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ELECTRICAL-INSPECTOR RECORD
<br />DATE ID/SIG.COMMENTS OWNEN BUILDIR DI'LCARATION
<br />I ltrq\ rnnf, unr.r Fn ! r{ Frrlry thd I m.k,r$ nom ltE c(,rIlILl6 LLrnE l:s lff rh. folro*i.8 utn (sd70.11.5
<br />BNin.s lrn ProLrsion Codr) Any City or Coul, whth 'dtuiftr i IEM lo odM, .116. itrprorc. {tmlirh nr EFn y
<br />rrurN, rn{ to i'. nrllN, i!. F{!ir.r rlr .pplasr r.r suh F nil ro lit r rtmn rlrl.mnr rhll lE or {8 b li.cnxd F!tuiI
<br />ro rlE F.vkions of rlE Corlrrror'l l-irnsn Ljw (Cllprd L ConmEinS w h scli,. ,uD of D'vis.n 3 oa rh. BlriEs ud
<br />Pmfcsi)nr Codc),r rhd L d {E ir.r.m0r lhmiom ml rlf, trris for rtE ill8.d cr.n{ti'. Ary vblrrbnorSdi,n 7o115 byrny
<br />+pl.dt for r Fm sul'Frsrrr rplhc.ni ro r.iyil F llyolmt mErh.n fir. hundrd d.U[r (Stn).
<br />_1, a ovEr orrlE FoFny. d ny.npbFs vtrt w{( a rlEn sE onlEn\crn. sil dr ttE sdt !t dE {tu i! m'
<br />inlffEl or olIcEd tor sL (Sa 7Ol4. A6ie$ sd PDf.{ri6ni Cqle Th. Conhld\ Li.r.s trw de! mt rpply lo s owftr ol
<br />rlE rft,Fny rrD hil& d invroE dEu rn Eh d6 rdrq,t ti@ror tFElf orlthugi hir r lEr o*n.nphFr.
<br />ptuvidcJ rhri r!.h iniprsEftnh m d inlcn&rt orolidBt fd qL.Ia hoM, tlE h{irfiry a inlmEr n$BeilhhoEFe
<br />ofcorpHbtr rrE OwE AuUb ri! lbE thc t{ih orF,!!E dr lEd rrE dd d hli! or irFoE dr FFly for llt FIFE of
<br />_1. r\ owBr of rh. p6l*nr. .n crcluriftly.o rdin8wnh lRded codrdoB toonntu1ill lrej.cr (Sd ?O,14. aurifts
<br />arn EoliarihCodc: Thc ConrrEroir Lt.nrc tr* dN noi.tllyro owmr or pn,Fny *ho ttr ild. or inpmE. lh.rq,n,
<br />md rtll €dtuk rrr rkh FDFr wnh r Codr(onrr laB*d punuri ro rlE Co ,rlor'r t-snr lre)
<br />_l m .r.mp' un&r Sdbn_. A & P C. for lhi rctq,r
<br />woRl(Fxs' c()ltlPirislTl(l:l
<br />uEcldaalra!
<br />I h.hhy.mrm un&r IrMxy o! F.jury.E nr rlE (,llowin3 .l( hrli.,nr
<br />_l h.r rn *iU di.rrin . Cdir.tr. 6r G,n-.' b S.li lNUr. fr q,t6 of,Fo3.lion. .i rmviLi lor by atrri,i 17@ or rli
<br />ljhr Cod., ror Lh. p€rfoMc. of th. Mrr fd whkh ihc Fmr ( tsud.
<br />_l hlr rln sill tuinrrin *o.1.^ .onpc etb. in\uftE.. .! rcquircd b, Saiion -1700 nr tlE lihor CDd., rDr th. tEfollla. oI
<br />rlE worl f( whih Lhit Fmir ir i.$.d My wrld or{Ens.lhn insl:K.arir rrn Flty nlds e:
<br />PolicyNunrb..:-
<br />l.cnily rhol i. rhc pcrtbrnqr-'c .f rh. *o'k lor whih rhi p.rnln r nsu.d, I shdll nol . q,loyuy F ion io un, 'unrcr$ n b hdl,m ohFr b rh. srt6'oryEndi'n lrw\ ol C.liiomi- .d rAN rh, irl dnul(t k<om !!bF1 ro tlE
<br />sorr.n' .ompcnsr mn pmvnions of Sdiotr :1700 of rhc ljhn Cod.. I \h l. ronhw(h .omrly wirh rlFs nmvirns
<br />WARNINC isr[E to rcurc qorLcB ompcnruri,n covrdsc i\ noltrwrul, dtut rhlll sublccr lrr.nplortr ro riminol Imllii rnd
<br />.ivn !iF. uP ro oE hudEd rhougld dolL^ (Slu).(tD).
<br />'n
<br />ldqrih
<br />'o
<br />rlE .o{ .l6n0.ndhn. d.ms.r N lrolil.d for lli
<br />srrk,n 1076 ofrh. llhr C.d. 'nr.rt{ idmv!L.\ /,
<br />*,,' /ro.,lrc .- **^,&"t%z'ItElrEDrAlr8Atn8
<br />DECIISAIXI!
<br />I hcEby lllirn u Lrpcnrllyof Frjury $al I.m li.usl urdo rmailion orctuptcr 9 (mmminS wirhSdion?()q)) o,Divisionl
<br />oa rlE B!iE$ e.d PturdsbB CeL, r,n ny lt.nE ! u tull roe !d clTd
<br />L/
<br />.aoalilaucllQurEBDllclcE!.(f
<br />I lEr.t'y lrEm unds F Iy o, Frrrry rh.r rldr i. r onnMbn hnting .8.8y lor llE Fn()ffi of rli wt tur n'lth rhir Frfrr i
<br />issu.d (se lo9?, civ. c )
<br />Sile-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lile Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab /-Elqar
<br />Bondino Gro'undilrq / UFER z-8'"(/Zc/9 /za< 417
<br />Translormers
<br />Torqueing
<br />Sub-Panels
<br />Floof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilinqs (Hard & Soffit Rouqh
<br />Ceilinqs (T-Bar Rouoh)
<br />Meter Release zr82(/ZCtia /€.?r3 -ZV
<br />Rouqh
<br />Service Meter
<br />FINAL zg-"(lZea Vr/. a qza
<br />Notes, Remarks, Etc
<br />Rev 04.O7.2O15
<br />APPROVALS
<br />Air Conditioners
<br />AETLI!}NI.DECIJIAIIA
<br />I h6l6y altm uid( Fnnry or pcrrly oft of rlr robsin8 rk knlionr:
<br />D.mliri6n P.rniu.A.!.tur t{oriadbn tu nl R.t[lrbnt (Tark rl0. P,r6)
<br />-Rcqlird
<br />t rrdof llotifurbn
<br />_l enily lh{ llE fcd..d r.BULdo ESt ninS eltcs'or Emvd e ml !pdt.!L ro tht! pDFl.
<br />_lenifyrturIhrrcEdthnlptltorionlrnrkrcrharrh.atnvcinforrdionb.ore'.IltMlocodylytilhillCiryandCou,
<br />lul.Rr !,n Sr& LrB Eidt ro hr d'ng (9'rrr!rlbD, .rn lErry.udDriz. EFE-rr.liB of lnir Cay !n Coon,lo ard t+dn tL:;:,:^:x::,w4-- ^,,2/L/"tIHlcl.mtDrilrr:
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