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ELECTRICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS oWNFX BTIILDFX DELCATATION <br />I hcFht.lrtm n,rl.r irn.h, r,f !.rjury rh.r I n.rcn0i h'm rtr c:rnrar6 b.nr l:* 6n rlE nnb*trs r.iJ.lsd 7lrli r <br />AuqF( !n Prol6tir OrL): Ary (ny or Crunly sh.h ..quirt . I.rmii r, LrtMer. rlrq. invntv., &frnirh or Elur dy <br />dru.rq.. I'!tr ti r !\u!rcc. ako Eqrrcsrh. appl{ r ntr ruch[rmrr b nhr nSNJ n.r.mnr rhr lrorlE ! lt.nrJ Fmad <br />h rh. Frv!$ or r (onn-E r Lr.nrl li* ((n{id e. C,'nW |ns * h SdrDn ]{m of D:virD. I ol rh. 8u.iF( r.d <br />Pnrf.$n,.rC,xLtdrh.rh.orrh. b.r.npt rh.mfnrd.il rh.hr{r in rh. .lk8.tl .i.nlrll b. A.yvolllDnolSerDnTl.ll5hy.nt <br />.oll(dr ntr ! Frmr ruhl.rrr rlr .Illtl{.nlt!.uvrlFEhy.i hr frtrc rh.. fr.. hunlErj,lnll{! r35&l) <br />_1..ro*r,oarLlrlFny.rrmy.mIk,Frwh1.8.r6rti.r*c',qndsn.BiIrtrtlrrrt!illEq,urm!n{ <br />dcnLd or Dll.FJ for sl (SN.?044. Butirc$ rd lhni$r,n. Cdl.: Th. (i.rErrnir Lic.rE Liw 'ler mr qitly t[. 0*6 ol <br />rlr FlFny *n) l[ r n rltE6 ilEB& rl ph' rlB ut uxt hrmEll or trNll d rtm'ugh htr d lE. oBn .fl?!rr6. <br />Fuvddl rh.r rkh !i!h,hm s e nn htdkrl M ollcEr! t)r Et ll h,Mrr, rtE ttrlltlla d nrlnEmnl r sU rnhh dm ].r <br />oI oit,ldrr! rlr O*rr Bo&r *t[ hrk rl hhlo of F,qrE rlll lE u dr Jn L, t0 l d dtr.Ellr FUFy fr rh.,{qrEol <br />_1. rto*Rr.l rne F'Irdy. mcrlunvcly(onk.d tr h l'(.n\.,1(o trx.!r\ r,.uf\rn(rrhc |L't Lr I <br />.n-l lh,h1$rcdL:1h. Ci'.trktr r l,E.nr. Lnw .prly k'.no*Er ol IoFnrtul wlrr d'nttuk ftr reh F')csr *(h{Cotrkkk <br />I <br />D{k q <br />DECLAIIATTON <br />I tErchy .ll trm un&r lrMlry o, Ixr'lry oE nr rh. !r t'rtrX dcLrdi'n(: <br />I hrE rDl wrll mnra. c.nrr..l.otc.'n*.t b s.ll-l.!ur f qrl6a .rmrEnr.li'n. r( Frvird fo, l't S(rrh l7fri oi rtr <br />t2trr Cotl(, fttr rh. !.rIo,flkc of rh. w.rk f(tr wh*h rh. Ff,n s Frucd <br />I hrv. aDJ wrllmirrfln work.rr .onrp.nlaron nsurrBc. r\ rcqutrc'l byS&1k,n 1?l[ol rh.l-rlxtr(i*].,l,r rlk I'slnrfr,r..l <br />rlE *.rI !,tr *h.h rh(lcmrr r! trrBr M t v'itsl .onlEnqtrr nluoB.rrEr Jrl Frry numhr e: <br />c.mr.- <br />lr'lf,J_ Numh.r <br />_I .cnny rh.r r rlE IE trdBt ol rh. s.rl ld *h.h rh,l n rd n .ruJ. I rh.I nn ..rFby .ry F.sn o ey l|ur <br />y' st,cL(.nr \u$irir b rlr *o' kcr\, $nll.n\!r(r L*rol(ilLlortr . rtr(lrsrc.rhrr 'i I nr{Ll lt(ont nrhr( <br />*od.r Loft{Ensri,n pn,vniJnr ofS(ron r7ffJnf lrh, CrJ.. I shrlL fdh*nh Nnilly *( h rh)c |ln)v <br />WARNING: l..rlurc r,' surc rortcn .r'mp(nernn ( <br />(,r fift\ ur h, oE hurl,cJ rh'usd lollan rll([l.1 <br />uicR( x*l rnomy s tL$ <br />Q\ <br />t]Lqn&ull <br />I lEeby .rrrm unLr Fn I y ol Frruy rh! I m lN.sl unh FrvBbn ir ChrF6 9 (NmBEnrr *ilh Sd Dn ?(ll)0) or Di!trion .t <br />of lh. ausrcs ind PoLkonr Codc, dil my lt.n{ F hfull forcc 16l.fihr <br />(alSrBlqLl{rNtEUUNi.i{iEBlJ <br />I lrmty r,lnn oBlr, Irulry ol Frjurr rhd rkr n, onrrNrirtr Lnlitr8 '8.r, tu rh. p.rlotum..l rh. urk tr whrh rhn Imnn $ <br />Nrud (Sa. .rg.r 7, (:rv. C ) <br />APPLICANT OECI-TXATION <br />I hi, rltid unler p.n.lry ofp.rjury om ofrhc,,'ll)eus.l.cleuri'n\: <br />Dtmnrx'n P.,m s^ll'.(o\ N lfi.d.n r.ktl R.8uLrirr (Tnk40. Pd6) <br />R.fl trrJ ldrfl nrN,i,lirrrm <br />I !d'lvrh2r rrr r.Jr; <br />I ccnrryrh.r, hrvc rcal rhr h.uoly *ih.ll Cny.,n cl'unry <br />ordDrBr!.nd Srrt. lrws rhroS <br />thrt mnri,kl l'lFdy tur rrlhl <br />Appli.$l o. A*.nl Sign.lr <br />Site-Work <br />Underground <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Lile 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 Conditroners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soflil Rouqh <br />Ceilings (T-Bar Rouqh) <br />Rough lo.t - t1 *,ll/^tl <br />Service Meter (\/2 <br />FINAL il -'+-l?LlLlrtL. <br />Notes, Remarks, Etc. <br />L.d.rl dlRl( <br />Meter Release