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ELECTRICAL.INSPECTOR RECORD
<br />OlVNER BUILDER DELC RATION
<br />I ha.hr rruh un& FEly oI pcrjur] rhd I o ddn tln th. Co ,.cloB' Uc.ns Llw lor rh. folbsi!3 ,6, (Sd 701 L,
<br />BBin6s lxl ProfBion Cod.): Any Cir, or Coudy whth r.nun6 r Fmil lo on rud. !hq. inprc!., darclilh or lq& my
<br />lrtu iue Fior ro irs tsleq .to r.q'riG llE +dka for Mh Fnn ro frL. r,r,El nd.rGn 'h! lE or nE iltqa.d pd.!,rr
<br />ro th. Fnriri(s oltlE Coil,Eldi Lk. .d lr* (Ch4|d 0. CMi.s rnh selDE 7000 ol or\nbn I or r BGiE &d
<br />PrDldbN Cod., c fi, E d rh. k ddpr rtddom !n rll. t-i' tor rlt.ll.sld ddryion A.y vblrbn of SdIb. 'r0l I 5 tt D,
<br />.lplkDt tor. Frd $bjar] rh. ip?li.et lo . dvilFuhy ot@l mG thr, fiv. hun(H drlln {1500)
<br />-1.
<br />B ow of rlE FnFdy, or my mplorE wnh wls6 s ltEn ob onpaldio.. will d. tll wort ad tlE nrtl@ i ht
<br />i' qrbl or ollftd tor rl. (Sd 7or4. BoliE rd Pr.ld.io6 Code TIE Codr..rd'. Lic@ t * dtd @' ryly ro s ow of
<br />tlEs!F!r sho hild ( IEDE ligor tn \ is dc idr q,I hil4ll o, lEEllot llEust h. t b om drrphtq
<br />Forid.d rh.r *h idr.otgEt ft mt ndr!.d c ofrEld fq ,l t[, ho*!G, OE h(iBi.e d ing$sEi i' !U *ann oc )d
<br />orongldior. tlE olffi B{ild, *in h.E dE hldar ofFortl8 ,!r lE d ft .,il ml hild d np.ow lh. FDPd} tu t E FrFa of
<br />l. s o"E of lh. FoFry. u dcluivcly co'fi-ros *nh !.r!.d mdr(6 k, cordtu l tlE rNJ..l (Sc 7o+r, hliE
<br />.d ProbrsCo4: Th. conlr.rq ! Lk@ L.wdcmr qlglyto !o*nc.f F.F,*h. t il&o. iEFoG ll|aoir
<br />ed *'ho ofirt! for Mn Fojrs wnh r conldo(i) li.d!.d p{l!d lo ltE coddd t Lid& t w)
<br />I cdrfy lhd in rh. r<rfortuncc of rhc wo& for *hich rhii Fnn i! i.s.d, I thlll ml @rk y dy p.ren
<br />'n
<br />Dy me6
<br />& 6 ro bqrn. lubjer lo llE m a'ompdriio. hs oacrliaomiq dd qd lhd if I .hould hdom€ ruq.d lo llt
<br />*ortd' NmFBabn prDlirioN oasdli.n 17m of rlk t tlo. ('od.. I tEll. f(rhsnh 6q,lt *nh lor FwiioN
<br />$ARNIN(; ,ra'lun ro qu. uo*6
<br />c'v,l fin.s uD b orc hundr.d rlktllsd
<br />i6. .o\als. n ub$ful. r.d rn ll sbjd m dnpL,ts to dnuul FutlE lvl
<br />(ll(l/!),firci. h.Jdnion ro th..{d of comlt@rion. dm+6 B l,oril.d ror rh.
<br />s(rion 1076.rrh.lxtr' ( o& inrdddd
<br />-o<?-
<br />DTI.A&IITqI ,_(;,,I hftby rllim u.do pa.Iy o f Fjury thd I rn lic6Ed !n&r Frvnior of (lu'!l6 9 (comn.inB pilfi
<br />of tlE Buins ud PrDfBioN Cod.. &d my lic.e i! i. tull fo@ Ei.llel
<br />Lta* CL!:-
<br />-Lt.e
<br />Numbd
<br />CAIIIBIJCIIAU.LEdDIIIG.AGEE{:T
<br />I hc!6, r,Im u.dd Fulr, ol Fjory rhr tlE! it. odnf,1io. bdiR.scy tu tlE FfMc otllE stl tu *t llbi! Fni ir
<br />i$u.d (sr 1097. civ. c.)
<br />AfILICAILIECIJEAIIq!
<br />I hdltt dfrm uidd p@.Ir, o, pgjury onc of th. fDllo*ins d..l4d htu:
<br />D.mhion Pmnr-Arb6tor Norinc.rion r-qrn.l R.guldhB (fnb40. P.n6)
<br />R.qurqj L.{6 or}(irfdin
<br />ly wnhrll( ny.rd Counly
<br />y &d Coory ro 6rd qin dr
<br />APPROVALS DATE COMMENTSID/SIG.
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rouoh
<br />Ceilings (T-Bar Rouqh)
<br />Meter Release
<br />Rouqh
<br />Service Meter
<br />FINAL l-1o. ta Mtt lm
<br />Notes, Remarks, Etc
<br />.),51i
<br />I n.\dn u.d. sdrrn . B & P( lor llir'@'n
<br />-,, z -q- 17 *T-l 7,..rrzo--2|Ix' foRxins ('omPlis^Ito\ -,,-.,2Y \ !!CI.6EAUa! .-'
<br />I h6.b) a m, 'n un'ja p.Dl$ .f Flu4+n. rl rt}{allor ins &rl-drB.
<br />-l
<br />hrr. u'd *iU @t.in . ( drifEar. of colwr lo S.lf-lEur. aor rcrk.a 6h!.e!ion. s ForiLd 6r by S6lion l?(x) ollh.
<br />L.bd Cod.. tu rlE Ff(nlrec of th. *ort lir "tih dE Ftd ir i$!.d
<br />-l
<br />hrrc rd $ll @inr.i. m.tdr' conFBabr iMffi., u Equir.d by Sdrrn l?0o of rh.Irhor Cod.. aor llt Ffolr,e. of
<br />rh. Ert fd which thi! Frmil ir i$Gd My *orlfl coEpdlrion iGutuc ffir t d Flq nlmbs rc
<br />t ndd'r Nrh( _
<br />L.d6 , Adn* _
<br />I
<br />I
<br />a.ddsl r.suhlioE Es&!n* ah61or roNul q. nor q'p[.!bh to rh6 p rrdl
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