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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit),.5,
<br />Walls (Rough)v)qlt4 1a wEL'-)
<br />Ceilings (Hard & Soffit Rouqh I
<br />Ceilings (T-Bar Rouqh)
<br />Meter Release
<br />Rough
<br />Service Meter n
<br />FINAL .^l{"11 xtLI0
<br />Notes, Remarks, Etc.
<br />+
<br />OWNER BUILDER DEI'AR .IloN
<br />I halby .!Im undd FuXy of pajury rhi I m darF tDD rh. Co r.cl6 L'.GM l.w for llE tollo*ile ,!sn (S* 7011 t
<br />B6i.a d Prolt rir Cod.) Any Cny or CNny whih rqllB . Fni lo @in t(l. .ha. iq.n\e d.m[$ or rqi dy
<br />tudG. Fix ro itr isl,se. .!o rcquiG rlr 4pli6t &,, sn Fri b 6k . san d rrsEn $i lE ot Ct ir li.dE d FIrd
<br />lo th. FovnioB of ih. Conlrtcror', Li6nr.d L.w {Cn Rs 9. Commdcins wi$ Sdion 7000 oa Divirion I of tt* BBi.4 od
<br />PrctdioN Cod.) d lhr b n th. ir q.rnB lhd.ton Dd dr b6i for rlE dL86d qoDFi,. a,y viol{bn ofscrion 70115 Lt e,
<br />.pplkrnr tor. FEn $U6r! rhc .r?la.a ro . oril pdltof @r mrc th6 nr. huftH 6lld (1500)
<br />-1.
<br />s o$nd oalh. FtrFrly. or my nploys wilh wi*6 d thcn sl. drmp.Nd ion. wil do th. qut rd llE lErtl@ b @l
<br />i a'd.d oroffald tm rL (Sd.?04.{. &Bic.od PmlBii6 Cod. TlE Co mrt !LkoEL.wdodtul@lyloeowMof
<br />E Frfdy qtb hilt' d !p.o€ Eq^.n *ho &Esnwd tuelro, h.t*rf or muah hit d ls ou drdotd
<br />p.o!id.d thr un lrsoriEr! E d -tdiLd r otu 6. rl.. ll ho6q. llE l!'ld!* r s+..1E1d it 5ld winh ft ta
<br />of.onpkbtr tIE Ownd AliBq *ill h.w tlE hnl, of Forrls 0t lE or JE dit d hild or mFow tlE Fapdly lir lh. FrPos of
<br />l. s o$E otth. FDFD, d qchBndy.orir'ry r'nh licnB.d.otu(6 to mdrud
<br />'lE Foj.rl (sd 7Or4. &!t6
<br />lid Arfr.bi Co&: Th. Conlr..loir Lic.nr. hw d6 not.ppl, kr e owrs ofp.opdly $ho &ildror improtd lhqoi.
<br />md *h. ontEclr tor !!chFojdr! Birh. Conrtto(,liccG.d !u6od roih. ( dtrcloai Li.ae li*)
<br />I o .!dPr uxl6 S6lior-
<br />][oaf,ESE.cqMtEllAUq!
<br />E ClllAua!
<br />I hd.t , ,mm und6 palhy ofpdjury oE ofrlE followin3 &.Lrrird
<br />-l
<br />h.v. rrd will minr.in . Cdrard. of coe ro s.lf-l6e ld *dlda anrFution, d FbviLd lor ty Sdlion 17OO ollh.
<br />Lltor co<lq lor rhc Ffo.lur of dr *o.l fd *6in 0E pcni i! i.*l
<br />-t
<br />hrvc.td *ill m.int'in m*.rt .oEFB.rion iNrrN..6 r.quiEd by S(lion 1700 of lh. L!b.t Con , f.r lhc p6follre. ol
<br />th. *oA for $ hhh rh! prrEr u !&(I My w!d' onFrsFn 'Eufuc lffi .tn Fl() numbd 4..,* . *,/ ((r,{aA 3-L
<br />LLJ O o"-ot-LoZo
<br />-l
<br />carify rnn in rlE Ffolllm. of rh. sort tm s'fitt rtB Fhi B su.<I I tbllmi d,9bt My Fsn in ey @E
<br />s s ro tE od rut ..r ro rlE ssrt6'@mFBaion Ls of Crlifomn. Md !8c lhd if t r,ruld hdod sbF ro t,r
<br />*o*a codFution lrovilioB of salion 1700 of rlE hbor ( od., I !hdl. lonhwilh cohply wirh tlD. ,mvirio6
<br />WARl\ll\(;: F.ils. b s. trorlG omFBiion cor(rgc
<br />cMl n.d up ro on. hlndr.d rh1rurrd dollG (tl(x).ouj), in
<br />Srlion 1076 ofrh. Iibor Cod( inrdd $d.nohcy r 16
<br />{dl rhr.( e allo}s lo on l dErE tnd
<br />.or of .omFulion. d.i!s6 a Fltcd aor rlE
<br />1.L9.9
<br />I h@t, .ltm ui& ,quXy of ,6jur, $i I 6 li6!.d ud6 FvLi.n ot Cllpls g (onnftos wih Sdb. ?m0) of Ovision l
<br />or rlE BuilB rn PreftsbE Cod., .'d d, li.o& ir d tull foN ii €fi6r
<br />o {1 .?
<br />2:2511
<br />(olsrllJcllo!.lJlDtlclGtlcr
<br />I hcrtly rtfm uda d.ly of Fiuly dlr tic ir r 6dr4rion L.dig +*y tur llE Ffo. Ec offi.rvi 6r rtih lhb Fmi it
<br />Ls.d (Sa. 109?, ( iv C.).
<br />ATTII(AXLDICIAAAIIA!
<br />I hddly.rEE lndE D6"n! of psjwy 6r of th. fouo*'iq d..lfiio6
<br />D.imlnrn PGIhl^lbdc thilic ion !-.d6rl a,.auhitu6 {InL 40. Pd6)
<br />-R.qutcd
<br />krB ol Norifrcrlbn
<br />l^'t rhd rh. tut6.1 rcsuhhE rrrrnn8 6bc.br .6mrd e mr @lic.bb ro rha FoFr
<br />.torc inforulion ir cordl I rgra lo omdy vnh d City .ld Couryrhd I h.L. rod rhis.pplic!lion
<br />odi,@6 rd Star. Is! rclrnB N b(ildi.l sld hs.b' lurrb@ r.F<rivd of rhir Cily &d Coud) ro arc uF. rlr
<br />rb.Y. IMrbncd FFr) fn dEp<lbn
<br />\pplir{trr or rsrtrr si!trnrurr )(
<br />.mr,E -.. {p,rno: tIx,,^,iwr.
<br />24q71
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