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APPROVALS DATE ID/SIG.COMMENTS Otf IIET BUILDIR DEI]CATATION <br />! ho.6y rlfm ondq p.ndly oaFiury lhn I m dcmpl Eln th. Cod[do ' Lic.nE t w for th. lollowry tun (56.7(rll.5 <br />tlBilld ,rd arcfd.nn Cod.): Any Ciy or (iuny $hah r.qlic . Fn o otu, .ts. i,V.orq {beli'h o, i9., ay " <br />itrucl@, p.d ro t! isusq a!. aqut6 thc lppli.ei ao.3uch Ffllr b fiL r !i8od nrtul lha lE ot liE i! lils.d Fro.rr <br />to llE FuirioB of tlt Cono*d r Lenr.d trw (Cltrs 9, CoMdi,8 *nh Sdi 7m0 of Divirion I of rh. tldilB dd <br />Prol*Fnr Co&) or rhtl lE M ltE i qdnpl tlE.fmn sn th. bcir for rlE dk*.d BdFnn. Any rFld6n of Sdion 701 L5 by sy <br />.r?licor for r Fnn ubj6r. rlr .rtli@r ro, civil Fulry olmr moE $d 6rc hutxH dollr! lt50o) <br />l. s o$n6 oath. prlFly. or ny mplor6 wilh *u*6 s lhcn $k comFBaion. trill & tlE wk lvi lh. srnl.lr i! kn <br />,rod.d *otu lq ELlsc.Toaa. BiBil6ed ftof6ioB Cod. llE Cqr.dd'! lj.ot L.x'd6'Dl ?9ltb aorGof <br />$. FbFry who hrild. or iErF.rB tlEEn, dd who d6 sh slt hillclfor h6*ll6i thrcuBh ht or hd own mplolt6. <br />Foriicl lh.l Dch imFllsEa e rd inqd.d or oE*d 6. rt lt, lb6q. rlE txiltlr8 M urslv.Er it Eld virhn oE d <br />ofonpki.E EO*E&,ildswillhvrlh.hdcrofFllvs.h.e!h.dndhrrlilori"4..1tlh.FotdytotlllFrpcor <br />-1. <br />s oM6 of rh. Forqr). @ dcluiv.ly .ont dins wih lica!.d coilrelos io mntlru(1 tlE Foi6r (Se. ?o14. &!ind <br />nd h$tsdn co&: Th. Contr.do. r Lt6. Lrw &6 mt .ppl) lo & o*,s otFFny sho b{il.h or inFov6 lh6on, <br />ud trlF oddr lor u.h Elir€ unh . Con*ro(3) lt6B d plr&ad ro ih. Conrt lor', Li(u& tr$) <br />I e.rmln unda S.nFn <br />jlaaf,[8clolllEdtallll! <br />lEgldlauq! <br />I ha.6y lmm unrLr F[!y of FjuN or of tlE folh* ,'s d..ldr.B <br />-l <br />luvc rd $iU tur.ia. CdrifE.l. olcoMr ro s.lf-lM for wtd @rFqrio[ B Frid.d for by Salion ]700 of lh. <br />l,!or cod.. for rlE Ffolrle. ot tlE *qr b. rnth dE Fmd ! isu.d <br />I h.!. Dd s ill mid.i. et td' comFrs.rion iMm.. 6 r.quiEd 4 s<rho lrcr of rh. L.!.t Cod.. for rrE Ffr'nle. ol <br />rh. Rorl for whicn rnir p6nir ir ilo4d. My wdld' coirEtsa{'n iquD.. cMid ,n Flt, numbs rc: <br />, Sit'IC f uh.irl <br />lcqrssz /:c <br />I cdirylhd in lh. FIotu. orrlE sorr fd niih rhG Fnn it eci. I nrll mt arpb, ey F$n in my ffi <br />e a ro i<rG ubirt b rl'. *o d'omFstun L$r olcdilomi., &d isE rhi it I it utl b.roft $t.d lotl! <br />ert6' onFulion FolirioB oasclhn I700 oflhc l,bor (irle I dEll. fonhtrth on9t, *ilh ltbs PmrLioB <br />\IARNINC: Ii.ilu.. h su. worl6' compdB.rion .ovqnr. ir uihwiul. ed 3hdl srbj.ll m orpbF lo ainintl FohL. d <br />(N'l nB ot ro oE hud.n rhoued dolLE (ll00.1)(rr). t .ddn tlE coe oI conFdion. &n s6 6 Fovii.n aor rlF <br />sdho 1076 ol rh. l-abor Cod.. inld6r d.donry'ii6. <br />I <br />ITCBAAIIIIB <br />I heby rlfm u.dd pdtly o f pdjury lhrl I M lic.ns.d unds Frvisnrr ofchqnd 9 (.omachB *nh Selior 7000) of Dirition I <br />of lrE t\Bi,B dri Pr.lsb6 cod.. nl my lkG L n aull roft rd.fid <br />s-1o /c-{u t30.{ s I <br />tT{l n E$lf&o I,"LNL <br />g]TIIBICITO!.I.IITAG.A(iE CI <br />I hd.bt rrtrm ond6 lEnahy ot psjury lhd lhsc s . NfiruclDn h.dins i!d., for lh. Ffolrucc of lh. q,.I nn *t]ch lhis Fmh a <br />ieal (S< :!097. Cr C) <br />rIIU(ANLTECIJIAIIa! <br />I ha!6, .trm !.dd po y ofpgjury oE oflhc followiry d.cLturioB: <br />ttmlirs. PmiB-Arbdd NolifE.rio. l'.d6!l R.auLrbN (Tnb {0. Prn6, <br />-Ratuir.d <br />l;t6 of r,lorilrnion <br />-l <br />.dit rhd th.,.ddal r.xuLlioN r.gEdins arbdtor rmv6l ec ft,| EPlubL lo rhi! pNjd <br />f,lcdiryrhar I Mv. md rhielpplt dion sn slat. thd rh. !bov. ofomarrn !.ordr Iasreloconnly*ilh.ll(hymd(oonry <br />onllm(a ,d std. t.*r Ehr{ ro boiLCiry codruclirr !d rurtEriz r.F.sdn 6 o f rhit ( iry &d Coury ro 6t6 upon E <br />!br. mdrhn.rl tnoFnt for i6Fdio.\1tltlApp0onr or <br />^adr <br />shor{rc )! <br />pmi,Fn.E.rpn.o: rts- sg*finhU itl l-U lUArrl <br />Site-Work <br />Underground <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monumenl) <br />Life Safety /Low Voltage <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor I <br />Bonding / Grounding / UFER YWa I <br />Transformers IJ <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 Rouoh) <br />{1e1g+ Qglg65g JdDEQ 7 <br />Rough .la'ht)-+-l{'tq x"v-{lt: <br />Service Meter <br />FINAL Ll-l{"1"YWil) <br />Notes, Remarks, Etc. <br />--) <br />ELECTRICAL.INSPECTOR RECORD <br />t-1J"N1V{-D(- <br />v