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APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Life Safety /Low Vollage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bondinq / Groundinq / UFER
<br />Transformers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouoh)
<br />Ceilinqs (Hard & Soffit Rouqh
<br />Ceilinos (T-Bar Rouoh)
<br />Meter Release
<br />Rouoh
<br />Service n/eter t, I
<br />FINAL 7t 5t7n .w37
<br />Notes, Remarks, Etc.I
<br />o!{Nl,t Buurllt Dltl,c lrllrcn
<br />I My ifm, ldld FMhy of pcrrry il! I e .Enpr i!6 rlI Ctdrrrfi t!* Ir* ior dE ldltvlt! E.s (5<.1011.1
<br />BBiid rrn k.f6irn c.d.t: An, ciry or cany *tti Eqlr6 r Fn* to m{d, .x6. irrproE &fllitn or (F, uy
<br />,llfu, Fu ro iri ier.. .lq, Fqui!! r& ??lisr for $cft Ffri b 61 . ,irrd ,rtrr'r rhr lE or dE i! li€Ed pudd
<br />ro E Ftrvililu df tlE ( otuddi lifiEd L* lorqd 9, Collmrint v.fi Sdlfi 7(m oa Diviti'n I oI rh BBc! .i
<br />ProL.rtoD Cod.) q thr lr q rlr ! GE,$ ltdtiDb rd uE h-! ld lll nt..n G&rSe Ary bhin orsdM r03l.J b, ey
<br />lrrli! ld d Frnn subj.lc rlr aprltoni to d dvil p.Mhy ol mr mE $ nvc hundEd dollrs (!tlt))
<br />_1. s o*rr of rlI F]l y. c my.inliye' eah,.g6 u th.r ik oqdh( qll & dE qrt.n 6. ,dc r d
<br />iidrral n orE ql fq rt (sa.?txa. BurB ud PDr6lift cuL, Th cd$r'r t,j.ry Lr l}E d .f'Cl, ro u w or
<br />trE FUFi, w,I, hil4! d B{lU€ rrq !n vtD dc rdr srt hilu! o, lr*lf rt orSI hir 4 h.. oq a4h)*{
<br />prndl.d tl r(h imphwfiik d n{ id.nLd (o,tu ror r.l.ll tnftw, tlEllildiq d in!.oEE.r i. bu *ilum r.r
<br />or.oipt ia tlr O*E Buiur wix h.E dE hrda orFxrB r,. lt r tE Jil '!i tci! d dvroc th Frdt, frv rlE F,Poeol
<br />-1.
<br />& o*E r(0E F Edy, rm.EUrn.ly conrtuiint wth liu.Bal coturs t' connnd rlr FoFr (Sa.'70.14. Bws
<br />.u! hldsincott.: Th. Co tut*t Lk.nr br dra d irnly lo s oeB of Folcny vb t{iB! or inyowr rlEr@tr
<br />.d vtr orrds ld rEhFnFB dh.ConEtxl.l lic.rd Fol\4 brlEcdrfu, tim tiv)
<br />-l
<br />&r.ri{r urds SErxn-, B eP.C ld thit Ersn
<br />lllrf,5lls:.grrlldtaDr,N
<br />DEcla8AIla!
<br />I h.rcby aflirm uBlcr F lty oaptjury or of rlE n,lk qra d.ch ioB:
<br />_l h.E rd *ill tuu. cdirEr. ot Coerr to S.U-IM rq kto .!.Fda a FDvd.n t( by Se1n l7@ ol th.
<br />lAr CorL. 16 ,E pqr('*. ol dr rqi Iq *tuh rh Fan - Bud
<br />_l h.k .,rl vill nEinr'r worLd .nn{rB{on b.uhrE., G E{uir.d hy S(ibn l7@ of rlE bbor Cid., for IIE IEIol]]e! ol
<br />rh. *qt ru vhth thir Ftu i iqEtl My *stsr' .!4GdDn iM. ffit ul tllty .unt.r {.
<br />Poli.y Numh.i-tirpn '
<br />-l
<br />d'Iy lhr r$. Frldruc olrlr *olt t, wtrh dN Fd ! itted.l iEI d.nPby u, Fx, r r, lME
<br />s s h b...,E runiu ro rt *xI6 conlEMh. L*s orcrlrrom.. $d rrB $.1 'r l inlld b.com t d ro rrE
<br />woltm.onrFMrirnpovirioNolS.{i{nl?LUorrh.bbdarod.,lslEll.fonhwnhotrplrwirhtl@PruviiioM..
<br />WAtnNC: tr [. b 6a rnt6'ohFdEn oErt t uLyrut ,n rldl (bF e al?bF ro a,ErJ FIIB !n
<br />ci{l fiE! up ro or ltun!.sl thulrd dou6 (llm.(xD). i! ,lhion ro rtr $! of corFNrir( d!r4.t ! tovn.d lor rtr
<br />S(rion 3076 ol thc ktarr Cu!c, hi.rd rnd &bBy i fes.
<br />Drr.:
<br />UIEllE-cqNIlACIla
<br />DEC1AIAIIIIE
<br />I lEEby .frufl !d{ Fulry or p.rjury rh, I o h.tr J u la p.lririotr of Clupra 9 (dnmNf3 vin Sdri,i ?000) ot Diiln. l
<br />ol Lh. AlGi.id PFksrn Co&- arl ny lsne i h tull fod.rd.nd.
<br />Li..B. cLs:-LitB. Numb.rl
<br />D,r.
<br />-
<br />CdE .lor-
<br />g0lslBllcuQ!.LEd[ltr{j-atiElcr
<br />I tmby i rh ui&r p.Mly.I !.dn rhd 0E n.@dNtr L.din! .3.r, rtrdEFnlrlw.,tlt}rI i'l r'fiih rhi' pd6r i
<br />i'ruJ rsd 1rr7. Car C )
<br />AEII.IS EI.DECIdS6TO!
<br />I H't rrnr unLr [Enrlry of p.rr(y orc of rhc foll,vi.8 &.Lrdnru:
<br />tlcruliii.n P6n eA'trno, t*iff,r!{ &rd R.rulrDd CIrk aO. Pd6)
<br />-F.qurcd
<br />ldb ol lidfui.
<br />_l ccn y $! rh. L&r.l r.BoLrioB rc3rdlr8 ahcitx Er$d r. n l +rli.bL b rhn PDFr
<br />I cd,ly rhd I lsE Ni rlu! .p?lrrr$n sn tu. sr E rt E mfi,rdx,n ! .qEd I qc ro 6nply vrh rI Cry rn CMry
<br />dilinftd md srd. l*u, rLtitr! ro &'!linr cdNrrucrioa Ild hd.by .ulb.iz FF.etutis oI rh! Cry rd coor, to ora uPoi Lh.
<br />.by. EnriorJ pmp.n, Id inrp..rion tllrpo!.s
<br />AFtd d Ardl stDl{F,- El.
<br />fandr(Mm.i.rl r
<br />rxtrI.!!
<br />Rev. 08-07'2015
<br />ELECTRICAL-INSPECTOR RECOBO
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