|
ELECTRICAL-INSPECTOR RECORD
<br />DATE ID/SIG.COMMENTS OWNET BUTLDER DELCARATION
<br />I hcrchy rffrm und.r lEMlry of Frtury lhd I m cr.r?t lNr rhc Co r4lo^ l-is* kv lor llE folh*h! Elbn ls.( 70]l t
<br />Burimsr .d Pnf$rion Co&) Atry Ciiy or Cddy *hich r.rtumr r Fni k' onnrEl. .hq- iqmt, dcmlih or r.Ftr my
<br />dnt1ft. Fir ro it ir{.ft, rko EqliEi rh. rJlo|fl ntr rkh Frmir ro iiL. risftd ii.,cc.r rhd lE or tE ir licncd rnryr
<br />(, rh. ln uri,nr of tlE Coirrrlr \ Lirnsd Lrw ((-luFd 9, CommrrS *nh S.dhn TUI| ol Divirnr ,r or rlf, EuiE$ rnd
<br />P,lfcsbnt CGjc) ir rh.r tr r df, ir.r..$ rtFdbms,r, r tr$ tu tlr llkscn .rcqii,n Any ri,hritn ol Selhn 70.1I Jby.ny
<br />rmh.rd rn . Fmi {hFh rh. .!Pli.nr ro t ciril FMny ol mr .mE rhd fik hlnlrd doll8 (35m)
<br />-1.
<br />rr osEr of . FFdr. d my.'q,r'!Gs wirh s rFr.! rlE, t'lc mqm!.ih"- *ill(tl rtt rdl nrl E.MlEiml
<br />incd.n ot6d ftr qr (Sd 7044. BuriB rnd Pnf6ii)m C'd. Tlt G,nrrrd r li.N b*.rB ml .!Plt rn d o*d or
<br />rlE FlFny *lD tril(h r DtioBirtEr rd wtn d{F u:i krt hin(lr h.Rlf or rllugn hn u lEr o*n.rl?bF.r.
<br />|trovir(n rh.r rEh d{roffir N Er ri.d.d ,itu for -l lL L{N. rlE lliEi{ d irFNrEd i IB }ahin tn ,{s
<br />or$ntlriitr E olrEr auirtr *i[ lsE rlE hrd.n oflrtittr hr lt 6 !t. dn d hiB, in,rtrE dE F)pdiy rq Dt F,F*6r
<br />-l..1.*rcrol
<br />rhcpr)Fny. rncr.tuln.I,ontn rnsr hlkcn*lcn kr..lt, ondrud rlr F,j.t lsd 7{X,1. BurrB\r
<br />atol lhiirshn (.ld. Thc Conrmrroa r Liccns. l rs
<br />'.1,E(
<br />ftn lnlly n) trn o* Nr trf ln,F y stx, huildr or imlmvc\ | h.r.on-
<br />!.d $ho (nrh_-k ror \uch p(+cB *irh a (i,n!toci,n n lrc <l pununr tu !h. ('onrrlcroi r l,tcn* tr* I
<br />l)utr ()*n.r
<br />Iu]BtrD8frlAlrlll rl)!
<br />Dl;rt arallll!
<br />I hornt irlirnr ufd.r p.nxlr!oIF-'juryotu or rh. r')ll,'snN J.rlrfutxtrtr
<br />-l
<br />hrrc 3d *illminriin ! C.nifur. of Cutrsd h s.ll.ln r. ft, h.k(f onqEnsrion, 'r F.lii.d lor by Serir t7{r) of rh.
<br />lihr (iilc. fm rtr rrrfolrrm na rhc *i,l ft , f, hth ilE Fnir n ^odl
<br />_l h.tr !d *ill tuitrr.in *6rtrs c.i'ocnurir r$,ft.. ( rcq,iEd by Sdion 17fi, of rrE liff co&. aor rlE Ff..fu ol
<br />rlr eqt fq *hth rhi{ Fmir k k$.d. My * ln' conlrdi'n inrur.Er ffir id Flty mmh.r c:
<br />(.dr, ' M!L?_h_zql,L-_
<br />//-o I :14'q-g'oq6ol
<br />l.a.nift rhxr inrtFFfttrmrcofrh. tro fd *hah rhn pcrmi n irrwd. l ih:ll ft .r?hy ao, p.ron in My @ntE
<br />{, o( h tEnnr ruhJcn ro llr srts mr{hsrnh ber ofcilirnmo- unr !8R rh.r ill .tnuu lE or \obj.rr ro
<br />'hcktrl6 mr{Enqri,n rnishns ot Sd irn 17m .f !h. l,trt (irt . I rh.ll. fonh* h orq'ly r irh !ho- pmriri.n! .
<br />llAnNlN(; Flilurc h \_ur. *oikcr (onrlEn{ri'n (r.r!*( ir unhttul. r.rl \h l {ha.r ,n .iY)hycr t, sinintl Fehis tr'd
<br />$rl nn.s trt t, oft hufrlri rhouc0nd d.llon r$llx).lxx)r. rn rn fnn h rh( .od of rc IEnqtion. d4ro3.\ r\ F,vil.d rnr !h.
<br />'
<br />:,,"^).",- : ^ t; 1;; 4 i 14'
<br />tlE(l.^f,AllQ!
<br />I hcEby afinm!ndcr I'cehyorF+ryrhd I rn litn*l u.dd ntirirbn ol Ch.nrs 9 ($mfttuin8 *irh Sdi,n 7lf,x)) ofl)ivirion l
<br />oI rlF Burift$ lnd Pmfcsrhns Code, erl ny lic.n* ir m lull rne dnl cltal
<br />(lo q1 t6
<br />qlllirauqu0Nljdt&[(i.AaEtr{;r
<br />IhcEny.fiirmo ..FMx,otFi,ry$artftirtNdMInL.dhr.!.EyforrltlErdffioltlrrvtlor$ntfirb\Fnhk
<br />tr.ucd(ss.](l)7.civ.c)
<br />lrnLr'r N.m _
<br />atturJrllrLl.|.t BAIII):
<br />I rrnl,\ irlirtrrun.lcr Brrllr) of N,lurv Ltrr,n rl'. lf l!,s tr,r LlrL lJ'ir ,rr
<br />l\rnrhrn)n |rrnnr\ ,\ltl.n'(Nlrni.rrx r l(l(rri k.'r,lixr,.r l l\'lr) lli,r6r
<br />lr\.tt .tlIrrkr,,rN,liliuri(tr'
<br />l!.,r'r! rhn rh.lidlnli.lulirr,tr\ r.lrnltrir r.l\-r\,rtrk^rlr. ni,,tr)lk.Lln. L! rhr! I'n,r(l
<br />nl h.rchytrtrrhtrr. r.l,.E,lllivc\.lrhn Ciyand C.u.ryt,.nlo uFr l,E
<br />rhr( nrnri(nrd pn'r^-'n) I'r iNp.cri)n
<br />,rpprr..nr ".,rs.nl Si1*rr* {
<br />".-u* -..,rnr,, ?( €tl'D
<br />Site-Work
<br />Underground q.1.%?4 IWA W +fui*ru Yvuv'rrto4
<br />Pole Bases O{-
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Late Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER (tl Lt lz,t Plt\fiat'w
<br />Translormers I lr
<br />Torqueing
<br />Air Conditioners
<br />Roof Top Equipment bl?jlu \hfll.a-'t kt7
<br />Factory Wired Unit I r'
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soffit Rouoh
<br />Ceilings (T-Bar Rouqh)
<br />Meter Release bD4zo DM,n-*w
<br />lr
<br />Rough
<br />FINAL b_t>71>o Di-rf,r 7116'l
<br />Notes,.Bet1tarks, Etc.II /'\
<br />z tl.N
<br />-+
<br />APPROVALS
<br />Sub-Panels
<br />Service Meter
<br />-{WN}^ ?A TIA 6a - UrC \)DarrW:
<br />ll & l' (- ltnrlri\,.rur
<br />ordrtu'ku M S'!r. tj{r rchtin8ro hoiUirg
<br />'glu/e
|