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APPROVALS DATE tD/srG.COMMENTS Orc-Bsild6 Dclr.rrion
<br />I td.by.,I'rn u,nd Frt, olFrlrt rhr I e .ldB fom llE Co don LEm L.* lo. d'. follow'rt ,.s(E 70]l , qt'B
<br />$d Prol6tion Cod.): A!, Cn, o. Coulry wtich r.rui6 t Fmi ro 6Br!6, .td, imp.oe. d.mlbh or r.Fn ry rM u., Fh?b nt
<br />irtue.. .lt cqut6 ll* 4rlic.d tu tBh Fojr to lilc . .ia!.d ,tr6et llll lr d rL ir lt.@d pB6 to rtB povirioG ordr
<br />Co.rds r LG,!.{ r,r {cllFr o. con,l@h3 rth SdEr 7@ of DE66n , ol E B6rn .d P.ofq.bB cod.) or rL t a
<br />th. n.rdpl thd.6om r $. bui6 lor lh. !nc8.d qoFbn .Ao, vioLlhn of S6rio! 7011 5 t, dy .ppli..nt for t ,amir .!bj.ci' lh.
<br />.rplic..r 16 . civil Fult of Br @E rh.6 6vG hutilerl &Ua { l5@).
<br />L a owrd oa lh. pop.ny. or ny .nphy6 with w.t6 a 0Eir hlc ..mp.ndo( *ill .L th. *orl .!l{! th. $ru.ru. i mt intai.d
<br />o, ofisld for qL ( SE ro..l, Brlg.tn P..l6r.c Cod. Th. cotuo,i Lr.!& L* &€ 'Et.rpt !o D ow oari. pDFn,*t t{ik!.r inFov6 rLr6E !d *ho do€ ut rort hi@lfornE [dllEorytnnorlE or..nplry4 proviLd rh.t.u.h
<br />improvmol!!r.noli.nd.dorofiB.dforrL.IIhoe.B.lh.buildinioriop.or6.!ritrctd*ilhinocy.uor.odpl.ti4rh.
<br />o'rc-Blildq rill t w tlr hd.. olFlvirs llrr lE or.!. @r hrild o. !np!r lo, dE FrDo( of !b)
<br />l-sowBofrt prcFry. e.rcluiv.ly conr.dil3 *nh [..Md.o rIl.r ro 66r(cr ih. Droicd ( S<. ?044, Bao6r rld
<br />Pbtu{io. Co<L: TIE Codr.cor'r L..@ lrs dG d .ppl} ro u ow olFoFiy eho b{rt& d Fo!- rh.r@. , .nd rtb
<br />6nhdi lor.u.h prol-. wih. conrdcro(r) hcar.d pununr ro rh. Conhdoit LE.N. ltw )
<br />ltoru(DiS COMPENSATION DECLA{ATION
<br />I ls.by rlr@ u.&r p.ohy orFijury oa offi. folb*ins &(luri,6l
<br />Ih.t..dsill illti,. Cdlifi..l. of CoMDl to SllaJtu.lor Erk6r'oap.dtp( o provd.i,forbyS6tDnlT0oof E
<br />t borCo&.6rrIE Ffollll,Eof UE*o.t b.*hthrt F6n nBu.d.
<br />I h.v..ri will mrn[r. s.tdr' 6nrp.Er6^ tnlme. B ..qu,Ed by S.ct.n ]?0O of t[. trbo, Codq for t r. FfomN ordr
<br />sort for qhth fiL FDi it is!.d My m,t6 c6np.ut6n 6url@ sr.id polEy ruEb6 r.
<br />_ I .alit thll h lh. p.rfoM. ofth. *o* fd whi.h $ir FrDi i. isu.d, I 3h.ll not dplo, ay pden in.., mnn6 & s to
<br />bc.m.u6rd b rlE mdai 6rn .dron lE of C.LtunL .r.l .|rE rL lf I nEUB bcor !ub6 ro !h. wr6'
<br />comp.uriotr prcrnion! of Selior l7m or rh. trbor Cod., I thrl!. 6nh$nh conply r nh tho* pNririoro..
<br />*,.!_2/2!L
<br />w RNlrC F.,lur. ro Kur.*old3 sn .M'n.o\d ilr.ll lubr.cl D ophF lo $ihiul p.oki6 lld .iril
<br />fM u, lo * hurnrd lhoEn doltE (l100.0O).n .&iion lo llE d oacoop.urbD. d.d36 a Forlld fd ll! Sdirn 10?6 or
<br />rl* Ltbor CorL, inr66r sd .r1or*y r ld
<br />UCEBiED.COtrIAA(IAIS.DISdAAUQ!
<br />I lE .ty !,Im uidq p. lr,of pdjury th.l I e li(.Md und6pF\nionof anrprs I (officins snh Sdbn 7O@)oaDivi3ion I oa
<br />rlE &silg .!d Ptul*h6 Co&, .rn Dy li.e 6 6 tull forcc.rn.fi..r
<br />Li..rcL!, A-,.,_{2t11j
<br />v/2
<br />.-,.-', !L
<br />I h@by .mm unda p.nrly of Fjorr rhr rhG ir. cGttu.lioa kndirA.Smy lor th. pafolrie. of rh. *o* for whth thi! p.dn n
<br />i!.u.n (se. 1097. civ. c.)
<br />aStu(Atut tclJaallotr
<br />Dcmli bn P@io. &b6r6 Norifc&. t dcr.l R.suhbd (fn b 40. P.n 6)
<br />R.qun.d L.fid of Notilr.lion
<br />I cdrd) th.r r,t r.rrnrl rsuhrs r.3rdine !b6rG r.mri @ mr .ppli..bk h rhi. Forai
<br />I c.nio rhtr I lllv. od rhn .D?lr.rion !d trn. tur rlr lbolr inlomrion L cond l.Jrrocorplyrirhrll(nr.d cody
<br />Gd'dr€.]d Sl.l. b*. r.l.ri.8 ro hildins co6rru.ri,G .Dd hd.by rurlbti* rpr6. nirBofrh!Cny.dCoriyro dra uDor rlE
<br />r/Z1rf
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountarns
<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 />Torquing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough
<br />FINAL
<br />Notes, Remarks, Etc
<br />{
<br />ELECTRICAL.INSPECTOR RECORD
<br />Psl\PmiuBpGdion Fo,rE\El.clncll-lnsp.cton R.co.d doc 03 31 06
<br />-l e .r.nF u.r6 S..1an _.8. a t C. for rta lru..
<br />Polty Nunb.r_ _ _ExrirB:
<br />(Thi. !-iin E d d b..6qh.d if dE rctn ir b. On hodL.il &lkt ttlool 6 16)
<br />:!::l:"# jW#o.-zr;e.*:
<br />Site-Work
<br />Service Meter
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