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ELECTHICAL.INSPECTOR HECORD
<br />APPROVALS DATE ID/SIG.OWNER BUILDTA DEI-[ARATION
<br />I lErcb, amrd lndcr Ftulry of Frury rhd I !n .r.mfl ltun lrE O'nrdoft Lt.nE t q I'r lhc nnhwiry ms'tr ( Si-.7(X Ll
<br />Ausi6s {al Pr.t $i,n Cak): Any Ciry or Gr y ehth Equrs r Ftu kr oBrN. .lls. inqmtc d.dlllt or EFn uy
<br />(ru.rurc, Imtr'o irs irsulEc.ols Equtcx 'It +nlicd tusEh Fmil x,6lc ! \isEn.r .ftnr rhar lEot stt a la{n*d lJmd
<br />ro rlr l'Ulnbtu orrtr G,nord\ Lk.n*d tr* (Chrpr..9, Co.lmEinS *nh Salnn ro(t) ol Dilirbn I of rlr BuliEs ed
<br />Pmfisirns Co&) o. rt t lt or stE t .r.n9t lhdrli.m rd rhc trrir rdr rh. rllq.rl .rcn!r$n. An, vhhrnn or sdbn 7{}] 1.5 by ry
<br />aprlica for u pcmir {br.cts rh. 'rpli.&r ro a .ivil p.elr, or h r mrc th.n fiv. hundr.n dollux (t5(x))
<br />_!.8o*mor'lI FoFry, m.r.luriEly coftrr8 e h li.nEd co'rrlr6 tu @r<Ml rtE Flir (sa.7o+r, BurEs
<br />. hlaR.ion Cod. Ttc CodErff ! Licc.E l,w dGs Nr dml,
<br />'o
<br />d own.r ol rrcl.rl y sho huilds or imrmEs th.i6rn.
<br />rd who onll*k f6 sah FrF* *ith r c.ddo(r la.tr€d Frsu lo llE C.dBlc i l,i..n* L.w)
<br />_l arcx.nrfl und.r Sccrn'n-. B & PC. torLh$ rc.son
<br />lhlc l)in..:
<br />\1(rRKt R5', (',()trt P[NSA;IION
<br />DDCl tL\TlOl
<br />Ihcrrnr Jlltrn, un,l., n!.rlrr- olplrltrr, otr.,'lrhr loln,trn! dr.lrr rtr,.s.
<br />_l hlr ri will nui.rrin r Ccnif.rrc of Co.sni t, S.r.lBUc (r wks oiqEn$l$n. ar FDti(H tu by Sdrir. .17(n o, rlE
<br />Ijhn C.d.- tur th. Nrfor@cc of rh. worl lbr whhh rh. p..n ir ks!.!
<br />I hlvc.nd vil! mi 'in *ortcr'.omp.n\ahon trtrurrRc, e\ r.qlrcn hy Ser (,n .17(r) ol r h. Irtnr (iilc. tnr rhc Frf(,h-c of
<br />rhc worl f{r*hahrhis pcmii is t\kd Myworkr^ .onFnsri(,n m\urm. cui.. alrl F)lay nuDbcr rc
<br />PolEyNumhs
<br />-
<br />l,.p*. t
<br />-
<br />;,t€r
<br />A, ddr rhlt h rrr Frlormm.frll volt tm whkh lhN Fnr ir io.4 I trE mr .,pb, rn, Fmn h.ny nqE.
<br />Io'!r x, rE&r qhJ( r rn rll r.dB smFn$rx'n l!$t ul Crlrl,'mE, rd +R thd rrt \,Duld tR r wbj6t rutlF
<br />*oltqi cotrp..srirn pDtirioN nr sdio. l7m .r th. rrrDr C.&, I tBll. forrhtnh omply *nh rbi tmvnba
<br />WARNIN(; tailurc h (curc workcii .onqr.srk,n..vcr.Bc ir unla*6r1. md \ha :n d{'hfr t, LYrllml Fetar und
<br />.*il 6ft3 uI ro oft hudr.n rtbliud d.lls (llu).frt
<br />S..rion 10?6 of$.Ijbor Crxlc, int.rcs !ii.my\ fes
<br />er0.. d.mg.s .s provd.n f{, th.
<br />I
<br />'12-: 1 .,'LO,trrpri.."nr: X
<br />Tll,CLANATION
<br />I h.Eb, !flim !.d* Fnixy of pcqrry rrrar I rm rn:nsl iffi pmisin,rCtu, s 9lenErcing *nh sftrbn 7(m) of D'lifin 3
<br />of rh. Burids erd t\nf63brt Cod.. tnd oy li.cn- il b n)ll foN .,n .fiftl.
<br />."""*.r*"C-tO t7Ll x7 z?
<br />,,,," 12-3 t- zoz'.L <*r.,.,*l ?.Dta11 6t trcfric,
<br />CONSTqUCTION LEYDIN(; GFIICY
<br />I lEEby arrh un&. Fndr, ot p.r!r, rhc rrE Br@dMirn hnin3.r!rcy tu rlE Ff(ilr1aB 6f ilE mll ft, *hih rhn Fmi i!
<br />issucd (sa. 1097. civ. c.)
<br />AEEUSANI.D&CId8AB8
<br />I hEdly rfrtr !'nr Ffl.ny ot Frrrr, 6E or 'k folt,sit! d.rldi'n.:
<br />D.tulirion Pcrmik.Asb.nos Norifi.lrion ltdcnl R.3uhrn,trs (Tirlc 40. PM6)
<br />Rquncn lrlcr or fhia.di'n
<br />_l .drly rhd tlE li{.nl ESultrirni EB4dinS r\rEcor Enrv.l N ,rr {'rlt{hh ro lhi pDFr
<br />d01(,,rr-rhr I \c rcJi,h', Jprrlrri,n *r(1,.,rr,eh,v. i'rrormrr)n rs..fr\r I rSre k) (,trvly * ilh .ll Cii y rnil Counry
<br />odi N.( atld Srot. I i*{ EhrrB io hd'ldina tEEby rlrh,k E|'rddrw3 of rnn Cn, md Counry ro cn's nlrn tlE
<br />rblc nEnri(trri tmpcny ir trapccrtrtr,pu
<br />,rpprlrur or erar Skmtur I
<br />P.mi,F Mm.,pnd,: ,Z qlruiA R DrqE
<br />,.,,4L-Zl-@
<br />Site-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 / Floor Ir .,--0t
<br />Bondino / Groundinq / UFER 'lldl d,aLue),,J0
<br />Transformers I
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilinqs (Hard & Soflil Rouqh
<br />Ceilinqs (T-Bar Rouqh)I tl
<br />Meter Release tlluul MtwJ rW
<br />Rouqh I ,L
<br />Service lvleter / il/la{lv-,,^{1 intYlllzl?/AK''IU /\YtgV
<br />Notes, Remarks, Etc
<br />-r.
<br />Rav 08-07'2015
<br />COMMENTS
<br />FINAL
<br />_1. r\ o*Nr or rh. fl.tEdr, or ny .fttloF.s wirh w!8d us rhcn v,k comp.nmrn,n. *nl tk, rlt wdr lri rlr {dm s mr
<br />id.fildl or.rlcEd for d. (S(.'7o4r. Au\iEs e.d t\.fcrrioN C L: Th. conhl.r'r l-E.ns L.* &Er B, +pl, io r owEr or
<br />rlE F$Fry *tnl! &d,rims rhqF ., *h. &-r uh trlt him*lf or h.rclf or trmulh htr m ls own ctrpbrs.
<br />p,nvildd lh{ such iqmwnEnh e fln inr.nLd or .lYcrEn nn st lf, h,wcE rh. hrildint .r IqmErnr h $kl silnin om Fu
<br />ofmiplctin rlE O*E BuiLls *ill h.w rh.lx,&o orFt'ns thd lE d:lE dil d t{ild d "rt,.B th FtEly ('lh FirIEe of
<br />(MBr
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