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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underqround
<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 (Rouoh)
<br />Ceilinqs (Hard & Soffit Rouoh
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough I llc 2)
<br />Service Meter
<br />FINAL /o-3o'rj 1/-c 9r)
<br />Notes, Remarks, Etc
<br />OWNER BUTLDER DELCAITATION
<br />I hqlty.Irm u dFrhyolFjury$rI@6@F6DDllEcollncrd'LkortwforllE&uowirs,!&/(s<7olt,
<br />BG,na !i Profsion cod.): Any cny o. coudy qtkfi rEqun6 . Fna lo olntu<r. .xa. nlttovc dmlid m r.!.i ev,
<br />rrudu,q Ftu ro ils isulN, .Lo r.qui6 rh. .pplicel for ruch pGtnn io fik . rUD.d ltdcn lh, h. or ,E a !icd!.d lituar
<br />ro $. Fovilird of tlE ( onradoit Lico!.d L.w (Ch.ptd 9. Comdins wih Sarion 7000 of Divilio! I oa ih. Buid xd
<br />PmftsbN Co&)n rha h.or3lE 6 6@F Er6!n srl llE tGi for 0E .tlg.d adFbn. Any riobion of S<ibn 701I t bt o,
<br />epnc! fot.pdonrubidtrh..ptlitullo.tivilFutlyof@rmErh&fir.hu'r&cdd.llEs($m).
<br />,B't. o o* orrt poporr. d m, .orhy6 wnh wasd s rlE .b .onFlriof,. qill do rlE *<'t -d lll rid6 . @r
<br />itrdt d m olfold fd !& l Sa 70,14. &!iE dd Piot6.i'6 Cod. IE Colr..id t tile ts rlc nol +,lv 16 e ow ot
<br />rlE FoFry pl8 bil(bs trtgD!€uEqE 3!d wtF dGtd*st hirelfor hc*lf orltftueh hit lE o*n 69Lo)6.
<br />protid.d rhr $ch imFovtuil! cmt iidrLd ororald aotsb.l( howM. tlE hliEuls or itpro6td n$B wilhinon Jd
<br />of cdlPldDo. llE OqG adil& wiu h$r tlE hrdar of Fot B U[ lE n {E dil d hild d itr!.lE tlE FDFIv 6, dt F,po..ot
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<br />1. s ow oath. FnFiy. m .(lBiv.ly .ontdrg wnh hcd!.d co rt ron
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<br />codruci lh. pre)c(t (se 7044. 1t$ind
<br />an PrDt i. Co&: Tb. Conlrclr'r Lkdc L.w &'6 rcl ,r?ly lo - 0*.6 of p.oFly *ho hild! or inprov6 rh6@n
<br />ed eho .offi! fd sh Fqcri *irh i ( oddnlt) las!.d F,tun lo rh.ao slix ! Liu* t *)
<br />I &n.rmpr udd S(r
<br />o...o5-/o-1 q,,"..#ib,i,/o B.- .sla[la:i:(atrlfIlsAflq!
<br />DICI.AAAIIA!
<br />I hd*, .mm un&r Fuliy oaFjq_ om of lh. folbu'iq <k(lr.lF6:
<br />I h!v. !d will n.inrld r CariaK.r. of coEal lo S.ll'lBu. fo. *d*da qt.Ddslkr. s F$vit d for bv Salnrn l70O ofrh.
<br />Irbor Co&, for lh. Ffolll@. ol$. s. for qhich lh. Fhil i i$.d
<br />I h.v. Dd will rotlll.'n mrkdr .otrpddion iNullr.. s r.qu,!d by serion aT(D of lh. Lrbor (-o&. 6t lh. Ffdre. of
<br />lh. qort for whkh rhii F.trit i! is.d. My *ork6 ompdsarn iNlrmc. cMi6 dd policy numbd E:
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<br />c6nry $r i. th. Ffolrre. of tlE u ort tor *tth rhs Ff,n ir ir$cd. I {.ll tut nnphr r.t F$n in inv ffi
<br />$ s ro hdom tubid to thc w.t6 omFdion L$! orcltilomit dd tsGfi, if I {Fuld haoG $tid
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<br />mrl6 comp.Mlion p.ovi.ioB oI sdtion 1700 oflt l,bor Codo I JEll. fonnwilfi omply wirh lhor PmvisioN .
<br />WARNING FlilE lo E@ wt6 @mFqbn olsrsc il unhltul. td rhdl rubj.<l d dploF to simird F.li...d
<br />civil lind up lo onc hundad lhousd doll6 (!IOO.OOO). in addnio. ro rh. .oi of conF@lion, dIEgB E ptovid.d lor rh.
<br />sdio. 1076 ofth. Llbor Co<ra inrqd ed.nqEy ! aG
<br />l-,t,/o S
<br />D[CIlsAtlO!
<br />t Hy .rm oid6 Frn, of Fiuy lhr I s litqE d urid FD\lion of Ch.F6 9 (o,ll,ai.e enh SaInn 70@) of Dn iri,n l
<br />oa th. Bqi6 &d Prcf*io6 Co&. ri my lk@ i! iI tull for.d drd
<br />coNslnr (-TloN I rnnlNc ]rGrN(1'
<br />I heby amd undn Fdry oa Fju,y lhal rhe t a conntu(io. Lajins osocy for rh. praolroc. of ltc *orl for which lhn pqmil i!
<br />is.d (Sc 1097. Civ C)
<br />Lc,Jd r AddB
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<br />APPI IC NT DDTT A'r^TION
<br />I ha$y rrFm unds p6.hy ol Fjury on. ol rh. followinS dalaalion!:
<br />Ilatuhio. Pmnetub6rG Noliiolion F.da.l Rcsultril8 (ThL,lO. Psl6)
<br />R.qun.d Inrd of Ndifi.nih
<br />-l
<br />csl it lnn llE f.dqtl rcguLrh6 Eg&tins stdo! rom\.1 !. d +tli..bk lo thi! FoFr
<br />&l cqrif, rhd I h6,c rc.d rhis rptlicll nrn ed rlllc lhal rhc !tnv. irtotuio. i! corccl. I isrd ro onPlv rnh llt (
<br />'rv
<br />ed coonrt
<br />odrMce &d srd. Lr*! Elril{ to hildins connrudior dn h<.br furhtn. EFsndivd ofrhit (-nv !d Coum, ro al6 upon llE
<br />rhr\. 0ork)ncl D.oFn) n 6Frn,n puFs
<br />Appu..nror^rdrsisr,ur f- Vl>; o /q
<br />pdr,(..6.rpnn,r: >9IUl"fq g
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