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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS 01{NER BUILDER DEITARATION
<br />I ffi, rltm urla Frny of Frury fir I 6 da!r( io6 rl* Cotuhd Liru ta- fo, i,E foll.'wD3 l6n (Sa 70! L5
<br />Aaine !,n Prof6ion Cod.) Ary Ciry o, Coutry shich r.quic r Firn to .odru.l, a, inFoE ddtulin or re.n uy
<br />lrMEe Fb. ro irr b.@. .lo rcqliE rlE plilll aor sh Fni lo 6k . t{r.d tlrMr thr li or tE i lkdE d Frid
<br />ro rh. p.lvirhN ofdr Co.!&td'r t-ian.d t w {C1lrtn6 9, ComocinB *nh Scli.. 70(x) ot Dithn I ofdE AsrilB od
<br />FFfdbd C6d.) d lhd lE or.lE it a.trpr lhalf.r !d E bGb for rlE.lkScd ddFio.. Any rhhnn ofs<rbo 70:t I 5 b, Ey
<br />+llicur aor r p6Dir ruliaL rh. .p9lic&r ro . civil p@Iy of ior mrc fie liv. huidr.d &lL6 ( lr00)
<br />l, r o"E olrh. FsFly, or my.hplor6 with w.!6 a rh.ir $1. conFtB.Ihn, will & rlE wi !d ii nn'arc ! mr
<br />rrd'&l d olt6d for Ek {Sa. rO1,{. BEiB -d PmfdbB ( od.r TIE cdEdn'r liqe trs do6 ffi +pl, lo 6 ow oa
<br />rh.Fnpdry vho hikh or inprov6 rtsFi. !d slb d,6 qd *.ri hi@|t.. hd$lf 6r
<br />'lmugh
<br />ht d h6 om otrDby6.
<br />rmij.drhd sh inqoldEae d iddrLd dofici 6r *.1( ho"6s. th.hrildiq or irs$lE i,&ld *hli.on raororlpkntr E (xffi Buil& sil h.E tlE hril. of FDvi,B fi. lr s dE dn m' hlld m ihF!\r rtr FlFq &tr dr Frpd or
<br />-1,
<br />u osE otrh. rrcFry. n.rclBir.ly .onrrlclins $irh lico!.d .o ra(o6 kJ odqtucr rrE F.j<l(56 7OU, A6ad
<br />.,t fttlsin Co&: Tnc cmlr.doi ! Lk@ rrw do6 mr Sly ro d o*E of FoFry \ lF toiLh or mFo\ 6 rhqoo.
<br />lnd who .o 6cr! for tuh Foj*ll wth i Co.'lturo(r) licaEd plNuir ro rh. (-ontrdd ! l-f,.k llw)
<br />-l
<br />M.xmpt u.dd Sccrion-, A & P.(. tor rha r6on.
<br />l)ire On&r
<br />tlaBli};&r:(aurrNllla!lrf(J]r8iurc!
<br />I ho.hr alli,m unds psultr., I I r-jury ot I r rh. rol[nv i',9 d(l{aluB
<br />-l
<br />hlvc rrl *ill minr.in a CdifEdc ofcon$r ro S.lf-ldur. tor hrtd. enlFrs'iol\ 6 Fo!ir,.d for by SEli,n.!700 orlE
<br />/tto Cod.. lor tlE Fft)ffi otllE rsl tq rtrEh rlE Fnn i is.d
<br />Z -|'. "u ",rr."r,.. *"*6'(omFMbn rMec ! r.quir.d b-t sdhn 1ro0 orrtE t bo' co&.lor rlE Ffo,ll4. of
<br />rha sork f6r *hich rhi! Fmi ir i5oql M, tr'ckdt @mpdBd(q-"nir rn poky nmbc d /
<br />cSP{ (4 o r oa
<br />l.diry thd in rh. Faolr:m. ol E worl ld $hkh rhn pdmh s isd l 3dl ml drphy sy F$r in Dy @E
<br />s a ro b..oft subjdr to rh. world' coh!.6aion laH of C.lilomi& ud lsc thi if I rhouu baoft rut,cl l. rlE
<br />wd6 mmFdFn FovilEB of sdir lT({) ordE L.hr codq l idt f61h*ah omdt { nh dbr FoltioB.
<br />$ARNIN(; Farturc t! 6ur. *st6 a)nFMion ir unlrstul. arl Jldl at*rl e dploF lo oEdl Fsli..d.nil ,in6 W ro on. hun&.n lhorsnd i!ro rh. con ot conp.Mnon. danrsd d Fold.d fo. tt
<br />scron loTn olrlE hh, co&. inrdd arl
<br />DECTAAAIIa!
<br />I hdby .mm und.r Frty of Fjuy rht I 6 liq!.d ulla FlritF. of OrF6 9 (@ffiiB rnh
<br />of lh. &!iE ed PmfdiE Co<t . .rd Ey lto& ir i, tull for rn .,Tt -"
<br />v
<br />"^zLy/q
<br />g t-tBlj_rqltr:luli-ilit)l.r
<br />I haluy dTm ulxtq Frlty of pcjury 6r $@ i!. @i!tuclb! kldiig .s@y for in Ffolruc. of th. mrt 6i
<br />is!.d (S< 1097. Cir. C.)
<br />l,nd.arNM.
<br />AIIIJCIXLDICI.AIAIIA!
<br />I hc6r dtm undd Fn.h, or Flury oF of lh. follor rng &.bdnB:
<br />Ddhl iin PdmiteArhdM Norifkdion l'.dd.l R.tul,rionr (InE 40. Pln6)
<br />R.qtrrcJ l dl-of Norilidiur
<br />-l
<br />c6l it I haI th. lcddal r.sulllioE cs&dr.r 6b.slos ronolsl e nor qPli..bk !. rhis FoJ.d
<br />l.dify rhd I havc rc.d rhir rlplic.rion d nd.ihd rh..h\. i.fom.tnn ir.ord lasraro mmply *nh.ll Cn) md (-ount,
<br />oil,Mft6 !i sri. lr8 rlinB uB .od^d$tr dn @ .l,tnriz. r.Ferdn 6 of rhir Cny !d Counry ro drq utbD rh.
<br />ahvc mflhond rropcl, for
<br />,\rrrrlotrl or As{l str.ru ,(zlzlolfi,.4u\,.-
<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 />Facto ry Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rouoh)
<br />Meter Release
<br />Rough
<br />Service Meter lt
<br />FINAL ft\,t\(q ,Wha,\
<br />Notes, Remarks, Etc
<br />-*rr-
<br />\\/l.'/l?
<br />krt.ir AddB _
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