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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS ID/SIG.COMMENTS OIYNFJR IIT]II,I'ER DI]I,(:ARATX)N
<br />I hcrrhy rrltm undcr Fnxlry oi t rjury rhrr I .'n cr.npr lion rhc (i{frdctra Lk.nQ lj$ lor rhc tulloqirs rcrsD {S.r.70ll 5
<br />Ausi'r.\s md Profcsion Cdc) Any Ciry or C.u f qhrh ftqrnc{ n Frnrir r. .on{lrucr. rlrcr. imnrove. dcnnnkh or rnrn "
<br />{n'.xtrc. IYi hirs i{\urnce. nn. rcqunc\ rhc.prliunr lor {kh run ro liLr \istrcd slarcmnr rhrr hcor \h. i\ li.cn!.d Nr{Mr
<br />h rtu F,vi\ion\ oI Ih. C.nrd.ktr s l-i.cn{d Ldw (Chlt)rcr 9, Connn.friDS wilh Secti$ ?00O oi Divni,r I or rhc Bu\incs rtrd
<br />Proli\\iotrs Codc)or rhat hcor\hc Gcrcnrnrthcrciotrrind rhc hsn lor rhc lllcgcd crcnDri,n n,vi,'hrnn,.fsdhr7r)rI5hyny
<br />rpplicrtrrtor r F:irnir suhtcd\ ihc xpl'licnnrt,rcivilnrnrlrtofnornmrhrnfivthuidrcddolld\il5lX))
<br />l. 11 oFncr ol rhc ltl,lrny. or Dry cnlllnrcc{ with *.!cs rs rhcir \ik co'n|Enslrbn. *ill do lhc *ort Ml rr. itum i. n r
<br />i,ncn al orollrrcl ior sh rsr 7l|,14. Bo\imssatrd Ptrn.$ion(C ]t-lhcG rnckn\I-icctr\cL wd€( o! lFply ro M.sncr .l
<br />rhc nn)tcny rh) ta'ild( or innrorr\ rhcNn. r whod,f,ssu.hu.rkhims.lforhcrsclforrhmuehhi\orh{roqnc'npl,'ycc!.
<br />lrovidcd rh.r \u.h i'nptuvcEnr{ urc kn inrcrhd or oltcrLt nn qh ll. h.Bcrr. rhc hui iry or i'npnnsrnr h n,lll *irhi om )tr
<br />ofm'npLrbn. rh. Osnu Buikld sillhnlt itr blr&n ofF)ving rhrr lr or \h. dkl mr hulkl.r rltlmE rh. tmJtny lhr rhc puqrc ol
<br />l.nsownrrolrtuI['|xnr. tr.lu!rclv.onrr rnigsirhI'c. \cd.ontn.nr\h.rn(rucrrh.In)i.crrScc 7(lr,l- RlAi"u$
<br />rtrd t\llirs!i (\{1.: lhcConfiicrol-c l-i.ctr{c l-nw d(Ec tror
<br />rnd {ho .onkrc(ntr\uchpmE.r\qirhrContrr.rnl$ lic
<br />ro rnnwncroinmpcny*ho 6uild\ r nnprorc\ rhcr..i.
<br />pur\ua h rh. Cont .ror's Li.utr{ tj* |
<br />irl4 Selri . a &t1 ,,".".)4
<br />I!:!L]-B/IUAI
<br />I lrr.hIrlltrnutrJ.r t).trr rr!r t{rjrtr\.trc!r rlr l!,ll,Nill ![\1d. i,,,\
<br />lrlx,(irlr lnrr[rrurntr r rc.frlrsorknn trl'rlrrlr]{'trnt ^^{r(l
<br />rlr\o'1tu'shrl'rhAl{, 'ir'\a{r N1t$o,lr'! L,trrI[n\i[,tr, trtru1r,...,r"(' I!lJi']rt n0nrhlrrr.
<br />l.crrlyrh{ririrhc|{rtunMkcolrhcrokturhNhrhrfrnnir F ir{cd.I \hrlltror crployrn, |Er$r in rn)_ rnncr
<br />$$hhcsrr{i6jcdhlhcsr.r\confctr\nn,nhs\oiC3liii,n,ix.rn.Lrgrrcrhrrifl\houl{lhcotu\uhj..it'rlt
<br />workc conrt^-nsl i{nrI'ovi\iiin\olSrcri,'n.l7ll)oIrhcl]hnC,rlc.l\lr'll.lanhsiihconrflysirhrln,{ln)!nn s
<br />WARNINC: I;llihtrc t, {ctrrc \orkc6 co tEtr\{li,nr c.v.risc h*1nl. rn(l n ! {'hicr rtr cn,t,l,,!rr r) dnn'rtrllf, xlric\ rid
<br />.ivil lin.\ tr! 1o onc h!nnrcd rhou\Jnd dolIr\ lllixr.(x]lr). i,,i{r t, rhc co{.lconT{tr\rrnnr. driktc( ts l,tr'vidrd l'r rh.
<br />liiL,i'
<br />irnc'rqr nrntri.v \l.r\
<br />,lppris"r, F(e
<br />l,tltitsliDroNl&l{.uaIrljrr,\a]lllox
<br />I hcruhytrrlinntr cr prmlryorp.rjuy rh,r I m lircnsdd trnder pnrltnnr.lChDtrd 9 (conhrncire *irh Sccliotr 7l{x)) oI l)ivnbn:l
<br />oI lhc Bu{rcsand Profcslions Codc. and my liccnsc is in rulltu.errtlcficcr
<br />g)NEIAIJCIIUNIEdIIITGICENCI
<br />I h.Ehy arfinn und.r Fnrlryofpcrjuryrhar lh.rc k a co.ndcrb.lcndinr lcctrcy for thc rrf.rnDncc orrhc wor* ror whichrhh lrrmh is
<br />nuM rsN l097.civ c)
<br />AIIUCAILDICLAAAUAN
<br />I hcEny0 inn undcr ncnllty ollcriury orc ol'lhc tulk,*fu d(larurios
<br />D..diri.'n Pfinirl^lhcsos Noriicrrion F.dcrrl RcSulario,rs lTnh 40, Pln6l
<br />Rcqurcd t (cr of Norilicalhn
<br />l1.rrl! rh, r rlr lr,L rl'.!trln ,trN trurln!i)vrlrc tr.r.'|)|,'.rhlc !i rhi\ r.]!.r
<br />&f."nnr,nu, , t'" ,"oo ,no 0fnlicar ion {rl da rh^r irrri,rnHriotr n.onrrr lr gK k,.o flt*irh trllcir) rni counry
<br />o'llnrn..\ rn(lslxr.l i\\ '.lr!'rg n) huilJ'ng r r.f r.\drxr'vr\ or rl!\ c-'rl ! Counry b cnr6 ulnnrhc
<br />rhovc nrlllioncd Dmpcny lor irspcclion luryxcs
<br />l,,fnApDlktrnl or A[enl SiEnnlure:y c f-T'rPll€R /E
<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 />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER aL,/tq
<br />Transformers
<br />Torqueing
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilinqs (Hard & Sollit Rouqh
<br />Ceilings (T-Bar Rough)
<br />Meter Release c/o,/ t't
<br />Rough L/,,1t<
<br />Se(vice Meler 7'?p Llzrl tf De'r6 l5r
<br />FINAL Olzrl r1 Elrt? toa
<br />Notes , Remarks, Etc I
<br />DATE
<br />Sub-Panels
<br />I
<br />Li.cn\c NtrNhcr:
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