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ELECTRICAL-INSPECTOB BECORD <br />APPROVALS DATE IDiSIG.COMMENTS <br />Site-Work <br />Underground <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Lite Safety /Low Voltage <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bonding / Grounding i UFER <br />Torqueinq <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rouqh) <br />Ceilings (Hard & Soffit Rouoh <br />Ceilings (T-Bar Rough) <br />Meter Release <br />Rough <br />Service Meter/ /,lF|NAL 7/to.//7 f/il (/ <br />Notes, Remhrks, Etc <br />OWNER AUTLDEA DEt,(ARATION <br />I lrnl', drim ul.r FDh, ol FIry rh,r I s .r.npr tsm rh. Cdnd'n l-rcn* L.* li'r rlE tulbwo! E.r,n (S{ 70!l a <br />Eunkrt lrl Pror6(r Gr,.): Any (ry {r Cd , whah FtuB . Fnd h rrnrar, .l!d, invnE. &frnsh itr RI.r ut <br />(E(rurc Fx ro r EruBr. .lv, rguFt rlr {Tl-,rr for ut Fd[ k, ih r rBrJ {icmd rh, h. or !& ! lt..<.j F,.urn <br />ro rh lmyFbB of rr Cbnlr*(i'i I...nql t * (Chpl( 9. C.nmE6! B h 5(r$. 7()(n of DtYFsr ! .l rlr t!!r.r .d <br />Pnl:\r.r CGL) d lh.l lE r !,x ! ckn$ itdtfnm.d rlt b(ir nr rh rlk8..l .r.tq*m tuy vr.rnnoaSerni 70.1I i hyrhy <br />{rtlt.d ntr r limir lubj<k r,t rfi'l'c$r b r ovn FMxy of sr mE rh., riv. hu rcJ ,.nnl.n (s5m) <br />t. r\ Dwmr .t lh. ptr,tEdr, or my .mploy€t *rrh *rycs !\ lhcu v'k $mlxtr\3i tr,n. wrll d) rrr wrk inl rlE {nrh'rc s nn <br />tr rrxlal or olt'crJ lir s.lc ( S.r 7iH4. Rru.s rnJ Psni$n,n\ C,rl. 1 h. (i6krn{ r l-(.nt hw 1ll'.s nor amly n, rh n**r nl <br />rh( pn'Fny who hurlds or !qnE! rh.F'n. dn *h, d,f,r se,t H'.t hm\.llor h.r{llor ihn'ush hir { lrr owt cnTl,y..t <br />nn)vrl.d rhlr ru(h r{B'EnE.n u nx or.rLd dr.fl.Bl ltr qL lr, h'm\E rrl hu l,n3 r r{r,ltmnr s !,U strhln .k w <br />nl (rfl{r,h. rh Own.r Bu d wrlllEF rh. l{nLn orF{vme (hd h.or{h.Jrl htrU.r r{nrt rtr FIEny i!tr rh. PqrE$l <br />l. .! .wr oa rrE rmrEnt. s .(lo!tly lr,rraro! *nh li!trrn odLtn (r onrur rrr FFi I St. 7{x.t. Bltfrs <br />lrn Mrrn Cdk: Ih. G)draroi. l.E.n( L.w drB ml .Ctly b - osB ot Flttrny wi. bo'Ur or mPNEr rlF@n. <br />nrl *h' onBir lm lrh I'lrFr! *ifi rc.dEro(r lilfuJ lir'rid hrlr (i,nhr.ii L.!.€ b*) <br />I r .r.hd unLr SrrDn <br />-. <br />B. & PC nn'hn (ron <br />IIaBtrESI'.(:OUIENIAIAU <br />DECLAAAIIAB <br />I tkr.$y allmrrn,L.Fnrlryol priruryntu nlrh. tulhr*6* 'l(ld.rDnr: <br />I h!\,n will rornirb . C.n,ri.r. o, (irs,{ (i, SclunsuE L, *rr.n' (onl|Iner$n. .s F)vrLd ttr t'y S(r'n lTtrr trl rhc <br />Irhtr Or!. nrthc Fdl)|me. ol rh. urt lrr rt*h ltE IEm ss{ki <br />_l h.v. rll * l ninrru krt(.n' ronlrnr.rbn iNl*., .. EqucJ ny S(rrD l7(xr ol rlE Lrtsr Cur., fttr rll Frl(llm. or <br />tlr srt (* whrh rhr tEd ! lrEl My rdr6' sr{EMs rnurB: ffi, rn ri(y dn*ir &: <br />I (.nnyrhri in rh. Il.rlornlnk. olrh. work nn wh'.h rhr Frh r F{tJ. t ihrlln.rc.rDl"y:nyn (onmrnvninncr <br />\) n\ h) h.(m. iuht er!]rh. *nk.n (,mFtrlrron h*roic{ omr. xkl una. rhrr <br />'r <br />I nn llj h.c.nr {,hrc.r i!, rh. <br />rorkcri ( omncnsaron I'ruvtr un\ o, S..r(r lTtxro, th.ljh,(ixlc.l \lull,l(fh*[ht, nfl] r[hrlr)r nr)vr\nn\ <br />IVARNIN(; h ur r, $.ur. *orl.r (otrqrrnrrk,n (rtngc ,\ nilr*lll Jnd null {'hr(r rn cnlrl',)Lr t' nmil Fnrlr\ ihJ <br />lNrl lm.\ un n' oE hunlBl rti,u\ml &,Urr l(I).o(x)}. i. alddkrn !! lhr (d of .r,rlp.nqron. Jd!.. I Ful.d ntr rh. <br />S.(rkr \,-16 ot r,l. Lhn (irJ. mr.r.{ <br />ul!)st!t-t!!.B.lj_!.lB!lE!!-!!l!l!]) <br />I lrftht rllrm unk Fnrlryol JE.pry rhrl I rn lNn<n ull.r F)vni'n ol (luri( 9 r.ommNmS *dh Sdrhn 7(I$) I Drvnln I <br />ol rh. Iruw$ .nd Pruf.sd! Cod., rrn h, lr.n{ L1 n full n)(. .il .ll.!r. <br />7 <br />I h.rhy .l,tm unLr FMly ol Ir rl(|ry rh.r rlEr 6 | .rh{uiion Lrnor r!.R, t{ rlx tFrl(trlr4. .l r h. utrl ntr * <br />hrEd (sd ,rml. civ. c.). <br />lrn.ar N.E: <br />- <br />t.nkrr Ald....: _ <br />AIILICANIDECIISAIIO! <br />I hEny dflim undcr l'.n.lly or Frjry om or rh. rblbpmf ,lc(ls.r i'n\: <br />l).ny'ln('n P.rhik-Asb.nos Norl(3!on lrcJ.rrl Rclulron. (T[1. 40, I'rd6) <br />-Rcqutrl <br />lx(croi Mrfrchn <br />-I!d,!rhr <br />rlr fgLhlF!!L <br />/*,s.,",1*,,*,*,,x tur.! ! slr( L,*!rr.4i!! <br />.tIE Nn mTreo}.ny i, ,!Fr <br />!rrr E!.rihr.{rnor Em,r.l!. n, qll'l*.hk h !,ui |h'j.rr <br />rrrn lrl (rr. rha UE rlrn uf.mrr)n!ltmr l.!ra ro.rrq ywlhrUCry.nlcl'udy <br />h!,U,n! onnMrbtr.rn lEr.ty rurhtru. EF({d.trwr ofrhr. Ci!,rl (iiudyt'..1d uF n tlr <br />ot>E Lc I <br />3 z /.7 <br />Transformers <br />Pol'(y Nuntrr: <br />^", sf z7lt1