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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE COMMENTS
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Lile Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Bonding / Groundinq / UFER
<br />Translormers
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh) f nd,
<br />Ceilinqs (Hard & Solfit Rouoh 7-tz- l{t-t tlu
<br />Ceilinqs (T-Bar Rouoh)
<br />IVIeter Release
<br />,Ay-w't}Rough 2-lz-t (
<br />:(
<br />)w,
<br />s.
<br />-z,n I
<br />Notes Remarks Et
<br />-/yr
<br />FINAL
<br />OIVNER'UII,DER DELCARATTON
<br />I hcrcty !flirn undcr nctrahy ol p.rjrry rhar I m dcnfl fbnr lh. Conn lo.s t-tcnsc ti! tor rh. follo*ina rasnr (S(r0ll5
<br />Burimss eld Pror.sion codc) Any Cily or Counly *hich rcqut$ a pcrhir rd c.o{d.r, tlid, improvc, &mlhh or rcpon lny
<br />sIfl.turc. trior ro ns issuarcc. oho requtcs rhc E,I,liclnr f{tr such Fmir b fih r si!rcd i{cmtrl thlt hc or shc n licen*d Pu^ldr
<br />ro tne pnvnions of rhc Co.rr.M r Lic.nscd trw lchaprcr 9. CoDumrcins wirh Scdb. XI$., Divkiotr:l oflhc Busi.cs and
<br />Prur.ssions Cod.) or rh,r h.o.shc ncrcmpl lhcrefromand lhchrsn fulhc lllcscd cxc(trion Anyrioltrlionofsdi.nT0ll5bya.y
<br />trpplictrnr l'or a tlcrmn subjech rfie lprlicanr ro a.i!ilpcnslrrornor mrc rhtr. fivc hundrd dollrs (S5m).
<br />I. as oqncr ot lhc pmpen!, or my emplores wirn $ascs ar lh.n $h .o,hPcndnnr. sill
<br />'jo
<br />th. *ort and llE {tulum h B,
<br />inlcndcd or ofcrcd for $lc (Scc 7044, Bu\irrcls nnd ft)rc{sion\ cdl. T}tr (ifirrdd s l-icc.sc ll* dod ndr lpPly b rtr o*rcrof
<br />rhc pRrt n, who builds or irT,oB rhecn. lnn *l!) dEs \uch *o'k hnn\.lf or hcsclf o hrouSh hh ot hs o*n .mpk,ye.s.
<br />F ovid.d th.l such imDroutrrlrs m nor inrc dcdoroflcrcd rnsrL.ll how$cr. rhc tuilding or iqmlcdnr iss lwnhinum )qr
<br />ur.onplcrion,rhcown BuiBs will harc ltl hurdcn of rovirg rh lE or rhc did nor t{ikl or infmvc lnl F)pcny nn th. purtDr of
<br />-l
<br />hrvc oxl uill nEn ainrCcdirraicolC.nscnrrosc,flNurc[nsork.G conpcnslrion. N Irovidrdforbysccrion]70oofrhc
<br />tibin cdic. lor rhc pcrtormtrc€ oi thc sork fo, shich rhc pcrorir ir '$ucd
<br />-lhurconn$illnuinhi'rworkcncolPcnstridiiNuotr...asrcqui,cdhyScction.lT
<br />) oi rhc l-rhor Gdc. for rhc ,)(rlorromc ol
<br />rlrc \01lnr*hich rhi\ p.nnit i\ kud My ,nv,c.sarn r imurorcc sric, ud pli.ynun$$dc
<br />'<es ./P
<br />l.cniltrhari rhcNrfonrr,n.cofrhcqolllorwhichthisp.rmili\is\ucd.IshrllnorcDlpkJyr.,D(.soninuny,rnncr
<br />s Nto hcconE suhr.ll lo ihc $orlc^ co,npcn\ari,,n hq( otcrlifonir. rtrd r8rcc lhrt ifl \hoold tBcoft suhjcr ro thc
<br />*orkcr' compcnsarion provi\i,,ns of Scdtun lTm ol rhc Lnr (i)dc. l shall. lonhwith conPly wirh rlDt thlh ions.
<br />WARNINC Frilur b *ur. workcn co,npcnsolion covcrryc is unL,*ful. Md shdll subiccl arl oDloycr b oininrl lxi i.s Md
<br />cilil nnc\utk onc hutrdnd
<br />'hous0nd
<br />dollirs (Slm.ujo), in uddilion x, rhc c.n orcomFtrsrliotr. drrmScs rr prcvidl{ r rhc
<br />\.!rn) ' nrrri !)f rhc l.rhn 'il'-xfl 4-)
<br />ulau !!tua\
<br />unrlcr nctrrlly orp{rjury rhrrI nli(n{duntlrrlkr\i,nrolChrpr.t9l!onnn.n.in31virhSdrrn TU
<br />of rtu Bu\iic\\ nd Pn'fcssioN Conc. n nry lircns n in tulliuccudcltirr
<br />E
<br />!A! f,IJCIIONIENDINC.EIiENCI
<br />hrr rhc.. n r.onirtu.rFn lcndirp aFcncy lnr rhc pcrfornumc.frh. eork l'or sii.h rhh pcnit i\
<br />A.l&MNIDlILi&\.tr0r
<br />I ho.hy.n-mn und.r Fnalryoll)c juryone ollhc folbwin8 d(lmrion\:
<br />DcBrirbn Permir\ Ashcsor Norifi.arion FcdcBl Rc8ulllions{Tnt 40. fan6)
<br />-Requncd
<br />krrcr orNotrc tun
<br />-l
<br />c.nili rhd ihc f.dcral rcgularions ESrdins Nhcslosrcnmvrlrc nor lppli.ahlc ro rhi\ puc.l
<br />I.riifyrharI havc Ead thisrpplicalionond{dcrhd rh.rh)lc itrtofln.lion ncorc.r.I rgrcro.on y*irhtllCilynndCouniy
<br />oftlinrtrccs 0trd SIorc liws rclorina ro hoildinS co.(tu.rnnr, rnd hcrcb, rulhtrizc rcpr.\cnrdiv.s orrhis ciry Md Countylo enls lF)nrh.
<br />r\r rntotud nmlcny
<br />ln,,*, * n
<br />)'-,,*""."
<br />*,",G:/4-1{
<br />ID/SIG.
<br />Under Slab / Floor
<br />Service I\Ieter
<br />r -\Ltlt;.l
<br />-l.rsorncrofrhcpm,^-ny.rndclu\ilclt.otrtr.ri'r8sirhli.ctrscdconkrcttr\ro.onin(rhnnlj..r(Sc.7O,l-1.llulinc\\d Pnni\i Codc:lhcConrrrr.i\l-i.ctr\.1-r*dorsnorrtrplyk,rnowcroffropcny$hohuild\ori'nliovcslh.rcon,
<br />rnd who conrnrk tur such pmj..rs w hs (i n'ctra(s) li.ctr{J punnanl l{i rhc Conlrdktr \ t.i..nsc LrN).
<br />?krl
<br />C-/./-t.t--
<br />I
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