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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDEN DTLCARATION
<br />I h.rchy arfn undfi F.rlry or p.rjury rhx I m .x.r+ fr.m rh. Co r&lou Lkns lrw ln llE rt,lhyin! Er$n lSE.?oll.J
<br />Bunrc* rd ProLrsion Cd.): Any Cily or Coutrry *hi.h Equnct ! rErn'l lo orrrud, n!d. trnor.. thDlth o' nJ[, y
<br />(tude.rirt,irr ir\usft,.tb EquiEs rh. l,tlicd ror skhFm ro ik r {tmd ldcmnr ll lror rL i lcn*d pu d
<br />b rh. Imvi\ioni ol rhc Contturd\ Lt ncd tiv (CtEpr.r 9. Conmrrn! *nh S<li,n 7UI) .l Divnbn ] oI lh. BusnE$ md
<br />PbL$hns Cod.) or rh,r tE G slE is crcn r rhadron ud rlE ttrrt for rlE llt8 d .icqr im Ary riol,r io, of Sdbn 70.r I J by dy
<br />lmli.r for.Fmnsubl.rrsrlE.ppltanrro.civilp.Elryofmrnrcrhrnfivchlodr{dollr.{(t5fl,
<br />I. r o*F otrlE pmpcar, d my.npbFs vnh *186 E rl:n sb onFN.ri'n. vill.h dE sql !n ,! {furE ii rEr
<br />idd,.d c orcEi ftr sL (56 .,0.n. B6iE! ,ri EDr.rsix Cii. Tt c.dtr\ t(M Lw &ri d rp0ly to r osB o,
<br />rrE F{dy *lD bildr or !w.!6 ilEEr rd who d6 st qdl hidElror lEGlror rthud hi' or lE o*n.r+bFr,
<br />ptuviJ.n lhd *h i.!.ovtr!d( E d iudtu trotuEd fa xl. lt lsM, rlE tlitluB n lttmErEd it$ld wlthm Fr
<br />of or?rim. tL O*E Buill.r eI llE llE hrrln ol Frrs drr L ( t|l dd br hqild 6r iry&E rll FoFr, 6r rlt F!F- 64
<br />_l. rr o*E of rlE tmlsry, ucr.losikly 6tuog ri|n li!tr ri.odd{n ro onrdl rh. pftrr<r (S;E roa4. BBES
<br />.,n Elkrir C.d.r Thc Conrdror'r Lt nE 1,, dc rcr qt,ly ro o 0*6 orpbFdy slh huiHr or rr{,mEr rh.mn.
<br />!,!d etb otutf rkh Fri<! Enh icoliBonr) lira€d punulr ro r,ECo ar('! Li!d. L,*,
<br />lr.l. OrrE
<br />W(IRKTR\' COMPENSATT(IN
<br />IECIJAAIIIN
<br />I lErchy rmrn unds lENhy of rErjur, oE of th. lolh*i4 .l(ltilirnr
<br />-l
<br />hovc url $ iU tuinrain a C.niftrre olcotreni b sdilnflE ro. h.kn on{Enrdrbn..r pmviLd ror hysdrir.rTmordE
<br />trhn Colc, lor llE Frformmc ofllE vo* lor whth rlE Fmn n ir\ocd
<br />I hlvc rnl wrll rui.iNin p.r*rr' compcnsalirn insuramc, !r rcquncd by Scc'hn :i?(D of LE Llhr CqL. for tlE p.
<br />rh. *'trk l.rwhrhjhsmmr r\riNd Mr qorln. oGnsdonin.urrNc(MHUrlFnrynumh(re
<br />,*,., Ztt"lLii-"w,*blotJz
<br />I rnilirhrr inrtu pcrltnunc.olrhc *ork tr wh.hrhA l.n ir i\ h\uel,I \hlll r!, c t'loy rnyttrvr in !trynuNEr
<br />yr r\k)trconf, luh](rr hrhc sodcs .onwnsrio! Lwrolcultx ir. mdtr8N rhlr,tl \h)rkl lt.o t \uhirr t,rtr
<br />sorkcG' con{'ctr{rn pnlnrns of S{tion .l?(xl nflh.Irhr C,ilc.I d,ll. tunh*irh.onlPly *rrh rlr,t F,vt\k)n\
<br />WARNINC: Ij.ilurc to surc *orkcB'coqrn{lioo qncruE.L tnJ rhrll $hte.r an mpby.r to ainiml IrfltB.rdiirffiirlx'u{nd dollrn iSI(x) m'
<br />. d.cq ind rtror y \ lLt\
<br />ro rlr (u< ul fun{rnsrnr. JrmE r !i |nnrdcd for thc
<br />or rE Burim$ a.d Prcf6sbn. Cod.. lrn my ltctr€ ir h tul n,a !n .fidr
<br />1oilzlb8''.,,,.',''.,C-to,t"r"14r,
<br />I h.rhy ,flnn onLr F.diy or p.riiry rh3r rlEr t . oNMion hninS r8.ry fu l,E FrlomE ol rtE $r nn *hrh rn6 rEni i\
<br />istud (sc. 1097. civ. c).
<br />Ldclr Nrm:
<br />-
<br />il"tfll(lINLIlE(Ll.B IIAA
<br />I lr$t nk r o lcr |tdxlr) of trrlury otrc rl rh( ,rnL,$nr! ,l..lJ,rr n N
<br />lxn,l'rrtr,Irrnnr\A\h.{osNoriri.Ii,)nFt'1.tu1R.tulrrtrtr\alirlc.ll).P.trr(,r
<br />R.dtr'nl I.rtrrdtN nri.trrhn
<br />I ccdilyrhar thc radcrul rcSuhrions N8ordinS r )s rcnDvrlrrc ml4,Dli.lltll. tr, rhi\rn,F.l
<br />l.cd'ryrhrl lhNr rc l rhi\ rpp i.rrn,n I
<br />oRlinrru\ n'xl Srrr.lf,*\ rhrnl! t) hui
<br />rh)vc nrnri,,md In,p!nylhr in
<br />IApplionl.r Alenl Sl8nslum tbrr
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lite Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab i Floor
<br />Bondinq i Groundino / UFER
<br />Transformers
<br />Torqueing
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rouqh
<br />Ceilinqs (T-Bar Rouqh)
<br />Meter Release
<br />Rouqh
<br />Service lvleter t.il l/ /--..41l1A/aar4,r///51
<br />Notes, Remarks, Etc
<br />I !n.rcmpr un&r Sdtion
<br />I h.E$y dfun on&r F.,lr, or p.r,Iry lnd I d lirN.d u,id Fovinr. ol cllrrd 9 (d'mrmn8 wnh S.a:lioo 7(xro) of DrvBion l
<br />Irm rft nrnc(Drinr):
<br />Sub-Panels
<br />Air Conditioners
<br />FINAL
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