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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNEf, BUILDET DELCAN TON
<br />I lmbt rrrn lidd Fr!, ('t Frjlry th, I m.r.r+ n$n lll Cod.r.16 lilE L,* ror E r6lb*i8 lB)n (Se.7oll.'
<br />Bu.iffi. .d Pref*bn Cod.r Ary Cn, tr C(My stih E{!n!r ! Fnf ro 6.{M. rhd. npmE. &mlith or EFr uy
<br />irkim. Fir 'o
<br />nr irrlre, .ko rcquiG llE rrglirtr ro. sh Fmir ro ,iL. riri.d rdm drr lE tr iE ir lhtrrd F $d
<br />ro ri. Fovnh6 ol r,r co.rBro . Lir...d Lw (clIprs 9. co'EEins rnh s<rkh 7qD of Di!i.i,. ! ol ft. Buers !d
<br />PDr.rlionr Con ) r rh.l E r nE is .rctrpr rlEdioh .rd rlr b.!i fo. rh. .lLlFd .rcnprbn. A,y vbhion of Sdion tol ! .5 by uy
<br />.pplic.nl fot r Fru {br.rt r,r sFl,ltr ro ..ivil Fdly of mi nlm rh& 6w hud,ld &'lh'r (15@)
<br />l. !{ owEr olrlt nn)Ndy, o ny.ill!lot{r\ eth wrB.\ is rh.tr r,k curn cnsrnn. srlld. rtE *sk rtl tlt {ture ir E
<br />inrcftkil .r oficrcd ln {rk ( sd 7(}+'1, Businc$ snd Pr.lcsi,n\ C(xL 'l h. C(,.tr.ror'x LkcM lrw dEs Bn qlllly h m ouEr of
<br />the pn,IEnt wln, t{ild\ ur 'n$(,8 rh.Er. ard vho d(B rEh *i* hirrlfor &rrlfor rhrclgh his or h.r .wn .nqtl.y..s,
<br />Invidcd rhur \drh iurmhnrnh e r, imcnd.n or orIcrcd fd sL lr, lx,uw, lhc hoikjinS or impmkri! i! yr! *irhin onc ).u
<br />olsq)r:r,n, rh. OsR! Bul&r will hlk rlE burLn ofpmvins rhlrtEor\lE il nn hiil] or inFow lh. pmtEl, n" rlr pulF)* or
<br />-1,
<br />ai o*F orrlE ImtEly. m.rcluriwly.o,rE li.s rnh &rnrrl.nnrtbB ro 6ndd rh. FlFt (Sc ?0,1,1, Burimtr
<br />ltd hoaisir Co&: Tlr ConrEhr r Li.n* t:w d6 m' .|,Ply ro .n ovmr of FDp.n y sho t{ildr or ioptut! ilr6r.
<br />rnd rh. oddt fr rEh FDFdi pnh. Cldr&l(lo lkrnsd pu,ld !o rh Codfur's LrtN L.rr.
<br />I rm.knd und.r Sdrrr B &PC tdrhsE&m
<br />D1.:-- Off-
<br />wof,xrrs'toMPrlts,trroN
<br />DECI.AtAIIA
<br />I lEEby .mrm unds lcn lry oa tsrury oE of llt followhS &thn'ionr:
<br />Ihavco will nu inroitr r (tn rrtlrc ol Consnr lo sclr lnrur ttr *orl.B mnltns,rion.0. tmvid.n lDr hy S<1ion .l7(x) of llrc
<br />Llbor Cod., turh.tEhxrorc oflh. wulk ior *hth llEI{nnir ii isucJ.
<br />_l hNt lnd erll !Ei.r!nr wo.kcrr' coqrnslln'n insurrh.'!. !\ rlitutr d 6y SNrnnr l7(D of rh. btrtr Codc. hr rhc Fn{amc ol
<br />ttE *ort forwhi.hrhn n .nrir ir hqrl Myvorkgs comFnsrii,. 'n\uEtu..di.r and Jnltyrumhs @
<br />I anif, rnd an t|t lErlordrc of rlr Borl fd *hih lnn Ftu' n srxlr. I !h.ll mr .trplot y F@n D8y @d
<br />s r to b.or sbFr to llE mrt6 onrEnrdi,n h*t of C.lifom. rrn .ltE rhd al I dDuld h.or ruhFr ro
<br />'lEE t6' mqxm.lbn Frenrbnr of S.l1nn l7m ot rtr t tD. C.d.. I rlEll. (nh*nh 6i{'ly lnh tl$s FtrvisirN
<br />WARNINC f:lilurc k' $urc krrk.6' .or{rctrsrion !$vcna( a u.h*tur. rnd rhill subFl m oq,lorrr x' dniul Fsis .rd
<br />€ivil lincs np b onc hurd,.d riousnd dollxrs (llu),00()), in lddiri)n kr rh. cos or comJ'cnsarion, d!'tus$ !i pmvidcd ft, rh.
<br />Sdt,..1076 of rhc lrhrrOnc, inrcair..d alromy s rir(.
<br />D.l.:
<br />-
<br />ApplL.Dr:
<br />-
<br />ucsrmc.omffi
<br />DE{j|IAAIIA
<br />I hcb, !tun un&r F,rIy oa F lur, rhd I d liar.d !r&r Fviri,. ol Crqrrd 9 lollmmiry inl Salnn 1000) of Divirion ,
<br />or $. aNirsr .,i P,olc.ri,B Cod.. .,n ny li# n h ft,ll fo^! .!n .,tcl
<br />coNsTnucrloN LlrtnlNc acF crt
<br />t h.Eby rfinm und.r Ftu'lry of F ury fid rlm h ! .onnrucrion LDli.s ds.fry tu rL i(follM.. of lh. *orl (x whrh thA FmlI !
<br />ksEd (Sc..:1097. Civ. C I
<br />knd.l. Ad{n $:
<br />-
<br />A@I.(jANLDEIIdEAI1II!
<br />I H, dlm un L, Fux, or lt,rury oE or llE follo*rg d.(Lnl i,nrl
<br />DcDh.n Pdtur.ArtEnor t{riaE{i,n rrdcnl Rc*uhionr (TirL.(l. P.n6)
<br />-RcquiEd
<br />Lila or N.rirrrrio
<br />-l
<br />cdity rhd th. lcJ.r E&Llk nr Essrnins ast tlo! cm,frl rc nn '|'I,lubk 'o
<br />lhi! tmrcr
<br />IccnilirhJtlh{\crqklrhtrrtpl{rrk,iurlid.rhrrrh.ah,vcrnn (rnrc.trrcl Ill8rebcn Ply* h lll C[t rnd Counr,
<br />odinrnccs dd Srrrc li*\,clnrin8 b htrildin8.on{ru.rtr'n. ml hcrcl'y luthtrr. ..!r.snl!r i!c\ oarhi\ Ciiy rid (i nryt,.nr.r uF,n|tt
<br />ut !c nf,nri()ncd nNpcnyir n\trcli'n purrx,rr
<br />Appli.lnl or A(ctrl si{MluR
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Liqht Standards
<br />Spas, Pool, Founlains
<br />Siqns (monument)A+-Fr I -?-J +a^i
<br />Life Satety i Low Voltage 7 (\,
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor /..,\
<br />Bonding / Groundinq / UFER ^i ll-vl nwld)
<br />Translormers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rough)
<br />Itr'teter Release l-2*'zr )M0 Dl-'td/UYC f+,/l
<br />tug 8.. f4/l}ttJT l-v
<br />Rough Y.hrJ t}ol^tjf r4+- )4t
<br />Service Meter I -21 WWx N_&/0Jr aF -lcF_
<br />FINAL r-ll- zt S.llSllr
<br />Notes, Remarks, Etc.
<br />Rev OA'O7 2011
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