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ELECTRICAL-INSPECTOR RECORD
<br />DATE rD/srG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough
<br />Service Meter
<br />a,*8"/FINAL ,b fllu Dknnr
<br />Notes, Remarks, Elc.fI
<br />0
<br />OWNER BUILDER DELCARATION
<br />I h6.t_ry .lIm uft*r Frhy of Fjury rhd I m .rmpt 6om rlE Conrr6 Li6e tD' for rlr folkr*i& r.&n lS.( 70115
<br />I,l6ins ,n Frcldiotr Co&l Any Cny or Couny \hrch r.quc . FBr ro otrrrucl. .hd. idpro\a d.,mlirh or EO.ir or"
<br />sr'urttrc. f'tr, n) \ rsu rcqun6 rh. afi,l'canr forsuch ltmn r() fil.asirn.n ndmouh{ h.or 3h. ir lic6B.d t]um..n
<br />ntftro.! Lto*i L.*'t(1tr!r6 9, ('omtri.s rirh S{rin 7000 of Divirio. I of rh. 6Ein< ed
<br />rh.r lr q Jr a a.flpr rhccnon rnd rhc h66 hr rh. .lL8.d ddnFion Ary liolnkin of Sdi'n 70ll t b ey
<br />Fmn 3ubj..l! !h. lppliclnl !o a olrl l,6rlt, ol .or mr c thu fivc hundEd dollu r (St00)
<br />ao*Fofrh.F.Fnt.ormtmplot€$nh*ry6aih.r$LomFsi..,sill(I':sql!dlrElt8iEirDi
<br />iddrLd ofrsrd f.. sL (Sc 70,1.1. BsiB 6d iinfBbE Co&: IlE ftd8rd . Lt.a 1r* ds d Iply ro x orE of
<br />rh. prDFty who hrilrh n imF.r6lhqEr el qlb 66 sch w* himrclf or r'6x!ro' thruuah hi! .r ha om aployc.
<br />FoviLd th.r {ch inFvqc$ & @r idcr.Ld d oftold hr nL lf. tF*6s. r boildine G intmvffil i .ld rnhn m td
<br />of GlPkia $. O^G ltuil& *iU h.E rll h,rld! ofForirB fir lEortE dd nn hlld ( inpnn 0E FiFr, ftr E F4o,..f
<br />l. a o* 6 orrh. F,p<l'. 6 6.hBn.lt co.r*r ds *iih li.nE d codrdoR ro codM rt F.i.rl (S( ?0r4- ltliB
<br />.,n Ptotsn Cod. I n. Co r-loii Licru Lr do6 mr .rol! ro - 0*'16 o f ,.op.lt!.' r tF tnild. .r
<br />'npror
<br />6 rhaotr
<br />rnd rho odn(k ntrruch Fotdls \ih n (nmnt.,1s) li.oRd puBM ro ihc( onrdois Lic.e tr!)
<br />I m c\dnpr und< SdiJn
<br />Lr \.1 l<!q.z .Ot- aY-'z-cLo
<br />I h.r.!r.mm un&r Fah, DltEluryon.or'h.
<br />DT(]JAAIIAi
<br />I h^. .n * iU mid.! a Can,lRnc ol ( o'q! ro Sdl-l@E fo. *116' .omFMi,c d Ir!\ irLd for by Sclion l7m ollh.
<br />l,rx, C.<,a for lh. Ff(,lrM. otlh. rql fdr lttt lrE Fni i! is.d
<br />I hN. rnd *ill mainrn. wortd .onp.rodlion i6urrN., s r.got.n by Sdion r 70o of lh. Lhor Cod., aor 0E tdfo,M.. dl
<br />'lE
<br />$st lor whih rhi. Fnt i! ig,cd Mt rql6' omFdi!. iEUe. (ei, !n polay nldbs G
<br />ily rha! in rn.lEformanc.ofrhc wo't fo, \hich rht po,nir t issu.d, I shtll ior mpl.y.nt IrBr in on, mdng
<br />- a ro h..om ebrdt to rh. mrt6 omFMbn hB oaa.liaomi{ url qc lnl it I $ould bdod tulrcd t I
<br />*ort6 on{mdh. F!1irh6 of Sdir. rTOO ot rh. t tr{ (ii.. I slEll. tdh{ nh omply s'nh ltbr Ft\irioB
<br />WARNINC f!'lur. n' ku. *016' c.oFa.{trn cordrr. ir unh$tu|. Md Jrll $bjd u dpLrt. lo ainind FshE ed
<br />cNn fin6 u0 ro oN hurlr.d thouqd &lhr! (ll(I,. 'n &ldnih lo rh. cor ol comFdion. d!ug6 a F a,.d for lh.
<br />s&rnn 10?6 ofrh.lrhtr ( d.. 'nrr6r inJ n!
<br />?i Jn \<*t^u,oL o8.2r&
<br />I h*hy.mrm und€ n naityoIrEjlr,lhal
<br />IECIAAAIIA!
<br />unds Frvnio, of ( hrt d 9 (com.ing wnh S(ltr 7000) ol Dirilioo l
<br />of rlE t,6iB .nd PmldhB (-od., ml ny lkN ir in full ld.! rn.lld
<br />COISIf,TqIIQIIIJIDIICIGIICI
<br />I hdtby amm undd Fulty of Fjlrythr rlE i.@lEttu.lbn LidirDg rBfty forlt Ffotrffi. oflhc *ur tu etth th! Fnt i
<br />ilru.d (Sc 109?. Civ. C ).
<br />l.ada r Nmc
<br />AIIIICAILDIiCI.A8AIIAI
<br />I ha*, .llm uids p.nlhy of Fj!ry o.c .a rh. aolloq i.! ddlod iorsi
<br />l).'nohn,n f dmis.Artsr Norific.rion t'.dddl RquLtioctI lc.l0, Pin6)
<br />rhd rh. f.rLr.l E*ulllhB rcg.dhg GtEro. rmn .l e. m' 4,',lEablc n) lh6 Fnj.ar
<br />.8rer..omply *ilh.U Cnr ind Counly
<br />'v6 ofrhk ( nt drl ( olnlyro ols ulni rh.
<br />,,," Ql- oY-2a'2o
<br />APPROVALS
<br />La.e N@b.r _
<br />FJ
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