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ELECTRICAL-INSPECTOH RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS O*'NET BUII,DEtr DELCARATION
<br />I ncrcby lmrn dn'jcr r(ntrlry i,l Frjury rhlr I m cknFr liDm rhe ConL(lo^ Li.cn* ljw nr rhc rollowinS rcrsn (s(70.11.5
<br />Blliftr\ rn P'of.\ri'n Cdi.): Ant C y or Cou.ry *hih ftquiEr r Fni k, .!nfu1, ,ltd, irprow. d.rDl$h or EFn ry
<br />sltrrur., pm. lo ns issulmc. dko Equms llr trpplronr for urh Frmir h n! o siSncd n.t.mnt lh.l tE or slE ir lianEd pu$ul
<br />k' rrE ForisioN of 0r conrB-xtr\ Ltlnrd LB icl'spro 9, collftrins *irh s<rhn IXIJ of Diviibn I of rh. Bliir$.Jld
<br />Pmr.$ionr Cod.) or rhdr lE or rh. 6.x.mJ,r rtF.iom rrld rhc hdrn nn rh olkScn .r.nprnn A!, hlarionolS<1bn?l)ll.5byuy
<br />lprlicrnr rbr . pc'nit \ubr.rrs rlE spplic.nr b s civil t Mlryol.or )rcrh[. filc hundnrl doll&s rsrm)
<br />_1. ns owrcrllrt phFny, ,n nry e.{,hyc! eirh wrrcs a! rhcn blc enp.trqribn, will d. rlx k'*,nl lII r1d@ is mr
<br />idc..L.l d oficErl fd sL (Sd.7ora. aurims md PrcL$ioB Co& Thc C.d'Ilolr Li!trE Llw dEs d .rply lo u owr oI
<br />rh. tftFn, wh hild! d intftE dren. rn sho d(a rh knl fiimclf or hc4lf o, rhmuti hh or h.r o*n .npk ye3.
<br />povibd rhrl such inll)mwnis e nn irl.idd or od@d for sb. lf. ,nwE, 0E t{ildir3 or inpr.EEnl ir sl, *irhir orc Jtr
<br />ol onpbri4 th. O*F AUU#r *ill IEE th. hnL. ol fftvi.8 rtd tE o. itE dd mr hrE n inIroE rtE F.tdy fu rlE FrFr of
<br />_1. ds owmr of rlE F,Fny. m cr.tur,r!, .od.d in8 *irh liiEd .o ral(m ro (otr{M rh. pft,F (Sd.l(x4, Burms
<br />rd t\oft.sbn Codc: Thc Conlrrrol \ L-iccns Ln* do.. not alplylo !novncr of,roFdly*ho build!o. iq,m!.rthc,coD,
<br />md whr o.rdr ld rEh F.ir! *nh r Coffionr) lrrn.d runM io rh. (}[dd r ti!trr lrsr
<br />_l m.rnrpr und.r sdrion_, B. & P C.lorlh6 Ms,n
<br />frll€ O*n.r
<br />wotu(rfu ;c'otP€Ns^fl-ii
<br />DEcl
<br />^nrrnoNI hc'cby !lltm und.r p.mlryoltEjuryoft olttr loln,uin3 d(ludn,nr
<br />-l
<br />h.v. !,n will minrrin . C.nilElr. of Conrhl b S.lf.lnr!r. fd *o 6 omr.nrltion. as Frrid.il lor bySalion 1700oflh.
<br />tjbo. C(*. for 'lr Frrolrm ot ltr wMt for rhah rh. Fmir ir is$.n.
<br />_Ihtrk rndwill nr"intr r *orlc^ coiNn\uron,nrurrn.c, tr\ dtnftd bySsrn,n:r70Oul rh. trhur c(dc. for rhr ,l.rlomurc(f
<br />rh. rork nr$hihrhl\ Frmir ii trskrl tly*dl6 ror{E dx,n lFurft. rlrar or, p.lry nunt re
<br />llili.yNun$.r:Lrrtcs
<br />-l.cnrry rhlr rn rh.lE.lonENc of rh. uorl r(, shth rhR IE mn tr sodl. I rh.ll fl, crmkry any IER)n rn ao, lmE.
<br />w, trs to lt(,m ruhr{t ro rhc tr odqi convE.{r ion b*r of Crliforni( .d rar ih4 il I !h,uH k{onE sub}*r r. r rx
<br />srrts oqEnsrior pftlisi,N of Sdin l7m of i,E l,trr Cod., I {EIL todh*irh .brrf'ry r irh rh)€ FDri56ni
<br />ltARlilllc F lur ro sm rr).t * oqrndin drfte. ir unLrtuL .n rh.ll rubFr m cn{lbFr l{ oimiml lEulii lnd
<br />.ivrl 6ncs up to oft hundrcd lhous.d doll(r (sloo,tm). in oddnir to rh. con-of comlEfleri.n, d!trl8.s !r Imdi.d for rl!,.7
<br />,.",I?
<br />.It L+"I
<br />8/?,a: ApDll
<br />.-2
<br />)-0
<br />IESIJAAIIQ!
<br />I lEEby srrh lndcr FMlr, oa rcrJury rhrr I d lien*d !o&r FovLirn of Ch.prc I (omrhS *nh Sdb. ?(n) oI Divisirn l
<br />ol llt 8orircs .rrl PDlcrrbB Co<L. ud my ltcM i! in full foc nn cflst cKlocL46lPlu<t
<br />qTEIASCNQdIEdUNS-ASEJJ
<br />I hcEby rmrm undn rrcnrhyofrrruryrhlt thcE n a.on(Nclbn hndin8 l8cNy for ln. Fcrfm'lec oflhl work tbr *n(hrhit F.nn n
<br />isudl rsr ]{197. cr cr
<br />k r.a1 A&h$
<br />-APPT ICANT DECI AR TTON
<br />I ffiy lfm undcr Fnully of nclury om of lhc louoqing &{ld!lion!r
<br />Dc'mliri. Pqmil3 Arlnlos Mrificrlion tu ilR.slhbnr (Tnl.(). Pd6)
<br />_R.quird btr.r of Ndiiidb.
<br />lr.it'1vr[. rrFh\1.'r rc!tr ]rtrn\ k!mlrA r\h{r\rrnktrrllr no( q,t,ltrrhl. (, rhtr tro|e.r
<br />-l
<br />cnily rh.r I hNc rcld rhis lplrlkari,n dd {arc rhar rl1. ah,vc lrFLr r'roitnt$ h rllC{tJfrl (irnrl
<br />hyxurhtrnr rt.nrr\rtrrdirr\or rhn(\yri,l (outrryroctrty ut rllndirlNcs lnd Sllrc ljws rld iry ro buildin! cotr
<br />*( mnri,Gai ImJEnyf,n msF{hn pur - ^.)Z/f/2226Appll(al or AE.nl Signrlrm
<br />taP"mrlle n,i," l[.l r: )L"4
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Salety /Low Voltage
<br />Fire Alarm i Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor .t I
<br />Bonding / Grounding / UFER l+c 7A bfl,V<17
<br />Transformers I
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners I -.t
<br />Roof Top Equipment $,g 1,4-
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinos (Hard & Soflit Rouqh
<br />Ceilings (T-Bar Rough)t ^l
<br />Meter Release ll g 7I )*aygrl I
<br />Bough
<br />Service Meler I I
<br />FINAL v 4A v7
<br />Notes, Remarks, Etc.ITT
<br />6t/l-t/-1
<br />hadf
<br />oa.n7-201
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