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APPROVALS DATE ID/SIG.COMMENTS OWNER EUII,DER DEI.CARATION <br />I tn.hy .nim urk Fn lry ,{ Fiu, rt t m.r.'*r h'm rh. C.dEi,n trw uy litr rlE nnhMS F&,o (S.(.7Oll i <br />Burmr! .rn Prr,.s h CrLr Any ciry d CNiry *h.h rqu&r r Fnr n' dniltur. .lrd, inpntk. &frrdh or qsr 1jy <br />{turm. Fs k, ! B1u4(, .Lo RtuEr rlF q! .sr Lr ruh Fmr ni liL r risrt! .rr.1mr ihd rr ur {r a li.cnr! FWa.l <br />k, rlr ri'tihtrr 01 rlr (onrr-r,'i l-riniJ liw (chrfld 9. cillimBn8 8(h Serir 7q! of Drri,n I of 'lI BunEs .nd <br />Pn i$r!n! C{x]. ) or rhar rr rlk ! d.nIi tlrt.6om.Il rrr h8s tu rlE .U.!.J .r.qrIn Anyvi,hlit.utSdlnnro.tl5by:ny <br />alolrsr tu . tErmd ruhjGlr rh. .!dr.nr i,' r .iv'l FMlry ol n.n mE rhrn tw huilFi dolle ( l5o0). <br />-1. <br />.r owmr orrhc nNFdr. or my.mn,,'y..s w h *!s.r !! rh.n r'k oqEnirDn. w ld, tlr w{t.d rlr irure u n{ <br />urolal q orLEJ fitr ek (Sd IY4, au{ftrs !tu1 Phlcsrrnr Ciilc Tt (idrr{t r lj.n€ kw '}Et r .mlv fi' d orE, or <br />rh. F{6y eh' trdtt q ur|nlB rh.ish, 1n llb .16 uh $ hDt.ll or h.ell or rh^,ugh hr or h.r o*n cmPl,y.cs. <br />pmv rl rh:r ruh r{nlmnk e d ir.nlol !r.!iiEl lor {t . ll. hrrtG, rl]. hluuS o. o{nrEm n $tj q.hin nm F& <br />ol oitllclu llr (nEr Buitlr wil h.E llE lutn of IEvr{ rh, lt d {t tld d trr! d nih'E rtE F{Ely nn llE F]rF{ of <br />--1. <br />{\ o*n( ol rh. pn,Fny, 1n .(lunv.ly conr&r63 * h lf,.nc! (.rrr!.t,\ t! $nrru(r rlr FrF lsd 101t. Bulrr <br />.nl lhhrsrn Cirl.: l hc ConrrrrN s l,r(nr l,r* J,f,r nor lplly k! M .wn$ ot lmFn y slx, bu rls or mrrot r rh(.on. <br />rnl uh, d)dr rtqrx.hlln,j<kw h. G)nrE(,nI lrds..l l,usudr t, rh. c('orrlcrn r lrcnk bs) <br />I u ci.qr unlr Serion-. a &PC ror rhr r.s,n <br />.lll8trE8ggru8EltarqN <br />I,ECI,TTXAIION <br />I h.rc$y ritrmuftld Fnalr, ol FFry ok n(rh. krll,w,h8 dftbr.r|'nr <br />-l <br />hrvc .nl rrll mirr$ t Ctnlfrli. of Con-nr b S.ltlnrur t* kf,t6 unFnsli'n. .r Ftrt .l ld 6y Seik,n lTIl ol trF <br />til$r (ir,l. ld rrF txdnmu! of th. u,t f( lnit ih. Fn'r it B.u.J <br />_l hrlc lnJ w'll mlmirm wolk.n' roht'.nlrrrrt rlurrec. .r rcqural hy lALi r)n l7lll nf rh. Iihtr (irl.. ld rh. F.t,mt ol <br />rh. krl ftrwnf,h(hxlxm rs rskrl My w.rtdr cong.ns.lm r\urrmc rehr lrl Fnf,y nutnrrr e' <br />.*-, (lt:-(?-fo <br />),,,". - 1'fL q-"e,,r"y r.r,.r,".,-1f-[4;- <br />I (nrlyrhat rn rlrn rldrENc,rl rhc *ork ntr*hkh rhtr Frh,i tr r\!.J.1\h. ton cnlb, rny F&r r:ny lmftr <br />$ .\n,tnonrruht crh rh.k)ft.F (dmpcn'{tr'n lr*\ or C.lrforns. ulryr. rh{ il I rhtull *-{m Qhr{r kr rlr <br />*o'rd. .oqxn\.ri,i llnlvs(,ns ol S&r$n I7(f,r .l rhc I ihtr (irl.. I dult n,nhhih ondy wd h rh'e pn,vir$nt.. <br />WARNOiG: l,anu(. tu {Nrc wo cn .onrll.nslin' rovcEi. ri unLwtul. ml \h:ll \uhj..r x cr{ ,F. h flnml FnlrE ad <br />(Nrl ,]ft. u!' l,' oN hu[1..t, rhod\rnd dollrrs (!l0OfiX]|, o &lJ(tr'n b th. co( ol torpcn{rk,n. Je3.r r\ Fnvd.d ntr rh. <br />Sc(ri)n !076 ol llr ljhtr (ii., mr.Edlolrurmy r lt\ <br />9t rv{ l.t t <br />TECIJXAIIO! <br />I h.r.t y alhrn, unJcr Fnalryor !.rJxry rhlr I !m lmn*J und.r F)vrr)n ol(hlprcr o (.ommNn! tnh S(rirn {x{).1l)rrFrr r <br />ol lhc Busurcs !n, Pn'r.s[ns Col.. u nly lf,cn{ tr d lull l,rrtlrl.lter <br />e,o -2-.4,"t.'tl <br />calNrl!]lJrclllNuuc.AclBcr <br />I h.Eht . nm unld Fn Iy or Frrury lh, ilE! s t ordturEn Lulsl! rscy tor rtE Frfi) Rt of lh. Mtt lor ,txh r,i! Fmll E <br />rrkn (se 1097, crv c) <br />APPI I(' NT DFCLARATION <br />Iffi,,irmutuLrt nlllyoln rrury om of rh. nnb*inf LL.lcr.ro.t: <br />D.m',u5n P.rnit'Arb.{o! Noxfrcrlon FcJ.Rl R.8uLl r,.r tTrL {r, P.n6r <br />_R.qulrJ Lrrr..of Mnli{hn <br />I cdnythd rlE l.!.hril EauLrnr Etdlna.rtEnos rcmrtll a n!t ltlhkt,rhrImFl <br />I(d y ih.r I h.r rc*l rhN:prlrinn lrl {.r. rhd rlr rbE ,nfomrk'r 6cimi I r8d r'.nrq'|, v [h rll cny..d (i,unry <br />i,,rsrn.c\ r*l srxrc Irs\r(Lr ,r hlildirf $Nulr,n. al h.Ehy rurh,r. r.r.< .tE] of rtui Cny rr{ Cou y r. ols ulir rlE <br />rh'rc nf,trr('ncJ l]n I).ny i,tr trs <br />,\ppli.xrl or AE nl Si*Mlnn q, Lt lq <br />Sate-Work <br />Underground <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Lile Salety /Low Voltaqe <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bonding i Grounding / UFER <br />Transformers <br />Torqueing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rouqh) <br />Ceilinos (Hard & Soflit Rouqh <br />Ceilings (T-Bar Rough) <br />It I tl 'a <br />Rough IIl14 tlq Jl Yalull P v <br />Service Meter I l' r <br />FINAL v TIZD b#vnt L+T>a <br />Notes, Remarks, Etc.)'lu- <br />ELECTRICAL.INSPECTOR RECOBD <br />Meter Release <br />Irnl.r \ Addrc$