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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE tD/stG.COMMENTS <br />Site-Work <br />Underground <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 />|al,*o,fBonding / Grounding / UFER llzsltq t\ <br />Transformers I II 0\, <br />Torqueing <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Rough <br />Ceilings (T-Bar Rough) <br />Meter Release tl2dq -t vru/e.ttt 9b-/ <br />lt ot <br />Rough <br />FINAL ?ltlu'1 Lrlt.rcv <br />Notes, Remarks <br />OWNER BTIILDER DEL('AR TION <br />I hd.b) rllm !.&r Fulr, ol Frur.v rhd I m ddF nlh rlE Colnirr6 Lt@ L.q fo. rlE lolbf,irs 16r (S( 70:rl, <br />Busind .,n ko&.ri!n (-od.) Anr Chy or (nufly *hth r.qutrB a Fnn ro o rlru.r. .lra, inFor.. ddfrlnh o. r.Fr d, <br />trruc1u.. rrior lo it! isu.n... ltro r.qut6 rh. rppli.d ror such Fmi h nL r sigftd d@dl tha E or {E a licaE d po!!@l <br />ro dE ImrirbN of (E Conotrd! l-io..d l^ (Ch.F6 9. ( omtri.s rnh S<nbn 7((D of Dirnion I otrlE Blrilr 6d <br />Pmfdbro Co&) or rh, lE or ih. i! .(mF rh6.Irm .nd rh. bdii for tlE rlLrcd ddnflnrn. Any viohtirn ol S..l.n 701 I t by rry <br />!fi'lu tor r Fnil subjdr lhc .pplic.nt lo !.ivil p.mlt, of.or mor. rhtr fi!. nundrcd dolle. (1500) <br />L d 0*6 of rh. Fop.ny. or 6y dplo)G *nh *'!86 s rh.i $L onFrErio., qill6 rlE *rrl rd rlE rrElr i mr <br />ilndd.d or oll6.il l.r el. (s< 70,14, Buina and Ptrfdio6 Cod.: I hc Conrr.cloii l,iccM lr* do6 mr aply ro d o*nq of <br />ih. FFly stF txil& o iqm\ 6llEfr. rd *no &E rxh wt hiMlf o, hakllor rh6u8h har d hd o*r onpr,rG, <br />FoiLd rhd ssh imF.l.ds ed na!.!.d ( olhrd ftr -t ll ho$6q, rlE bildntr G irrlrffi it $U *ihnr oG € <br />oa conptiotr ft o*nd Bril& $ill h.rc rlr hdar ofF.sns tM rE or sh. dd ret tuild .r trynv. llrc F.p.ty tor th< BIFE of <br />I. a osn6 oa rh. FoFry. m -cluiv.ly codr.din8 snh .d.{.ofudm ro .odtud rlk Frir (s< 7or4. adiB <br />od Ptrrftsin cod.: Th. (..krcror'r l-ic.m. Llw do6 not aprly lo M oqns ofproFny*ho buil4! o, improv6 thmn.ud *ho o, rxll fm trh p.oFt $ilh ! ftddon.) lidB n ,El:M kr ih. (-odtud r l-kdE l*) <br />I am.r.mpr trndd Sd.on <br />^,1- n1n ,-{) <br />D[cldaarla! <br />I hdod rmm undn pndrl of FJU! orcotrh. tolhn iIs tt (lsnhB: <br />I hav.ud*,ll'uinl.i.t(.nincar.ofConsor to S.lf.lNor.itr$ork6r comp.n.dnrn, s Fovid.d for btSNr6.lTL{otrh. <br />ljiFr (irje f( rh. Faollle. of rh. trorl lor $nth rh. Ff,i ir isu.d <br />I htv. ,nd $rll mlinlain $orkd comr.Edion icuran.., a r.!on.d by Sdion l7(x) of rh. l,bor ( od.. aor rfic Ffommc. of <br />rh. *orl lor u h'ch this Fnil ir isud My r ort6 .omltM ion iBorm. .Mir &d rblty numbd r. <br />I cGlify rnd in th. pdaorma.c. olihc sork lor $hi.h lhis psmil is isu.d. I 3rallnot oploy.ry F$n i...y mdn6 <br />$ a to b..otu iubjel lo lhc rsi6' comFEdiln l!u! of (-rlifomh. md .3r rhd if I slbuld b<om $h,61 lo llr <br />$nltd NmFqirn F.v!i,6 of sdnn l?00 of rlE l,hr (-o&. I tdl. ({h| irh comDly s.nh drs p.!r i3ioB <br />W RNIIC: Flilur.lo su. trlrl6 mn{mrdbn cor6+. 6 unl,sful. d shlll tut!.<r x dpL)d ro dimi..l Ftrti6 6d <br />.nil rDd ur l. orc hud.d lhousnd {hll6 llloo.uxr). i. *r.lnno ro rh. .d of mmFMiri. dr g6 d F.\il.d for rlE <br />Sdrion m76 ofrh.l.stnrC{xL int66r sndan.llE 3 ad <br />^..-1-g-lq I <br />I h6lbl .lTrm onda Frly oaFju, rhr I m lica..d undd F.vuion of CrrFd 9 (om'la'ns *irh s<rF! 70m, .f Dn 6itn I <br />of ilE t di'B od P,oaah6 Co&. ril iy I*oE ir itr full foE -d .fi.cl <br />(axsrB.ltulaNrElDltliacE!0 <br />I hcltr.frrrn unJ6 tEnlhy of FjuD_ 'hd <br />rh6. ir..odrucinn Lndins axftv for !h.I6fol111e. of rh. *.rt lor "hi.h itu Fnn i! <br />rs.d {sr .r0)7, ( n ( ) <br />Atflr(ABl-ui(la8Aua! <br />I hsdr rrm unds D.n h) o, Dsju,! oEof rh. f.llo$ inr d..rr,r bN: <br />Dc,rehnrn Pdnn$A.hdor No fi.ari1n F.ddrlRcsuhtrns ('Iitl.40. P!n6) <br />Rttutr.d tird ol I'Jdifx'th. <br />I .drli rln rlr l.n(rl'clul.ri(ifs r.!tudn! rstrst\ '.nn\rlr( for nflirrbl. (, rh'\ IIoB{1 <br />l.d,f\ ihd I M\.r.aJrhN artlKark)nanisrrr.rhd rh.r[\. 'nnnndkx 's <br />c.r6t l {ra n) ..nrl\ \ nh all ( ) rnd(-.onr\ <br />,{J'nin(6 Mri \rar.la\q,.lar'n!r, h llnnf,. tr" di,n. ihl h6.h) tuthofl7. ,.1160llltr 6 ofrh's( ilyand(ountybdrd ulxn,rh. <br />:;,;;,:,^;,;,..7el7/r(Lq (0- -u '?.b-tcl <br />,-,*".^,,,n *.) t4}yl^ \(M 0 <br />Pole Bases <br />) <br />Sub-Panels <br />Service Meter <br />{-* ) <br />Etc.