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ELECTRICAL.INSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DETXAR TION I lE.tt rrm un& Fdry ol Fjlry rhr I a sdpr 6on tlE Col[rrl6 Lad& It* fo. rlE follo*i!8 re, (56.7011.5 Busin63 dd Pmfsion Cod.) Ary Cny or Couny whth tlqui6 . pdii ro orF wr- rhq. i'trFov( &mlih or lq.i -, ,n4r6( Fs ro ir. !!lec &. r.qunB rlE elimr f.r uh Fnn lo 6L ! 3isn d 3l.o6t lhr h. or ft i lics!.d putua to th. FovirhB ol dE CoDr.rn , Lt.r!.d L,w {Ch.Ba 9. Conll:ftile wnh sdbr ?0O or Divlri,n I of llE BuiB rd toadbB Cod.) tr $r lE or !n. 6 qmF llEcfsm 6d rh. b.!l! tor lh. dl.Aod craFior. Ary vioLrion ot Stdbn 701 L5 by -, .p?licur lor . Fni 3uticnr rlE .ppli.&r ro . civil pdty of er mE $e 6rc b!n&.d &lln {1t00). l. E w olrlEFDFry. u ny 6pb)6 vnh *rs6 a rltn hl @nrFEtioo. *i[ rb tll *st.n dE *ar i d ddrLd or ofisld ld slc (Sd.?04,1. BBind ed Prol66ir cod. Th. co rdoi! ljcoE l.w &d el +ply to s o9e ol rh.FiFy rln hilt d ,!sw- dEm sn *ho dE r.n srr iiMllor hdElr or rllou8n nn n [a oM 6nplot<r. p.oqlcd 6.1 s.h ,lFoErill e mt htaxLd or offsqt 6r rl.. l[ ho@6. tl! hildiie n lrlFDvaEn i! eB wnhin om tr olcd4lair! tlE o'ffi Brla ei! IEE rh. hdar of FvlE thi lr d slE dd ,Dt tuild or iqoE t E FDFy 6r llE F,F* of I. s M oalhc Fopdt, m.tcluv.ly co,n ..lins wilh licss.d co.t ldo6 ro {Bhd tlr F.}xl (Sa ?041, BBin6 .,n Etrt i6 Co&: Tt Co r*ror'3 l,rc.@ lrr &c mr .r?1, ro o osnq olFlFry sl'o hild! or inpmv6 th@r dd *ho sibr8 aor s.i Frjd wirh a Coturdo(r lica!.d pu6@t to lh. Co n tor'! Li.c@ lt*) I d crdp u&ld Sc.rioi \ oRxxns' coMPElsaTloll DECI ARATION I hd.!y .,liirn lhda F!]rt oaFluD_ om olrh. following .k l&.rirB I I'rE rd will tuht&. Carif*.l.orco'n ro Sdf-l@ fd *qt@ ortrpd.bE B FviLd lor by S6lDn 1700 of tlE Lltm co<tc ltr thc Ffolrrec otrhc ed. for *,itich rhc p6oir i isucd. <t<w od will miir@ world .orp.N.rion iEure., u rcquied by Sclion 37OO otthc L.bor Co&. ror rh. Ffollm. of th. *qL f.r rhih rh!.rEflt i iEr.d My sE*6 orDpdrFn !'llre (eG Ed Flry .mhd R.,*'fu4et44-J e"rcy*,*. /w?a.\Lb$ez- r^p"- Q/ 4/zo I ccniry lhrl ir llE Ffotrw. orlh. *orl fd *hah lhn Fnd i! e.4 l:ldl mr @phy uy FDn in dy tun6 s a ro bcno. suud to th. mrl6 comF$ ion L*s oacslilomi4 &d .sE lh.l il I .tould bdor tut*rl lo lh. ki.t6' ooFE rirn FrvirioB oasarsn I700 of rrr tlbor Codq I dElL ftnh$tn ontPly wilh lho* prcvilioB.. WARNINC fdtuE to su. *nrl6' coDFulFn row!. '3 db*6r1. Md 3htll subjc' s cnploys lo siEin l pounks and civil fin.r up lo oE hu(ll.d lhouend Sdi.n 10?6 olrh.l,botCodc, inlg.3 ,. s rldiiotr lo llE.oi of <ooFrudion. d!Eg6 B p.oviH for tl* 2/./a ./- -7--7- I hd.by ,iIrm undd Fnalty of Fjury m li@j u,rd6 Foririoi of cluprE 9 (coffii.s * h S.ob,70m) ofDn!io.l of lh. B6in* ud PDlsioB Cod.. d{ my licd. is in full forc. a .flal .n*.*, lL- -"_r/fi72o_ _,-, /oic37l I h@by ,ltm unrlG Fulry o l rEjuy rhd thq. ir s$d (Sa 1097. Civ C ) Llndit Nec - ;Mtudion lsli.s.s*y tor llE Ffolrie. of th. {st 6r $tah rhit Fna a AIILICAIIDECLAAAIIA! I ha$y .fiE unda !a6hy of Fjury orc of dE hllowing d6hrdio6: Daeliio. P6ni!-Arbd6 t{orificlrbn F.&r.l i.Auhionr (rnk 40. P.n6) R.q{iEd L.r6 of tlorifi.ih t .airy thr i. f.da.l r.8uhl@ ,qrdiis abdo. 'lmvrl @ nor +pla.bL ro lhn Pb.idr. 1l.cr'trhr I llw Ed rh! rprk bnen d.rhrrh..t E iifonniiod bcqiar I.gEro ondy with i[ City.d Couly ortiucc oa Sl.rc uwr rUeoj io hrildin8 @tulDE .n lE*, &tlui! rq6. ri6 orrlt Ciy ed Co',iylo aE l?orttr itr\ . nmrDn d Fopdly tm /<ile *" y'r1/e Site-Work Underground Pole Bases Light Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Voltage Fire Alarm / Dampers Communications Cable Building Under Slab / Floor t l^ .- Bonding / Grounding / UFER bfl/ru/t !{dqa/gJtr{ Transformers Torqueing Sub-Panels Air Conditioners . /- t-^-C?- Roof Top Equipment b/7/;sru ua/a 4,{d0 Factory Wired Unit Walls (Conduit) Walls (Rough) Ceilings (Hard & Soffit Rouqh Ceilings (T-Bar Rouqh) Meler Re_lease z /-fur7'aD v/et b/7/t{/,UtYt/W wdv Rouqh Service Meter ,ll a?,., FINAL a/71/uo *u/L woa o0 Notes, Remarks, Etc. Rev.08-07'2015