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ELECTRICAL-INSPECTOR HECORD
<br />OWNET BUILDER DELCIARANON
<br />I LEtry rrrn udd Fulr, of FJUry rld , m .knfl riDm rrE co.bd6 lr.M L.u for rlE foll,*i.s Er$n (S('7ol | 5
<br />Burim( adl P,or.sion O)dc) An, Ciry or G,onr, *hich rtuiEs ! ,smn o mn(rucl. dr(. imp.ovc, d.Dlhh nr rcFn lny
<br />(ME. F' ro il! irelre- .!o rcaoiB rlr .ppliur fo. ruh Fmr b iil ! \,gi.n nx.trnr rhd lE or sh . IirrEd Flsd
<br />b rh. ptutisioG ot DE Coa'ra.ttrt l,i..n*d Lr* (Ch[nr.r 9, Conm^_ing wirh Sdion ,(fi of Division 3 or lh. Busircrc &d
<br />Pr,f.snnr Cod.,6r rh.r h. d rlE i .r.npr rh6.fmm rnd rlE h..ir lo lE .ll.3.n ct dplion 4., vi,lni'nofs.dir701156ydy
<br />lprliclnr lor r Itd( {l,rccls rlr lpplka r. ! civil pcrrlry of Er mr. rhM ,lv. huMr.n dolLrs lltoo)
<br />_1,{\ Dwrcr of rhc phFny. ( n, cr0loyes pirh wls.s .r rh.n v,k ompcnslr,n. wrll do lrE w dltrslulNirml
<br />inn .n r ofi.Ed lft e]. (Se toa4. BuiBr ua Plof.r(iln. Cod. TIE Co.rl-rm ! liar L* .h.r d .!'t l, ro d ow, of
<br />rhcptuI.ny who boilds or inpmws th.6tr lnd wh' dG qch mi. hiru.lf or hcrslf or rlFu8h hix nr ho ow..mplirF$.
<br />Fi'rilal rh.r st iriFEmfi E d ni.rn d q offqd ,q rl li lbEq. ilE triBrE d i4.m.d n $B rilhi' .E Fr
<br />o, $ri'hibtr rtx O$mr Aui!.r will h.h ilE bfthn of !&vin8 rhd lf or slE dn dn hild m irprcw lhc poFny for tlE Ii4DF of
<br />_1, &\ ow&r oa LIE t'rotEr y. d.r.luriEly.otudin! wirh lEn*n @ ralo6 o coNlnLr ft FoF1l (S.t l04ir, BuiEs
<br />un Edb{sim Co<L: Tnc Conrrdoi r l.iccn$ Li{ {t*r bi r!?ly tr .n o*E ur pmpcd, who bor lds or 'opmEr lh.Kn.
<br />.n l *ho rinkk fr trh F)t$ *irh. Conrrerorlo litnqt pur@r ro rlt Codruloar Litn* trB)
<br />I .rc'nfl uftld S6.-ri'n .ll & r'C tu.rhk '.rw,n
<br />l)rl€ ()vn.r
<br />ll(rRrrR{ r'(r\rprrisaTl(l\
<br />uEll,anltuQN
<br />I hrch\ trlhnn un,t.r lxnrlr). olFajur! oN ol rlf, l,nb* ! tlc.l.trriinr
<br />_l h.t. ud *iU miflu r C.nir.n. Dr Cotrsnr ro S.lf- lBur rd u)rtdL 6r{Ednn. a! FDvil.d ro. by Scrion lr@ ofrlE
<br />Ub.r Anq fo, llE n tfomm. ot rlE *ork fr wfii.t l,r rErmn i! nrucd.
<br />-l
<br />havc rnd *ill mintain wolkcF co.rEnrolhn rnru,.rx.- .r rcqui^i by sftr i,n l7m or rk bh, Calc, for rlE FfolrlEtrc or
<br />Ur ro n{ rhih rhis Frdn i.r iirn M, *Drlsi @nqr(dirn irulm..rir rd Nliy.un$.r @
<br />_l.cnifyfier io rtt pcnbrtutucofrh. work for *hkh rhic rcrmn D issu.d.l shlllnol chl,lo, ypeBoninm,trUrcr
<br />$ $ h lEsrE bFr h llE srr4'mqEndio. Lvr ol Crrifomn. rd rsr lh, il I {!uU b..nft ltF ro rlE
<br />wortd coml,cnsln'npmvisions ofSarhn l7mof lhc L:bn (o.lc.l lhall, todhwid csnrly enh fi'* p$tisionr
<br />WARNING lijbE ro s@ hrlcn 6(p.n$rion coEB{c t unbwtul, lld rhlll \ubj.{r s ciirploF ro aimin l Frli! rd
<br />cril liE! np ro or hrdnld rhouqd dolL^ {llm.(m,. i. .ddn$n b rlE co{ of . itENlion. d.m3ct B potd.d fd rt
<br />Sdr6n .1076 ol lh. trbor Codc, inr.ftj u.l {orEy\ fer
<br />D.t: _ _ _ _ __ Appli@l:
<br />r rcnrs6 crrxinec_nrr
<br />DECI.dMIION
<br />I lmb, .rtum unds Folry or Frlrl llEr I d liend.d !'*, FoviriJ. of (lE,ld 9 (of,llm irg eilh Sdrbn 7(l)O) ol Diviibn l
<br />of thc Busircss ard PoL$k B Cod., an my ltcM i! in tull lore ltd crTe.
<br />glllilalllfxr{lElDrNoanillla
<br />I h.rby lrrm und.r Fnrhyofpcrjlryrhor rh.E n o coniruclbn lndin8 qcncy nn rhc Ilcrforne. ofrhc m.l f.r ebi.h thN Fmd u
<br />ku.n {sd lm7. c,r c )
<br />t nd.ar N!m.
<br />-
<br />AIIIIIANI.IECI,ASAIIOU
<br />I horht llfm uiiLr Fnrllt of F.riry oE or llE rolbvin8 &.hr:rionv
<br />thmlirion P..mnt Arb.ttN Mrifr.lhn Fcd.hl RcEuLri6ni (TirL 40, Pd6)
<br />R.quircd ldrd ot Nouficrhr
<br />-_l (.nilyrhJr lh.lcdclrlagulrrion\ rcE{,lrg !\h((o\ '.nn,!rla,c norrt'tli.rhlc b rhh tn)lNr
<br />- I ediry dlr I lavc rcod rhk 'lfli.{irn Md {c rhd rh. lborc inrirnuri{'n ir comcl lrrrekr.omply*nnlllCiry!trdCounly
<br />qdturci rnd silk tf,rs Ebti{ tu toiUins .ontubtr rn hcrby .ulrrin Ep.redlliB of rhn Cny rd Counry ro drd !rD. lr.
<br />a&,vc Dnriomd pmFfl, ntr irrF.rio. prrlbEs
<br />'1ppli(Dtrlor /t!0lSiaEruB
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Sions (monument)
<br />Lile Salety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab i Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueinq
<br />Sub-Panels
<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 />Meter Release
<br />Rough
<br />Service lvleter
<br />FINAL .i,t5_U ILc-rS ^rc-PS
<br />;Z!1
<br />Notes, Remarks, Etc
<br />II
<br />I
<br />III
<br />P.m lft Dm.lprinr):
<br />Ilndci\ Adtlrcs:
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