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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE rD/srG.OWNER BUILDER DEI'ARATION
<br />I hd.tt .rm ondd Fdry ot Fiury t,u I a dqtpi 606 ilE Cotutrc Lie t $ for lh. followi'B trn (Sa.?0:11.5
<br />Buinu ed ftoE3lion Co&): Any Cny o. Coor, $hth EquiB r Fnh lo oldru.l. ilt6, inroE &rclalh o tp.t D,
<br />$!.ruq Fi,r ro ir! iw.. rlo rcqung th. 4di.&r lbr ,u.h Fnn ro fih . !8,rd nroMl lid lE or .lE ir licoa.d FMr
<br />b rlx FDvinE of tli Conrr-loir LiEr.d t w (Cl|4r6 9, Com@hg *nn Sdion 1000 of Diynbn I of (E BuriB id
<br />PrcfBioB co&) or th.r lE or 3h. ! qdF rh6.&or sd th. b.ri! for lh. dkgcd sanFioi. Any yioldioi ofsGrion 7011.5 by Dy
<br />ry?lior for . Fnn iubjd! rh. rppli&r ro . .ivil p6uly of mt mr. rha fiv. l$ndr.d dolld {1500)
<br />l, 6 ow otthc FlrEry. or my dploy6 with *.s6 a rh.t sL 6mFsiol\ will & dE wort ed ft !rMr@ ! 6l
<br />inldr,.d or olTE d tm d. (Sa.7044. BuilB sd Pror6io6 co&r TIE Comr(m r Lto& L,u &Jd Nl +ply to D o$c of
<br />rlEFnFry ltn hil& or uF.o€ lta!^ tn *tE {trq idr srt himrf or h.Ilf or llDuah nit d lE orn fiplots
<br />Fov'd.d rhrr !u.h inFD\diEfu e mr hdi.d GolH 6r d..li noutw.lli hi d{s d it4.lffi L iE stnn m }d
<br />oaco"lpk,knl tlE O*iq Builb will hlE rlt hda' ofFlving thd lE or th. did Dl hnld or inFrE lh. Fopd, for th. p4o* or
<br />-
<br />l. d ou6 of rh. FrFiy, @ dclBivcly conhding wnh li.tr.d roilrlcloE lo rcinrud rh. Fljdr (sft 7044, Bd,nd
<br />lsl Altsir co&: Tt.Co r-toir LiGN Llw do6 ml .Dply ro d.wna of FoFly *ho boikL or inprov6lhsoG
<br />ed who olnrat fd *h Foirr! qnh r Codrxro(r ltcE d Fr,!@ io tlE Co'f!.1d r Lioe L.*).
<br />,,,.,",",,,,.,.,,.""..,,,,"'lL 5 -? 43 t,&,,(,{',^,csn
<br />,", 4. H - 2o o"N, V , ^-* 6.,ct et-- Co--a \l([{aFk\' ( ttllf} I\SA I lo\
<br />DECT AXATION
<br />I hg.6y lffim uirtd ,ouny otFJUry oE ol'h. folhr'trB .k l.rrrioN:
<br />I h.v. ri will Ei.r.in . CdrilE.rc ot (oMl ro S.lt-lNuc for *orld .onpasion. 6 FltiLd for b, S6lbn ]700 of llE
<br />tler (-ode lor tlE FfolIlB o r llE srt for *trcl llE FD{ 6 urdl
<br />I h!v..nn *ill B.inr.in worl6 comFution idu.mq N r.qunld by S6lir.l70O orfi. bbor Co&. ao. th. Ff(lirffi. of
<br />rh *..I fm rhrh fiilmi E sr.d" My 10*6 roruFEdDrise. .,lE d pola'.umbd rc,* -4?*tlcVc,Ls(kua-ut* t l
<br />**,*.0. L ffl <Sz |S\n&h*-'1kflt-l
<br />I cdiry rhrl in tlE Ftoll:rtr.olllE *orl lor shih lhis Fin b is.4 | !h.ll mr mploy 6y pcsn r uy naF
<br />$ s b b.roE $ti6r ro rlr qlrld'@sFBihn L*r ofcnifotui{ !i +E rM 'l I Jrlld hdoe xtiel lo rlt
<br />Mrld comFMrion tmvisioN of Sdi.n lT0O of rh. L.bo. Corte l rhrU. fonhwnh onpll snh ih.s provirioB..
<br />WARNINC rolr ro s@ *116 onFMhn cora.s. E uLutul, ed ndl rubFr D dp!,F to dimi.n F id !i
<br />crll lin6 up ro on. hututr.d rhousand dolres ($l(x).(x)o). h &ldit ro thc .on of coip.6rion, &mgd r pmlid.d fo. rh.
<br />Sdon .1076 ol rh. kbr cod< mrdd rBl dronEy ! fG
<br />o[dJaaarja!
<br />I ho!t, Im und6 Ftdry of psjury thr I u li€u.d un,a rovilDn o(ChlFd I (offiirg wnh Sdion ?0OO) orDivnbn 1
<br />oa !h. BsilB !d Pmf6io6 aode arj my lEw i! D tull forc &xl.lId
<br />z
<br />l"r /,o
<br />.7L) -? 4)I 7.ti6tz-- /Z-< ,
<br />ATII.ICANIDECIIAAIIO!
<br />I had, altm undd p6ahy of prjury orc of th. louowins d.cLr.liotu:
<br />Dcmlirnn Pomng&bdd tJor',icdon l'abd a.Buldbo (rirL.o. Pd6)
<br />Rcqun d l.1lo oar.l,,dfidirn
<br />I cdify rhd rh. f.d6.l r.g{L n6 Esrdins stEro3 rm\.j e d .rplr,5b b th! Fol.<
<br />_ - I .drify rh8r I hr!. rai rhir rpplf,arirn nj :n. rhd tlE anl* irforEd6. is cor.d. I rsc ro .omply whh lll Cily ..d Cod,
<br />oidiDN6 ad Srd.l.sa r.ldit{ lo bu .dhrM EF.!du!6 of ths Cny!d(oum,ro 6n.
<br />!bov. ndhonol rr6p.ny nl. nlp.dion
<br />apnu-, * ,r"', ai*-,*. Xf
<br />r,"",ir"" *." rp",rr, D('74L C-,2-.JZ:
<br />LO
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<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 />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)1-a9-A \1,'0-lA
<br />Walls (Rouqh)o t-2i-^,\JO,A,
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Roush)lr ,-20"?r [,YI6}{
<br />Meter Release V (\_,/
<br />Rough
<br />Service Meter n
<br />FINAL ?-1'Zdu \ilfut
<br />Notes, Remarks, Etc.
<br />COMMENTS
<br />D .,q- >l ' 2'?
<br />coBtrBucrroualllic-a0Edcr
<br />I halby r&B un<li Frl, of Firy rhl th4 n r otuhi lsldin8 +try fot lh. Ffo!tu. otllE srl br $tai th! Fbi b
<br />isu.d (Se. 109?, Civ. C.)
<br />L.n&.! Nm.
<br />a -ZJ;-?A
<br />Rev 08-07'2015
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