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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.
<br />Underground
<br />Pole Bases
<br />Lioht Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Lile Satety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Building
<br />Bondinq / Groundinq / UFER
<br />Translormers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipmenl
<br />Factory Wired Unil
<br />Walls (Conduit)
<br />WarrJrtWalls (Rouqh)lolulS C:*,)
<br />Ceilinqs (Hard & Sollit Rouqh t I \ \-'7
<br />'N4{//{,Ceilings (T-Bar Rough)lo-20-tgl
<br />Rough
<br />Service lt/eter
<br />vqeu&FINAL Jltl14 t'w
<br />Notes, Remarks, Etc.Ul
<br />oWNER BI III,DER DT,I,('AII4TI{)N
<br />I lw.by allirn undd lxnrlr, ol rcrjury thir I im cxcmpr rionr rhc Cofiftcn'r' l,iccnsc ltrs r,tr rhc ,,nlowirB rc.\on (Scc.7(ril 5
<br />Bust'cs rnn Frnicsn,n 6dc) Ant Cn, or Courly which ,cqutcs ! Fnnir b .on{dcr. thct. inuorc, cmlhh or rcIJt rn,
<br />(n,crr'c. priitrt' iis h$,nkc.rls.rcqnircsrhcrmli.rirtursu.h,rhnirlolilc.\i8ncdstdcnEnr lhll hcqshe is liccn\cd pxr{mr
<br />i. rhc pnrvhionr ofrh. Co.rrr.roi\ l-icEnscd h* (ChlPrcr 9. Comftncin8 \rnh sc.rion Tuoo of Divkion I 6l rhc qlsincs rnd
<br />Pbrc*ionl Codc)orrhtrrhcorsh. i!cxcry)l Ihcrfn,m drh.b*i(turlhc.llL'8cdcrcmplidr Atryvt)hrionolsc.ri. Ttrll.5hydny
<br />lollicadroripemnsuhjlrlsrh.lpnlicanrbacnilpcuhyofrcrnnrclhmiv.hondr.ddollnrsls5m)
<br />l. trs oNnd ol thc pmFnr. or my cmployccs vilh w.-!cs as Ihct sle c.nr.nsa' ion. will &, rrt troit rl rhc nfrtm h mt
<br />inlenL\l or olttrcd lor salc (Scc 7044. Busincs and ltolc$ions Codc,'Ihc G,.kd.d-s Liccn* Ljw des not ryIly ro !n owtur or
<br />rhc poFny alt, buildr .r nn oB rtraon. and w,[r dNs sKh sork hnnsclf or hcrcll or rhoush tis or hcr owtr .Dtloyc.s.
<br />proviJcd rlur ruch i'nr(*rmnh m nor inrcid.i .r nlftrcn for {lc ll lFwc!6, rh. hxildine or i'nln*cmnr k e,U wihr .rc )ttr
<br />.I coflrhlhn. rlE Owncr Buitlcr will hlve rhc lN'dcn of p,oving rtql he or shc dil nor huild or inpr.vc thc lmF.ly for rhc Nqr* oa
<br />-l
<br />arcic'npl undcr Scction-. B &PC lorrhi!raq,n.
<br />Doie: OPnei-
<br />wonxrns' triuprrslrltw
<br />DICTdSAII()N
<br />I hcrny lrfirnundc. pcnrlrr.lpcridry.m Drrhc rollo{int nechnrk).s:
<br />I hnrt and rill'tui' riidCc ill.rlc ol (in$cnr !, Scll.!n\urc lnr trorkqiconDctrrrri{n!. rs |[,vidcJ f(t hySLtti( l7(X)ol thc
<br />I-!tx, C lc.lq rhc lfrfornBncc ofrhc qork lnr trhi.hrh. lcirnir ir i\sutd
<br />I hrv. ,nd will nhi, nr wor*c.r .onlEns.liotr insurarcc. ff rcqutol by SL{l ior .l7lx) ol rh. tnhor Cldc. hr Ihc pttiommc of
<br />thc *.rk frshi.hlhk Nnnit is isscd MyNorkcis conrFns.lh insumncc.ffiier and B,licy nu Dbd dcr
<br />-l
<br />ccnilyrhrr ir rheFrhrnranccofrnc $ork for *hich rhi\ nrnni i\ n\u.d.l shllltror cnrPk'yany Pcrson if anrmdncr
<br />$ r\ tr, lr.ont \uhi.l tr rh. wo G\.omrtrs iotr lrws.rcalil trir. {nd lt.Ec rh iil \h.uld bNoinc \rhjcd lorh.
<br />sorkrN.onlrsarn,nrnrtionsofSc.rioflJTl[olrhcLnkr(irlc.l{hll.i,inhsirhconllllywirhthorE,vi\tr'i(
<br />W/lRNINC flrilurc !, Rurc s.rkc's onrncnsarion cov.ragc i\ un[trlul. rnd \hr]l ruhj.cr atr.nflo]t! to crininll pcnalrts md
<br />dollm (S100.0(n)). in nddiriotr ro rh..oe ofcon!f,ns ion. d!roges as lmvidcd fd rhc'wwfx:'
<br />I hcrhy aftnm dndcr lc rkyoifcriur] rhal I prcr 9 (.-nnmnciry qirh Sc.ri( 7UXr) oiDivniotr.t
<br />of rlr Busir.sslnd Pn,ic$n,nsCodL. md ry
<br />7tq/T
<br />I hcruhy rrfi'n orlcr ri rlryorpcrjuryrhdtlnct a[crct for rhc p.rronnrdcc orrlrwork lor *hichrhi\ pcnil n
<br />hsucdlSN lO97- Civ C )
<br />tadclsN!mc:
<br />-
<br />AP]I.ICAITIIECIAMIION
<br />, hI6y aninn onder p.ndhy of p.rjurt onc or'hc aollopnrS d..l,r,rions
<br />llemolirion Pcrmih Ashcsros Norili.arn,n F.dral R.guhrn,ns (rirb 40. Pin6)
<br />-Rcqutcd
<br />Lelrcr oa Nriarc{ion
<br />lrcn,l,vrhrr(h.lrdcrrlrcFUhrii)tr\rutidir!n\l[q.sic n,rilnrc tr.rr|)|]licrhld i, rhi\ n('J..r
<br />I (diiyrhrr lhr\c rc rhh imlicrr i{nl u,l nrrcrhar rh. rtxr. inf{rmrrbi n.onrtr lr8re I
<br />urditun.csrDd srdc Lrrvs rcl0linsto huilairsc.trrrn'clion. dhcrcbyrtrrhorhrclnc\.nrrrivcsoi
<br />N)r. trEtrli,nrcd I'on!ny i,tr
<br />Appli.ont or g.nt Sianeture -L
<br />COMMENTS
<br />Site-Work
<br />Communications Cable
<br />Under Slab / Floor
<br />Meter Release
<br />-1.
<br />owncr olthc ropcny. ! cxchsnclyconrEcrins sirh li.cnsed conra.t$ ro .onqru.( Ihc D$icl lS(. ?(,+,1. Bu\in.rr
<br />Md Plrrissar Cod. ThcConti.iofs Licctrsc L0wdocs nol app,!lonnoNncrofp(,t^-rrrwho h!il&o' imnn,vcsrhcrstr.
<br />rtrd sho contmcrs for such nmFl. sirh ! Conracrorlsr liccn{cd pd6ua t) rhc Conta.tr's Li.cne tjw)
<br />I
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