|
ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS ID/SIG.COMMENTS OWNER AUILI)I:R DEI.('ARATION
<br />I lE.b .frrn utds Frty ol FJuD lhi I @ donri fitd th. ('otud.R liffi lis ror rh. folloeinS lK. (S< r0rl,5
<br />Buirs &d PlorBnn ( od.l ,\., (-irr o, (-.d) \hi.h Gl0n6 ! Fni h ani{tu( ahn, rpiol., d.hdlil' or t4.n sv
<br />lrtuClw, prior ti irs isuMc.. .lso r.qut6 rh. lpplicdr ftr su.h Fmn h fih ! si8n.d n.hd lfill h. or !h. t lic .rl puBtr'd
<br />ro rh. Forlod ol rlE ( onrdoir l-t.rrd l,w (( h,rrd s. ('omcmiis *irh sd6n 70ol) of lhirhn I .f th. aGi..;. rd
<br />Pr.fdli.B cod.) or rhi lr o. sh. !.i@F lhg.God ind rh. t!6s tu rlE nk.d ddnFi An, t i6hin orsdio. 'ror I t t!.v \
<br />aprlicanl for r Fnn rubj.iri rh. lrpli.anr ro . civil p6!h, of nol NrE lh fiv. hun&al dollm {1J00)
<br />l. B .$ffi of th. FoFiy. ( nr Grilt)hr6 s'|h n.*6 6 rhar iL mf,p.$dnr r ill lb it *dt tn rlr rtuiE at Fl
<br />irr6'd.d or or6.d rr nh lsd 7O{,1. B$itB lld ProlsioN (-odc. I1E Conrrtld t li.G r.q &,6 ml ar,t 16 d orc of
<br />rh. thrtEly who h!il.! or imFov6 rhGFn, trl sho do6rx.h s hiF!.ltor h6clr.r rhmuEh hn or ha osn chplirr.B
<br />pbrd.d rh{ iu.h ihp 'ffi E ml if,od.d oro,Iled tor sL l( h*6a. rlr blillit{ or ir4frEEr'r i! sld *inin oE }a
<br />ofo,plai'( rlE(xffi B.nlld ril IEEiEh,&r orFori'tB rld LddEdn d toild inproE lh. FlFit t, rlr F FEof
<br />l. .r o\B.f rrt FoFn), m.\.kn.ll c.draina eirh li(.nr.d co,iraroE tu odtu.1 rrE rnli.(l (S< ?04r' &.ffi
<br />r.d Enisin (-od.: llE(tnlrrioir l-icoFI!* &6 tui.0fr! ro &o\nd ollnoFr) eho li{rldi or im! nE rh-en.
<br />otrd qho BrnlEds tor !r.h Fri$.$nh d ( irr6dod, licds.d
<br />',uu@r
<br />lolh. C'odr&1orr LicaE tis)
<br />I &.rnpr trBrd sdr.n
<br />Dirr osr..llBtitBsrauff:traMuli(ldlalJQr
<br />I h(.hy !m',nundd F.nrlr) olFJ'n on.oIrncfouo\rnr d6la,!loB
<br />I h!\. &rj I ill @inron ! cdirEd. oaconht b S.lf'lns@ lor $0116'$nFsirn. s F.!id.d tor try s<rion uoo of rh.
<br />L.htr ( rd.. lor 'lE pslnl]re. ol llr $orl n{ n hrh rlE Fn ! 6u.d
<br />y'hi\r ind q'llm.mr n q orkm n'Er.N!! nn rrourlN.. s r.qun d b sd ion l7l)0 of rh. Iih.r (hil., f.r lh. psaolllltr..f
<br />ilE *.rI fn sh.h rhi! D.mn i i$!.d Mr *,x16'{nnFsr,n rMnc rdE dFl(ymmh6 i.
<br />c,.,. ,Redeoqg Fize- ,c^6 Aq SoACFK
<br />,r,., n,,,,*' I=rzt^-lco tlta I {. . t-t-zo
<br />I c.nifylhir rrhcp.rlorn.n...lrh.wolk for *hichlhispcrnrn is Dsu.d.l$.llmr mplot.ny Fsen in inymdnd
<br />r, I b h.<.m. sbir t, rlE s.rt6' comrElt n n h\ i .f C.l,aomq a,i .*6 rnd if I th.uB b..o@ 3utFr to tlE
<br />*o.td <,mlxd ion For ih6 or kctFn r Tur otlh. lrtDr c,rL. I JDll. fodhu nt 6rq,l) q ilh rh\r pm\ bioB
<br />WARNINC li'luE ro Ku. $o,L6 Nm,Erlslion o\6aa. B unh"ful ani sh.ll tll,rel e dnl.r.s lo ainir,l FEbis Md
<br />cNl fo6 ut k, oc hunl.d rt !r.d &ill4 (tlm.ffxJ). in .d.ini,n ta rh. (d of ..mFMio4 deru*d a Fo*l.n lo, rlE
<br />Sarnn 1076 orrh.tlhtr(od..inrad and arhirEy s tc
<br />D.k,'b-Z.?-tS ^per-,r,U(};IIEDIAdIIA(IOA
<br />D[g3f,Arlo!
<br />I hcby !firm lodn psulry of Fjury lh.r I m licctrrd un& Flviioi of Ch,rn( I (..nrmocinS s ilh S.d hn 7000) of Dirili.n r
<br />of rh. BddB sn Pr.f6ioE ( o&. t'd m) li.@ r { tull n,@ 8i cftd
<br />r.*cr* ' Blc tO
<br />D.,. , G-21-tt ^o . toLlt4l!
<br />(ANIAI]C]IANIIdDIXG.AA!!(I
<br />I nfthy rmrm lndd Fnslr! of ,6jur,- thsl th6. is ! onsl ocl ioi Lndi.s .rro.t for !h. Ffo.ru(c of rh. $ orl for sii(h lhE IErn 'l !
<br />'eu.n
<br />(s( lrln7.Civ ( l
<br />AITLI(bILDIOJf,AIIII!
<br />I nffi!*.rm ndnp.f,alr,ofprj ryotreof rh. follosin3 dclamli,,nr
<br />D.frn io. P6mir!-Astrsk,r Notifirdio. F.,.ld.l R.!uh nns tl nL .r0. Fano)
<br />Rd|ut d lnrEofMn'a(dDn
<br />I .dif, rhd rlE f.!t.l rcsuLlr'G rcaadins GtErtti ,tu\ !l r,. tul rylrdbL to lh! r!j.d
<br />Yal cdiryrhd I h4. rdd rhis apphlrion dd sr.tc rhd rh.ibv.nrn'ml'ltun I con.( l.8raroronlPlyq h .rr (-rrr tnd ( oxmt
<br />odiEm6 srd Slrtc liw! dnr* 16 huilding ..drudiotr !d hd.6t lultrtur rqr.9ldir6 o f lhir ( ny 6d ('ounly lo dro oFn rlE
<br />atilr. nmrioFn roD.n\ n! mp.drn n4Fs
<br />Applhr ( or Asdrl si*nrlnrer(,r,,..(r-27 -tf
<br />P.mlrR n.hrrn.inrr: ,/ccdcn 5s,re-
<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 />Communicalions Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER e/,- lt.b,a nt
<br />Transformers
<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 & Soffit Rouoh
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough gll2ltt
<br />Service Meter
<br />FINAL S ltt lt t &stdto'
<br />Notes, Remarks, Etc.
<br />DATE
|