|
ELECTRICAL.INSPECTOR RECORO
<br />OATE rD/srG.COMMENTS
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains ft,51.((N\1 ,(//14(19
<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 (Rouqh)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough \b ts
<br />Service Meter
<br />FINAL L 10 r o')tqry(d)
<br />Notes, Remarks, Etc
<br />-+-
<br />u,riu
<br />OWNER BI]ILDf.I OETTARATION
<br />I h6.t, .l[m un<16 rEllr of pqjury thr I m d6dF frtri lhc Corrtlcld L{.e L.w tor llE blbwiB rNn (Sd 70]1 5
<br />,tuind !d Prcfdlon Cod.): Ary Cily or Coufiy *ni.h r.q!,6 ! Fna lo stdrucl. dl6. itrpNve ddmlih or ,qtn o,
<br />(odEe Fior to nr iMcq d$ Equir6 fi. rpplkel for !u.h Fnnil lo frh ! r,si.d lrdclMl thd It or dr b lic@.d PE$.r
<br />ro rh. p.resiod oa dE Conlrtls t Liencd L.w (( lqrc 9. comirs wnh s..rbn 70Oo ol Divnbr I of th. BurtrB ud '
<br />PtoldioB Co&)G lh.l lt d CE i aapr rhd.6on Dd rlE t-s tor 0t dh.d qsiibn. Any Ybhlion of Sdlbn'701I 5 bv &v .
<br />ltplErlr for ! Fni $bjd! tb. 4?lkr to.ciril FllyolFl mr.lhs fiv. tuDd.d &'lltt (!tm)
<br />-1,
<br />s om of rh. FlFly. or ny dplolc trih stg6 s lh.t $lc onFsao,! *il! do 1,E *a !niEi^.1@i n{
<br />inrdrd.d or ordd for 3.l. lsc 7044, arind ud Eoft.liod Cod.: Tn Co, r.cior'! l,icc* lr* do6 .or d9Plv to e o*n 6t
<br />th. FsDaiy who hri!& or irpro6 thcE( in who dGsh h hesclror hdxlfor lhrcush hi! or hc oM.mplo'6,
<br />Forid.d th4 sch intmlqEr! & Dl rrd<t d orotu d 6. rk lr. bw. lh. bildirB or itrF.rxfian i! -h *ith nE
<br />'cof orl9ldio.. UE Orc BuiBd uiu hr 0t hdh of FviB l,. lE tE dn d hiild d iry$! d. F!PGq t, UE prF.. o,
<br />-1.
<br />s omd of rhc froFty, u.rcluivcl, co rdins wirh licd.d coftr1o.lo odtu l tlE pmjdl (S( ?04'1. &-i.d
<br />x{ PDftsion Codc l'ft. cdtrllclol r Li..N. l,.w do6 not .ppl, lo d ownd ot Prcpqly qho build. or imProv€r th6on
<br />ud sto @IlidJ ror uh pmjrl! wnh . ( . r&r.(r) licoE n puRus,n b lhc ( ontn.lor'! Li..e l!*)
<br />_l e .rdF un&r Sd
<br />l4aB5f8!:(AltEdlArIB
<br />DIIIASAIIA!
<br />I hfthy rmrm unds p. nyolpdjuryon.ofth. follo$in8 d.(l&tlioB
<br />-t
<br />h.r!.d *ill Eintb. Cgrifrcd. of CoEd to sdfiM for 6ldt"@nPdrriol\ s rm!'do.t fot bt Sclbn 1700 ord!
<br />t tn Cod.. 6. tlE FfM. of dE toit 6r *ti.h llE F i! it ie.d
<br />- I hr!. .nd will n.int.in wo*di cof,paudtrD iMmc., s r€qutcd by s..l io. 170{ oallE lrbor (bd., for th. Ff(tu.. of
<br />rhc MrI aor whkh lhi! Ddtlil . ser.d My Mrtd .omFslion iNum.. cei6 id policy nuf,br E.
<br />.G ZD.AILI+ ,//vs
<br />zAwot 2q61D I 24
<br />-l
<br />ccnify firt in rhl pdtumEc otln work aor whth lhr Frnit is isu.d, I thlll mt aPloy uy Fe. i. e, n&E
<br />$ s t' b<!n subid to lhc *0r*6' .omIEBn ion l.ws ot C.litodi.. ud tgr lhd if I 3hould b<om. ubjel lo lh.
<br />*olld comFBnionFrvilio6of Sdion l?(lootlt tE ('o<L,l lhrll fonh*nh comply wnh $dr F.viio6
<br />WARNING F.i!ft b EU. *orld' $iFrcsn otas. ! uh*tul !d rldl st*tl m dtPk F ro dinid FErB od
<br />$il lin6 up lo oE hudr.d rhorEd dollc (tlm,Ooo), in lddnon rc th. N! or @trpc!6.llon. &D!s6 s For1d<d ao. rlE
<br />S61n,n 1076 olrhc hlttr 'odc. inl6.3 dd.xormy ! 46
<br />tt
<br />I h6$y .fim ur& Frty ot FJury rh, t u li.d.d ml6 Fo6aoo of Cbprr 9 (oMirs *nn Sdib 7000) of Dirnion l
<br />of rh. BuiB !i Iitrtu ioB co&. rd it lic6g t b tull aorE !n Gr6t.
<br />.c5)D5l
<br />1/,'/( 1' <..*-.,* )(.
<br />rDlriunr or,r8or sig {n,rr)A
<br />ASIUIA!:UllIl,A8Arur!
<br />I hady 6trm undq Fdt, of pgjury o.. ol rh. follo*n8 d4Ltd i.B:
<br />D.frnnion Partu'Arhdroi Norifi.lhn l.da.l R.3uldlbB ('l b,ro, Pd6)
<br />Raut.d L.rl6 of I'lor'frdir
<br />coNsraucrroN I FNDtr\c lctsN( v
<br />I teby dIm und.r p<!dy o f pcjury thd lhsc i! . @tBrN.liotr knding lstry lor lh. pdforlM.. ol lhc uort h. whi.h lhir psmil ii
<br />isu.d rse.1097. civ ( l
<br />-t
<br />cE1i8 lh.r Ih. rcdrd r.8!hlhE Es{dus sbGlot rdt'vdl r. f,ot 4pli.!bk lo rhn pmjd
<br />l.dify rhd I laL. ral rhi! .ppli.a,6 ioi n.Mdl l.selo codply*hh.[ Cny!d ( oury
<br />trdmn(6 n d sur. Ii$s Elrfu ro b{ild Ep.@lin6of rhs C r dd Co@i, ro da l4{!llt
<br />.trr. nmrnn n Forqr) tu ,aFli..
<br />P..d'lr(unrlprlnrl, )(.4 Lr^€yqo
<br />'n/r/'t
<br />APPROVALS
<br />Lsda'r Ad(tE:
<br />-
|