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ELECTRICAL.INSPECTOR BECORD <br />APPROVALS DATE ID/SIG.COMMENTS <br />Site-Work <br />Underground <br />Liqht Standards <br />Spas, Pool, Fountains <br />Siqns (monument) <br />Lile Safety /Low Voltage <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bonding / Grounding / UFER <br />Torqueino <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rouqh) <br />Ceilings (Hard & Soffit Rough <br />Ceilings (T-Bar Rough) <br />Meter Release <br />Rough <br />Service h/eter I I - rl- <br />FINAL E u I fl <br />Notes, Remarks, Etc.I <br />-+ <br />OWNER BUILDET DTL('ARATION <br />I rrrcby a0ird rndd !.tux, ol Frjury rhdr I M cx.mfl lmm <br />'h. <br />Cofllm€loF t-ians ljq ror rh. folk,*in8 Elsn {Sci 7}]l 5 <br />Busiftss rnd kof.ision (ln , Any Cily or C.uniy *hi.h EquiEr . Frn lo onrM. rX6, inl)rcE .bmnirh or Ep.n xy <br />(81u. FiE ro irr is\u.e, dlo iqriEt rlr qrladr ror \rh rtu b nb r r'3*rl {d.md th.l L or aE ir lirsd punrr <br />ro rrE Imvnbns of l,E Co.lmlm r Licn<n L.* (Ch.pis 9, Conftming rnh sdion 7flr.1DrvGitn I ol llE Bu.iE.r.ld <br />Itnfc$i6., Codc) D, thd rr or sh. Li .x.ntl)r rhmn m rnd rh. basl{ for rh. dL8cd cx.mlr ion Any riobltun of Sdion 701I t hyrny <br />rrpli}n' for r Fmit subt{lr rlE +t,lic.nr to o civ il p.Bhy of fl'l B)E tha, fivc tu lr.! doll{r ( $m} <br />_1. 8 o*rr of rh. FolFdy, or m, cmFbyci wnh q.8ci .i r,En qi. o.r{Ener nn. *ill do tlt *dl dd rrE {dm ir d <br />hEhh or orcEd for sL (Ss.7o.l.l, Burims! ud h.f.$ion! C(xl -rt. Conrdd,'s l-iinc tip dEs ml {,ttly b.n ouE ol <br />rhr tmpcdy *bt ilds ur ir{rDrcs rh.E,n. dd wh. dB suh u hinn.lf or hcr{lr or rhmDrh hn or h.r oen.frployc.s, <br />forilcd rhlr lkh inlhrwds e E, idlrid.n d oll.rn tur sL Il hft6. rh. ho 'liq d iqnEmfl ir sh *llli. oe r{ <br />or oil,lli4 rlE O* Er Buitiq *iU har rrE hndd or Fo!n{ thr rE d \iE dil m! hrlll m inprnE d. ImtEi, n, rlE F[F)E oi <br />_L as owmr or rhc pml,.dy. o .xdlu{iv.ly .oM!.! in8 vnh lenki cotrkrcron to cl,n(rud rlI pruj.rr (S( 7G.4, Baie\! <br />.d Eo,lnir Codc: Thc Co.rrEroa. l,k.trs Li* &a m' rpply ro !n oeB or roFdy who buildr or imnmwr lhcrsn. <br />lnd rb $dds rd rEh FDF! lnh. CoMonr) Iartrsrl p{nutr h thc CodrIlq! ttrE trr} <br />I mcr.frDr u6dcr Ss'tr'n ,B &PC.nnlhBrcavrtr <br />Drl.: Orn.r <br />worxrrs, cours,rsrrror <br />DFCt_An flON <br />I hccb, trflirn undcr Ftuxy o, Fjury oft ol rrE folt,* m8 d.cbn'Fnr <br />_l h.r! lri *all minrrin . C.nifrak or Cnnsnr ro S.ll.l niuE ior qrk6s NqEndion..s pn'vil.d fDr h, Stri,n :1700 or rh. <br />lltd Calc- td rlE Frflfut 6f dE wI fd whkh rh. tEnjr t (iu.n <br />IhJra rn I nuinrrin so,kcry conT.tr\rtion Nur!ft.. a\ (qoucd hy sdrx,n l7(x) ol rhc lrtitr Codc. ntr rh. p.rltrroE. ol <br />rltr r'o.k lnr whichrhi\ p.rnrir ir hskal Myworlsi ro 'rrn\ato' irNun rcc cmicr uil Flicynunrhlr m: <br />l\'lryNun$(t _Lil,'rcr <br />-l <br />ccniryrh.rinrlE Fituflrcoltlt uo* for*hihrhirFrmn n irocJ- I rlln .,pr.y.n,FMn in.nynEE <br />q' s ro b.aaN stFr ro rlE $rnr6'mnp.ndt!. Ls! orcrliromi., !d.8r fid <br />'f <br />I nDU! tE11rm shirr to lh. <br />*qtsr'mnlEtreri,.porirhtrsofsdinlTcl)6trh.l:lbrCod..litEll.lffhuirhotrply*ithrll'ipm!i\i]n3 <br />wARNlNc: rrihrc ro slE workch' ro'nFnsrion covmBc ir utrlc*tu|- and rhlll suhFr d cdploy. o dioiol F.lliLs dd <br />cilil tift\ u[ ro or hundrd rlsusnd LL,lLr! (llm.m)), in .!d {r ro lh. o{ of cor{Etr{rid- dmg.r s Fovii.n ftn rhc <br />Ssri,n 1076 of rh. tlhr CuL, Dt.d rrn dlmy t le! <br />D.lr:- <br />- <br />Applol:'' r-rce so conrqitc-tlF <br />DSgI.dEAITIIN <br />I l! Et y tn_rm u'r&r Frlry of Frury rhd I d lift r6d ldLr Fovirir. ol CIDlrg 9 tmltmrin! $nh S.{ridn 7qr) or DivFi,. I <br />of llE Busims.d PtDfcsbnr Cod.. rn my lt.M ir in tull foN {n.frd. <br />I rn\. Nutr!h.! <br />sItdglBlJtlt(}i.LllluNc.Acllll <br />I h.r.hy lrItro und.r FElrt or ,r4!ry rhd rhdr is r Nn{Mbn hnh8 .s.rc, nn rl. Frfoirr'nr or rh. mrk ft, *hi.h rha Fnr a <br />trrEnlsa .loer. Cit C ) <br />trndn s Nom: <br />ATELISAII.DEgI4BAIIIN <br />I hrtb, nllm undcr p.nulryorpdjlryond oirhc rollornrg dcclarcrions: <br />D.mlni,n Pdmi'r.AstErros ltorifE.rir tucnl Rqul.ri'nr (Tirk.lo. Pd6) <br />_R.r|!ftd L. c. of l*r'frrrs <br />ilyrhdr ihc lcdcrulrcAuhtnnr\ Elurding ush.dor r.ftrvd {rc mt,rllirblc h thn nn*rr <br />r I h6\! rc!.j rhs !firi.,r$n lrl {ar. rh.r <br />!ftj slrrc Lr*t rLrin8ro huilinS.urh{r.rrrccnrrrvcsolrhnC }lRlCounryn,cnrcruF,nrlI <br />rh,vc nr.!i,trEd lr('pcny it. n\0clbn <br />/\DDliMrl Dr A*ml SiEMnrm <br />".^r*-.",rn*,, DZ,l€C+'t7 1/Aotlrer't y'^y'-/ <br />315f,,. <br />Pole Bases <br />Translormers <br />L.n&..t A.ldEs' <br />- <br />Rl.!V 08-07-2015