h.Eby alfro !ndc, F..I, ot Friuy rh! I m lirn!.d u!d.r ra,virt'. of Cq,l6 I (.ommin8 eilh SNtbr ?0OO) of Dirnhn :l
<br />ol llE BotiE r !d Prcfeiirc Cod.. rn trry k.e it h tu[ for rn.l,6r
<br />garitrBllqug!,,lJsDlNli-acEllr
<br />t h.Eb, t frn un&r FMll, or Fryry lllll lhdr t t onrrsiotr !.ndh8 *Gt, tor tu rEf(]llj1,e of rlE wk ror whtn thn For b
<br />ilrun (se 1097. civ. c )
<br />AELEANI.IIECIdB':Uq!
<br />I hotby allmr unkr Fnlxy or Frjut om ofttF rdl'win8 ddlforions:
<br />Dcmrn-,tr Pdnik.AilEftr Notifr.rirn lU.r.l Rf8uldi,N (TirlcrO, F.n6)
<br />R.auircd l.u6 ot N,rili.rion
<br />_l cdify rhI rlE f.rhrrl E3lhrirnr rA[ iog adError Emtrl n mr 9flt.bk r. rhn ImF
<br />$ .xluyrlrul;l;rmlt{ion on fit. $n rh. .bor inaonuri,n N colff I rpr 16 snpl, rnh r ci! y rid cuu.ry
<br />tu\of rhisclry dC unryh cnrd nlr'.rtr
<br />ihvr nrnri,*d pnrFny fd \-\rrl'(rnr or rrd \i!nni
<br />ut "ls
<br />lzl
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Lile Salety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor a
<br />Bonding / Groundinq / UFER +nD{tru/UA w
<br />Translormers I
<br />Torqueinq
<br />Sub-Panels t
<br />Air Conditioners [^I II .tt ,a
<br />Roof Top Equipment lXfif 41 I ldt hWrA W
<br />Factory Wired Unit /It
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Sollit Rouqh
<br />Ceilinqs (T-Bar Bouoh)
<br />Meter Release
<br />Rouqh
<br />Service Meter tl il ,2\
<br />FINAL ltltLl uh/,u ffi)
<br />Notes, Remarks, Etc.
<br />-l
<br />m.rmpl unL! Ssll,n-
<br />-.8.
<br />& PC rorlh..!tun
<br />D.t.
<br />---
<br />..- ofn..:-
<br />lll85lEli:gqMrEdtal1')N
<br />PECIJSAITQ!
<br />I lEEby r,Ln utrds p.i.lrr ot Dqr,ry o* of tt rolb, nlg dc.!g.rb6:
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