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ELECTRICAL-INSPECTOR RECORD
<br />DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lite Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueinq
<br />Air Conditioners
<br />Boof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Soflit Rouqh
<br />Ceilings (T-Bar Rough)
<br />Ivleter Release
<br />Rough
<br />,tt
<br />FINAL o
<br />Notes, Remarks, Etc.
<br />OWNrI EUILDER DEI,CARATION
<br />I lErcby rfirm uBL. pcMlry of F rury rh{ I m .rcrfl fmh rlE Colllrr6 LisE Lrw for rh. folrorin3 ia$n (Sd 703 | 5
<br />B!\incs !d Prcfc(ion Cd.): An, Crry or Counry whth eqlcs {Etur ro tunnrud. .116, impmw, d.mlirh.r EFr dy
<br />ntutue, tritr !o irs 6sllf.. rL$ rqufts rrE +plier fr, ikh Fmi h f k ! si8BJ {!r.rnl rh.l lI or sL ii lk.rsn plm.fl
<br />r,, rlE Fl'riri,D\ n, dE Contrsroas l-ir.rn Lrw tch'rr.. 9. O)nrmft69 *nh s(rion ?(m ol Divnhn I or llE BusiFrs &d
<br />Pmrcsi'ns Cdic) or rhal lr or dE i. .x.mrl ltsEfion.tn tlr b.rir ror l,E .llq.d d.rsii,n An, vhhrirn ot seri,n '7011 5 by ry
<br />+drcunr ror r Fm rubFk rh. l0?liL!.r
<br />'o
<br />! civillr.u[,ormr mE rh!,ir. hu,rlEd dnlfs (l5m)
<br />-1.
<br />r( owF of rlr,mtdy. ( my.ryrLr.r *irh ras6 $ rlE otn'd{indbn,$lld,rh.*dt.,nortuad
<br />o!.rhl or olT.Nl f,r sk (Sd.704.a, B!im$ lnd Pnnasbns C(xl.: Th. Conrrctol r ltcntc Lr* do6 nor lrply r0 nn owxr nf
<br />ri. F,tEn, rtD tx lscinFo6rlEE(rdplb.l€r*trlrilhin€llo.t.rlfo,llmughhi'dlEom.'rrbFr.
<br />,ruvircd thol ruci imlmmnls @ mt inlad.d or dk lor sh lL ltrftE, Itt hiildinS r itrlt*mnr is sld within orc Ja{
<br />orN,ri'krbtr rtE O*Er Budtr s tEw E hsLn ol Foving HtrdrrE.lnd,h{itlrlqroE,EFqd,frthFqDrof
<br />_L r\ owftr .r OE Fqsr. .n.rclunEly ft B1ina *nt l.lrrd codrNoR ro Nont&1rtr F,Fr (sd 7o1,t, DurG<
<br />!d thftarirC6&: Thc ContEdol. l-ic.nsc l.l*d4rto, lpplrl. down.r olprnFnrwho huildsor ioproy.s thcrsn.
<br />md *ho $tuk fc rEh FlFrt wnh. C.dEhn, litMn purulr b rl* Codrxrd i Li.Itr Uw)
<br />I r.\cnDt unicr Sat$n .B &PC ntrrnNrcan,n
<br />l)rt. (rrn.r
<br />worxrrs'tolriirsrntx
<br />D!l:t xdrlQx
<br />I lrrch) ililrn undtr fl.tulrt of F_ilury oN of rlr lol['srn8 d<.hrl$n!
<br />Oit'"* ,rr *itt *in,". . c- ir..r..r coR b sclr.lNrc rc @rt6-sqE$.Bn.6 Fovd.d tn by serb. :rr@ otdE
<br />trb., Crnc. fdr rh. Frfo,rffir of rh. vork for ehi.h th€ Fftjr i! ks.n.
<br />f>t ll.r r *ill Niirdin *orts snqu'lrnn inruruc. s rruirn by sdEn lTm orrh bth' cod.. ror rh. Frfm or
<br />rlE hrl f* ehih rhi! rEmir Ll ir4.d M, wqtdt ontp.nr.ri,n isutu. Mtr {n poky.umb.r e:
<br />c*", p"r(rfir ( o vrafc,zrS,zrA r',-
<br />P.rtryNumh.r \^) A CC)S \-l (\ 1G 2 4+4_
<br />I rcnify rhrr i.
<br />'hc
<br />p.rrormft. of rtE vork nr vhah rhn lr.rmrl h is\u.n,I rtall fr,1lmpby rry lrk,n in rny nMmr
<br />$ as lo h.{om suhFr k, rtE *rk6'srdpcndion L*r of Clliromir dri lgN lhd it I slnull bcom srbFl to llE
<br />*ori6 strrrtnsiir Dnltionr of Sc<ri,i .l7m or th. lrtd Cui., I nsll, fMhwnh cDnply *nh thoc t'f,,vhhnr
<br />WAINING FrtuE ro suE wrk6 NmlEnsdxr mEn8. n u.h*fii|. rd sldl .ubi$ !n cn!:loF, ro ainirul FElix ud
<br />ctil nR3 up ro o hudrcd l,Drun dolLr rslm.om). in ndnion ro rlE mir of coq.B.rion. d.nrg.i r pr,A.d fo, rlE
<br />sdrhn 1016 of rrE trtor Cod., inrcd &d !'omy { 16
<br />u, ZJt J?P JI ee1$!At*S*- Sr^iCcu<-r+a-
<br />IIIINIED-IaNISASI!]8
<br />DEICI{tAIII!
<br />I hcabyomm!ndc, trNhy 6l lcrJlry rhrr I am lie.sn nndc. Forision.r Ch,prE 9 (ommxi.8 wnh S.dio. rmo) ofDivhion l
<br />of rlE AuriBr 6,n Pmfctri'N Cod.. .,n ny li.cn* n in tull rGr $d clld
<br />L_q G LRnr Numr. lo \ FoTIa
<br />trr., )tr l>orl c.,,..,., e\ela-t s- So\a-l-T-.-
<br />gllsralcnqB..LEdDAcJilB.cl
<br />Ih.Eby d,Irm unrh. Ir.dryoarrr!.y ltul lhcE n ! (nslulion tndirs rsc y [,llE Frforns. dattE work irtr ehah lhn Fmir il
<br />irlEd (sd l097,civ c )
<br />AXIIIIANLDECII8AIIO!
<br />I hEd'y rrm . ls Ftuhy ol F,lry or or !h. rollo*lng d.rlrnrirnr:
<br />D.mlirirn Prirnils-Astdos Noliricrlio. F{d.r6l Rcrulalinx (Tirlc tI{. ltln6)
<br />_RcquiEd L,rrc, of Ndifrdion
<br />_l (d ify rh{ rh. t dcnl EBUlrr io.. ES.rdirB asb*lor Emvrl E nn tprlt!$h lo rhn ,,oF
<br />elctn i8 rhlr I hsE Eld rhir +llidion &rl tr.r. rh.r rtr .lbE antotu b. ir <ffi. I .!c ro od{'ly rnh ru c'ry &d counr,
<br />odiuNt &d Srlrc tr*s Ehrru ro bdilling .nn!turttr lrd h.Eby rulhtriz r.Frnllliks of thk Cny md Coonlylo c.rd utbn tlt
<br />.t E mda'Ed FoFny fs itrVdion FqBs
<br />Aperksr d
<br />^t6r
<br />sk*rua: q t"-L
<br />P.rnnrn .* (p.t ): E!l1B!
<br />/>': rS*,1._-.- o.,. A-ll
<br />\-ia*.^".-"d <
<br />Tlllldlagr:/.IL
<br />Rnv ll8 n7 2015
<br />APPROVALS
<br />Sub-Panels
<br />Service Meter
<br />l.ndq ! Addrc\l
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