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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Liqht Standards
<br />Spas, Pool, Founlains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor l,
<br />Bondinq / Groundinq / UFER llr Wo DDard06,v
<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 Rouoh)
<br />ffeter Release lt ll
<br />>r)AY t,tuu b@hoe t
<br />Rouqh
<br />Service Meter Ir t
<br />IFINALrlLn(h \DuM4r
<br />Notes, Remarks, Etc.II
<br />O\f, Nf,R AUILDEN DELCARAIION
<br />I h4by lflm undq pdllty of pdjury thd I d o.6F ton th! CodhcloB l,i..e L.w ior th. follouos la$L,s< 70ll 5
<br />BEind !d P.oasion Cod.): Any Cily or Counly which rcqun6 ! pdmn ro oinruc1. .ltE, inprev., d.molirh or rq.n dy
<br />ntud@, !.ia r i! isnucc. rlo r.qut6 rh. rpplicet for Blch Fhil lo 6k 6 tisn.d lldo@t llln lE or slE i! !ic6!.d pursl
<br />lo $. FlrBioB of lh. Conrrttr! Lic6s.d lrw (Ch!r(q 9. Comding with SerFn 7000 oI Diviri,tr I ot lhc lrulind {d
<br />Pmf6ioB Cod.) tr rh.r h. or dE is qcmF rhdfrom rnd rh. b6|' for tlE.th8.d .rdlqbn Aly viohlion olsdbn 701I t by D,
<br />rppli.ut aor . Frtri subaR rh. .pplicsr ro ! civil FBhy ot mr mr. rhrn nv. h!i&!d &lld (u00)
<br />-1,
<br />s ownd of lt. p.oFry, or ny @plo,6 wilh N.se s rh.r elc @npdB lion will& dE ell.nd tlE lErxldc i ml
<br />intdd.d or.lIErd for d. {Sd.7044, B6a!B &d Prot6ioN Co&: Ti. Cornrdd r Lic@ k* 6. ml rplly lo u o$c of
<br />rh.FlFly who hrirb o in{r!6 rlEE( dl $,lD dE $.[ st hi,Mlf o.lE*lf or 0Nush hi. or I'a oM orplot6.
<br />ForiLd ltI.I sh imFo6E$ E rcr i'rddcd & olL.d ft, d.. lt holtr. lh. hlillnB c irEosErEl i $U *irhi, oc ,r
<br />oa@rplib( ln. o\rM Ariua will hrE tlr hrrt n otFsins 01l lE or 3tE dd nol b{'ld or iq.ow dE FDFIy 6r rlr F,!.cof
<br />t, d 6M6 ol$. propctr, dn .r.lsiv.ly conrr!.rire -iifi lica!.d codr.doR ro coG(rucr rlE Fojel (Se. 70a4, &!iE
<br />.ri ADkiorCod.i Tt.Contlcroi! Lictu tr* <i,e er lpply ro eo*{q ofFoFl,wt build! or try.lv6lhdon.
<br />ed *tD @'rr&r3 fd sh FDjds wnh. conr&ro(r ltau.d p{'rEr b dE codrcroi3 Li.@ Lrw).
<br />-l
<br />6 .rdfl und6 s6rio.-
<br />UABXEBTIAIUTNSAITO!
<br />IICI.Af,AIION
<br />I hd.bt ,mm undd Frlry ol Fjory on. ofih. lollowina &(lrrlDB
<br />I hrvc sdsill mnnrlin ! C.nific.lc oacongr ro S.lr-l@urc for trsrtEs comFro.rion. d provid.d fo. bySdr{n l?00 or$c
<br />tibor Codc, for rhc pqfome.. of rhc woik for ehi.h rh. ,fli i. isu.d
<br />I hw. ..d will minlih rorld coEFBrion iNreq s r.quftd !y sdi6n l?00 of rh. t bor Code for llE Ffoffi of
<br />rlE mrt lor whth rhir Frn n isu.d My wdt6 @nFsdion iault. ffiir Dd polty Dumbq &:
<br />I csri! fi.r in $. ,cfomuftc of rh. $6.l fo. shi.h rhn Fmn i. i$.4 I 3tull ml dploy oy F$. in ey iME
<br />$ a lo beoft .ubjct rc rhc *sI6' omFEdion LB ot C.lilohii. ad ttiE thi if I .lbuld b6or $+d lo lL
<br />mrt6' smpsslhn phvisioG ofsdion 1700 of|h bbor Codc. I dtrU. aonhwnb comply u iln lh* povilioc
<br />WARNINC r_!ilur. to s!r. worl6' cor.p.elion cov@s. $ uihBful, dnd .nrfl subjd s dnpkrrs to cihitul poBhis od
<br />.ivil fb6 up ro om l$ndr.d lhousd dolle (1100.000)
<br />Setirn 1Ot6 olrh. titorCo<L. i cd.d r|onElir f6
<br />th! c.i ol.o,'F@lion. dm46 a provid.d fo, ltc
<br />\
<br />I Hy rIIm und6 pouly of FJury rld I m li.orcd ordd Fovthn oacluOld 9 (@hm@it8 with S<rb. 7000) of DiGion l
<br />of ft. &!i6 ,.rt PmfdioB co&. r'd my lkqg ir in tull foe $d .ffd1.
<br />fi6 ZtDFtr..lca*JSoult
<br />I h.i.b, lllm !.dr p@!t, of FrjEy rh.l rhq. ! r.otrnru.thi lddins 44, to.llE pofolllry. of lt wrt for sfii.h lhir pd.il i!
<br />isu.d (Sd. 109?, Civ. C.)
<br />tadd t Ne.
<br />arrllcllr-oEct 68arla!
<br />I horly.mfrundd pdrlry ofpdjury onc of$. following dele ioml
<br />D.nolirior F@n!-Arbdor Notiic.tion l_.d6!l RqruLlbd (TnL 40. Ptn6)
<br />-R.qui'd
<br />ln16 of f,lorif.din
<br />I .dif, rhll rhc f.dqnl r.grhrioc rcgedinl 6b6lc raroval arc nol appl@bl. lo lhi! pojcl
<br />I ccrily rll'l I h,tr @d thit lpplkario! ad atov. mfomdion is cor61. l0grr ro e6ply with all CnyMd Counr,
<br />ordiM.6 afll sr6r. L.*s Ehri,{ ro hrilding ,d hd.b, ,uitsri2. rcF6snr(6 ol lh6 Cil y &d Counl, ro 016 ulnn rL
<br />r{ds
<br />qtrilzD2,o
<br />Rev.08-07-2015
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