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APPROVALS DATE COMMENTS OWNER BT'ILDER DELCARATION
<br />I h6ct'y iflm und6 Frriy of lsjury thd I m .rmF 6.m rhc Conl[(1oB Li.qe kw lor fic followi,s t@r (Sc.7oll 5
<br />auinB .r{ t'rofBion Cod.)r Any Cil, or Counly which ,.qu"6 . Fmi to sdrrud, dlE improv.. da@lah o. ..pdn ay
<br />rrructrc, Frr ro r i3@c., .l$ rqriE dE q,dtd for luh F,rit lo fik r r's..d 3ld@oi thd hc or dE a licsE d pwun
<br />ro rhc Fovi.ioB of tlE ( onl loi! Lt6Ed l,w (cllprq 9. Cofutring *th sqlb.7000 of Division I ol$. asnB md
<br />PmfdioB Gd.) or rhrl lE m .h. i! dmfl rhs.ton &d llE h.rs ao. rh. rlk8.d crolF ion. Any viohliot of Sdlrd ?01 L5 by sy
<br />+plrDl t6r. p@i ilbjda lh. .@!icsl lo . civrl p. hyoIrcl dor. rho fiv.hlndt.ddoll&3(1500).
<br />.1, s oqe of rlE FoFry, or m, arlphtc wnh w.*6 r llEn $L ompdBdb.. tr1l & UE so.r tn dE lridft 6 ml
<br />lrnxLd or oifn d lor $L (Sd ?o{,r, BuiB sd PrDlsi,B Cod.: TtG Cofr*lq 3 Li.oe rlw d,6 ml +9b lo u o*e ol
<br />iE FDFry glD hril& d inirbE dEdr na *h. 116 sh \r,t nlNlf or td&lrdr llwuglt hn .r IE o*r anplor6.
<br />ForlLd rhd $ch tI!.frqEr' c ml nd.t d d o,Ied fut..l. lf. hre. ln. hlddla m iry$qlar it std winf m )s
<br />ot.olpldir. rlE Orc &ilir trin b.w E hmh of Fwr Or l*6dt dd bl hrld or itrS.oE dL FoFy fot dE Frpcof
<br />. l,6orEoftltFlFry.m.r.lsiBlyco..rngsnhkalalonEldlo@ir'u.rtlEFoi{(Sc.?044.&EiE
<br />&rl Eb&rin Cod.: Th. codmort Lk.e L.w d6 rcl cply lo r o*.4 of F.Ft who hril& or hprv6 lhce(
<br />Dd u.ho .o'rrIt! for kh Fjcr. *'rh . Co do(, li<dldl Plt,lld lo th. Cofit loa3 ticE taJ
<br />I m .rdpl ulda Scrion a & P( lorfiurdn.
<br />IA8IISI.GAMTBSAJTA!
<br />D[Cld8AIlA!
<br />I td.ty .rm u!& Dddry ofDajur, oE ofrlE folb*,a .ldlrnbE
<br />I h.!. rd eill ridrn r CaiifsI. of Coen ro Sdf.l@E h. "dt6 corqd.ir. ! FDrii.d hr by Scrbn J?m ordE
<br />rrDc Co& tu E Fr lffi. orttE vci rn lt.h Oc FD{ b ie&d.
<br />, I h.vc .d s ill mitr.,. *0116 .orip.B.rb. iBuffi.. B r.quird by S<rE, 1700 of th. t bor Code tor llt Ffmta. of
<br />rrr @rt fo, whih rha FDn 6 isr.rt My wNI6 onpqErDn ufu.G 6it rn polty.unba E:
<br />-l
<br />cdiry thlr s lh. Frfor111e..f rh. xorl for *hkn lhir Fmn E iscd. l shrll @r dplo, &y Fen in eymllG
<br />$ 6 ro bdoft $brct ro rlE Nlt6'comFsdion b*! of crliaomi( !d tgr $r if I Jrould haom tutid to rlE
<br />*ort6' ompsslr. lNririoB olsclhn l?00 .rrh. l,lFr Co<lc I Jlll ffih*i$ .omPly wnh $os FoviioB..
<br />WARNINC l.rlu. ro Fu. *.rkn .omlddb6.ov6.8. n unhwtul, sld shdl obl<r e dploF lo qimiMl Fahb ud
<br />.ivil lind up lo o.. hund,al lhoBud d.lls! (tloo.ooo), in lndilion to th. cos of conp.Mio.. dm!86 a provid.d tor th.
<br />Sdrion:1076 olrh. L,t[, ( o&. inr66] dd d&ft] i fc.
<br />aDpllonrr-
<br />II(IITI;D-CONI8ACIAB
<br />ulcl.daallax
<br />I h.eby ritrm u6dq pdally o f pdjlry thrt I en licdsl unda povilio. of Chtpls 9 (comnacins vih S.dion 7000) of Division l
<br />ol lh. Bu.in* Dd PmfdioN Co&, rd ny licoM i! in full foN and.fi4t
<br />(:oIEIf,XqEAUIEdITdCIGEICI
<br />I hq!b, .fiim u.d6 Fnrlly of Fjury thd llEG a . cotlrtudb! bd68 t{dy aor llE pcfo|lre. of lh. *uI 6r Etin lni FEil i
<br />is.d (sd. 1097. ci! c ).
<br />a?PLICAnar nFCl {irtrlo,l
<br />I hodly ilttn und, po.lty .l Fjury orc ol th. f.llo*in8 &.Lrlriotu:
<br />Domlnio. Pmi,vtuhdrs Notific{sr Fdd.t R.suhr66 (Titlc rO. P.n6)
<br />R.q!irci Irla of lror'f'caB
<br />I cdit rhn rh. a.Jsll rcsuLrhB Er.$ng sbdor 'EErd e ml rppl.lbl. lo rhir Ftj.<
<br />I diry rhd I h6.. raj llii +da.rFn !n .r.r. lh. UE !t r i.rondiotr ir .orEr I l{Ic lo @nply wirh .I Cny .d Couly
<br />ordins6 dd ${. L.s ,!&Da b bilditts @ti.*lio,!, .n b!at'dtoM r.9.erriv6 ol ftn Ciy dd Coudy ro alId
<br />'+on
<br />dE
<br />rboE mrion d Flpary fd idDclio! Drrp@
<br />Appli.rnr or At6r shn u..
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER *l>.{to 144e'7
<br />Transformers
<br />Torquerng
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Roush)
<br />Ceilinos (Hard & Soffit Rouqh
<br />Ceilinqs (T-Bar Rouqh)
<br />Meter Release ?12*17.0 bk#k 7
<br />Rouqh
<br />Service Meter <12'lltu >&r+s,
<br />FINAL YlVr't7D Dfi*{
<br />Notes, Remarks, Etc
<br />Rev 08-07-2015
<br />ELECTRICAL.INSPECTOR RECORD
<br />rDisrG.
<br />I i.* Numbq
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