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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OI[']tET AU!LDET DEII'ARATION
<br />I lE.t, rllrn uidd Fntr, of polry thd I @ ddF noD thc Cortrtdor' Lrc.M tn 6r lh. lllt *iru l@tr (S<.roll.t t
<br />Burind .,n Proisior Co&): Ary Cn, or Cont $nth rqui- r Fni to ordtEt t!s, inprorc daelirh or r!p.t !, '
<br />rdu.tG Fbr ro ilr islet .lo ro(ilic rlE +dt!r lnr tu.h psfri ro frL . t,Sn d s!a@r llld lE or JE ir lics!.d Fman
<br />to th. FovnhB oadE Conreoa, L'eiEd Llu (ClrF6 9. CoEffiins wnh 56r.r 7lm of Dvirion ! ol E au"E ed
<br />ftorBiom Co&) o thr lE ( Jr n qoF rha.&oE ad rhc b6r h, dE .lle.d a!4b. Ary 1 ioldior of Sclbn 701 L5 by uy
<br />+?li.d for r pqinil stidr th. eli..,r 'o
<br />. civil pcrhy oa mr mr. th.n fiv. huD&.d &,lld (t500).
<br />-1.
<br />a ow ol$c FoFrn d hy alPkrr6 vnh u.s6 6 0rn bb @n d!rb.. si[.b dE sll rn lll *MrE i rcl
<br />i d!d.d 6r olts.d fo. rl (Sd 70ta, BuilB m'l PrcfdhE Co&: 1L ( o.llclor'r Lice L!$ &6 tur @ly ro u ow oa
<br />rh.Fopdry sho hrild. o.,nFov6 lnd6[ an *t. d.€ cn *ut hiellor hd*ltor rtuo!8n hir d lE o$n. prry6.
<br />Folij.d 'hd
<br />D.h rq$sErt G trr nsrl.d r oltu 6. nl. Il lr$w, fi. boiEiry or irrytrrEr L pld withir oi. )dofof,pkia rtE orE A{ ta $iU Mw llEhrttar oaF.vina rh, rE.rsh.did d hoild !q$w dE FoFry antlEF rEor
<br />l. 6 oms of th. F.Fry. m cx.luiv.ly conrdhs wnh licE d cotiErm ro N,rdru<1 rlE poj.rl (s6 704.1. gd6
<br />i.d Plobnn Cd<r.: TrE(-onlr.dd r Lk.@ trr rli€ mr.p?ltro o$E ofFoFnt who buildr.r inprovdlh66n.
<br />ud *tD coi,..l! lor suct Foixlr*ilh i Conr.clo(r) lico!.d punun ro rh. ( odr.dd'3 Lr.M bs)
<br />_l e crdF u,is Sdb B &P( fn rhie rain
<br />.wq8f,[f,L(alEElIATO!
<br />PECIJAAII{I!
<br />I h6.ny lllm u.dd FEh, oaFjury oE oi!h. folLwmg d<lEriioB
<br />-l
<br />h.E ild *'ill i!n.i! r Cdifrdc olcon€r ro Sclf-l64 flr *uld (mparliol\ 6 FDlid.d for b, Salion 1?00 ollh.
<br />Lt . Codc ttr lh. Ff{ruG of $. wrt for wtich lh. FDn i! isu.d.
<br />I h!r..nd *ill tuinhin wo*6r' omFMion ie,ee 6 r.qrircd b.! Sdlkin 17(l) of lhc Lbor Cod., for lh. p6fo.r@cc of
<br />rh. qnrl for uhich
<br />'h! flmir s,* lh'i.l-rJ s
<br />My comFrdrn idulE .eifun Flty .umb( ft:
<br />Pe cl^ih incurrtnce <r^
<br />Ib Tt6,#lo l4
<br />_l .6i'f, thn r r,E pnfolrmc of tlE *.rt for rhid thi! F6n s ir.!.d. I Jdl mr dplo! o) F6$n ir uy Il.lE
<br />s 6lobaaEHbjclrollEE 6 onFlnion huofc.lifomia !d asE lhn itl iltould h..oo. Nbjd rollr
<br />urlt6'coDpcsliooForiirEots.dFnlTO0of$cLddCod..lsrnLf(nlh*nho ply *ith lh6- Fui3irc..
<br />$ARllfiG F.ihrc ro M *Drt6' omFMion o16.B. i3 uLs'tul Md dEll rubjdt u oployo lo oin@l Fuh6 d
<br />civil nn6 !p 10 om hun.lr.d rhoLsd doll6 (1100,0001. in ldd ion trr rh. corr of cotrqEelhtr d&n s6 G Fovd.d for th.1
<br />llClJEAIlq!
<br />I h6.b, lmm undc F hyotFJury lh, I o l,.q!.d u,xlr FDri]nn of Cluprd 9 (o,1ll@iry *ii sdnt 7000) of Dilition 1
<br />ol rlE B6i6 Dd PblBbN co&. !n my kdq a in 6rll aoE Dl.,Ial
<br />0-t)<t4 (,93( 6rL
<br />t Z LO\Q 1o
<br />Ih6.h) rllinn und.IE nh) of pGJUr.- rhlr lhd. 6 . oldru(ir. rr{i,B .efty ao. ilE Ffffi. of
<br />'h.
<br />trorl for sti.h lhir Fnh ir
<br />iae.d (Sc 1097, Civ (.1
<br />attu(Alr-oEctrtAra!
<br />I horl,y .trh un<!, F!r!y of FJUry oE of 0t aollo*ins {,ab.lbd:
<br />Emlilion Psmit!-AshGror Notificdion l.d6!l R.,ruLrionr (Tirl. 40, P!n6)
<br />-R.qun.d
<br />kll6 of foliftdhn
<br />-l
<br />.qt,ry 0!. lh. a.l6rl a8ul.rn6 llsadr.s at do! rtu{l ec tu' eftirbh !o fii! proj<t
<br />-l.difr
<br />rhd I hn. ral rh! rpplicdon drl sd.rhd $. rbor. rn 6cotrdt IqctoonpUunh ( lrrd Cool)
<br />o.dill*6 .,ld sri. t^: Elii,B to ttr
<br />rnlk Miio.al pnrldly aor id!*lion
<br />Applionr or Atdr Sitnrrur_sa 9l mon 5.ry d_)
<br />olrhis( va ( ou.ty redlr uNnrhc
<br />"*.Y1 tf z"ro
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />ht Standards
<br />Spas, Pool, Founlains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fi re Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Groundinq / UFER
<br />Transformers
<br />To rquerng
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rouoh
<br />Ceilings (T-Bar Rouqh)
<br />Rough
<br />Service Meter
<br />FINAL s/z'r,/2,n-bqr
<br />Notes Remarks, Etc.T L-/
<br />Meter Release
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