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ELECTRICAL-INSPECTOR RECOHD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<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 />Buildino
<br />Under Slab / Floor
<br />Bonding / Grd(Elins / UFER .L n-44 4l
<br />Translormers
<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 & Soff it Rough
<br />Ceilings (T-Bar Rouoh)
<br />Meter Release .LI.?.1 tucz1 ,n
<br />Rough
<br />Service Meter
<br />FINAL 2,lD'21 rzc /r,ue2a9 ozv
<br />Notes, Remarks, Etc
<br />/1^ a,l?
<br />o*Nr.n auLDf,n Dil-clr ttotl
<br />I lErtb, rltm u a Frly ol FI,.y ih. I D .!r+r 6um dr (on xr6 tid ti* fo. rlr follo$ta E.s ls.c.7orl-J
<br />B6ilB rd Pr.rdi)r Oi.r: Any Cay .r Cany vh.h EquG . F ro .dEr. rlrr. i,qrmw. .lml.i d Ep., uy
<br />ffi,rnrtodr rrou...Ls EqlG rlr {'t'lr.rr for sn Ftrr ro 6tr tilrd di.rd rh.lrdtEtlian.d Fltd
<br />r. rE l,trvinN nr dr C.tu-rd r l-i$*d l,r (Ctt Fd 9, CollmEhS *ih Sdhn 7Ul) ol t)tvirrn I .t lti Buirs lrd
<br />Ptnf.Bionr Co& r r, rhrr tE d d. i! rkqi rr'rt6lm r,!d th. h.!. lor rrr .ll.3!d .En+.ion Ary Ehin Dl S<re 7011.5 bt u,
<br />rppliclhr for !Fmr NhFk rh. .ppli.a ro o.ivrlp.mlrrolmr mE lh.r fiw huidEd dollB (t5ln).
<br />_1. .\ otr n.r ol rlE lrcFny. or my .mpkl}t.s wirt *.3.s I rh.ir v,k or{rndhn, *ill dr r,l *.rt .d ilt ndE ir d
<br />iia .d or ofi.Ed ntr uE (Se 7U{4. Burin.$ !tuj PNr.sn}M ( Lrl.: TIE Codrrr,i Lt.nE tr* drE! nor rPdy r. nn o-n.t oI
<br />ilEF'p.ny wt! hild! or inltroEs rl6q fl] *h, iltE skh s* hinelf or tH*!f or rhreu8h ht m h.r o*n.npi,r€.!,
<br />pr.rd.d fi.r r(h ilt{'nrEmdr & mr id.n cd (,rr.rd it sL lr. lFr.w. uE hriBio! ot itrF)Emd n,r! eilh or ).e
<br />or.onpEtn dE o*Er Builtr villh.E tlE hnLn rfFrvus d. lr r JE dn d bui! d rlrot rtE FnF, rd t FrrFE oa
<br />_1. s o*rr of rll p..Frr, .h .r.hsn.ly !d..itr! *rh lEtrGl .dEr6 to MiM rrE FoFd (S<. 7O4a- Bes
<br />.rn hraqncixt Th. Co doa! Li.nk t r{kEdrlrlrro&orEotFoD.nyelbh{ t' or EFoEr rlsd
<br />.!i *|F m rdr rd rKh FtrFB dn r conddr l.ced td1d h rrr C.ddd! L&r t r)
<br />Ltr.r.n$ !BL! Sd
<br />!!laf,!81-ctl!lll;!larl0!
<br />DEGIJAA.IIO!
<br />I hcrchy rlltnrunJrr rmltyofFrjuryonc ol rh. n)lk'qr8 d(ltuur)B
<br />_l htE &d will nrinr.h r c-.nitf,I. oI Cor ro S.lllNE nr mrt6J $rFdion. a ,rtrvid.d lor by set$ l70O of th.
<br />lrld Cod., fd ft Flo.lrff. of th. ron fd $,hkh rtr Fmi! i i!!u.d
<br />U IEE .'d *ill Nd.r wrr. con{Ed,n hrurE , s EquiEn b, S.rti{ l7oo or r!. t b{, co&. rot trE Fflffi. of
<br />0E ,ql n wiIh rlD p.ftn 6 i(rd My *dlr3 o,FdM M .m .!d poliy rr&t G:
<br />c*, G&.t. F.nA
<br />_l cdlfy rlu h rlr tEn{nrN. ol tlE w.trt fr etrh rhn IEtr n sud. I ilEI d crpkiy u} Fr,. B u, @
<br />s s b 5.or rut dr ro rh. hltm'dnFMbn hwi orcnrr.ms..nd rlr rhd if Lnuld b.coc ub,..r t. tt!
<br />sortaaonlp..erlnpovurEofs.dorl7mofOEtllr,O..Ldl.fodhp-honply*irhrhorpoEDE.
<br />WAI{NING lsiluG n, *(ur. qork.is drmp.nsurn,n.ov.to}. unldwlul, rnd ihall ruhjcl an cmploy.r h rinribl Ftuhas md
<br />.rvrl fiEr un r, utr.lrtrtr&lJ ttxiusalrl dollm (tloo.Ollr, uldiri !, rh. (.r ofot{Erarion. d{us.r a rovi.l.d for tlE
<br />S(rion 1076 ul rhc trh, C.d., hGr.{ rrd dt{ryi lii\
<br />u!_L!_!!,!,!!11!
<br />I hs!!y l'rm unl.r FMr, ot Friry rhd I n ll.El unri FDvirin o,<tE .6 e (llllu!-u_--'inl wat s4rd irlD) or Driio! l
<br />or rh. B!,Gi rn arc, DBCdd.,,irtl-.ei!ofullllErn.ltd.
<br />q atAt49
<br />'*,.. Er-..,.. ?r-ru.. 9., " 1vr. "''J'\
<br />I9N!:BlrqIl1NI.!;dlllIi.AIiENcI
<br />\--- -_
<br />I h.r.hy i,llrm!nd.r F.ihyolocrjury rhd thsc ( r con{Ddx'n LndinS rSdy lr (hc FIrr.Ec nrrh. *o* la' which lhi\ pc'mir k
<br />ilru.J(sd 1097. ( ir c ).
<br />AITIISAILDEC,IASAIION
<br />I hqd, |trm und{ FMr, or Frry d or $. tou,,nl d.t,rrlo
<br />D.mt'r rn PrndlArb.n.! NirfEdD! tus.l R.t!! .fl alih,kr, Pd6)
<br />-{,_R.!ued ldrs or |*rift&,
<br />-[_l cdil, rhr rrE Icdsn riuldi,G EB.,i'n! ulcshi rcd'vrl e m .t ltrbL ro lhn ,Nj.<.
<br />-LI cdrI,rhd I lrrcE rhr rpplxrrbn.in tut Uu rh..h,v. irloh i.r i! ctrld. I rsrc to 6iply rnh r[ Ciry . Cou.ry
<br />ordulu.r&d Slr. Lr*rnhry ro hrrldinS..n!erh( rd h.Eby.ut riE Epcs.liE or rir Cny rd Coory ro c.rq upon tlE
<br />abor. 'tuiiNn.d pr)Fn, [n rrcron purIxEx
<br />ADplil r or ,\rEr sirn&'k
<br />IIIIIIIII
<br />Rev. 08 07 20
<br />D.&:rrlo1 (-o
<br />L.d.ii AJ.I6L
<br />-
<br />tlotl>o
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