|
ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS oWNER AUII,DFJR DEI-CARATII)N
<br />I hcEby.mirn und.r pcnalry of rcrjury lhd I '.rcnDr rn,m rh. C.6rr.ro^- Licctr* L.w fo, thc hllowin8 rc.w,n lsr...70.11.5
<br />Bosi',c$ ud Pron$ion C{xlc): An, Ciry or Counry $hi.h r.quirc\ { pcnnil l,r c.n(rucl- olrer, inrprole, dcmli\h or rFln dn,
<br />d.rurc, pnortu irr isruimc. dso rcquirc( rh. Jlllicanr lor srch Fnnir rn fil.a ngn.d nrt.nr.r rhar h.or sh. is liccnscd purflml
<br />t, ihe poi\ions of ihe Conlroctn s l.iccnrd l,r* (Chlplcr 9- Conrn'crcins wirt Sccrn'n 70oO of Divist'n .r orrh. ausinc* and
<br />Pilncrsions C.d. ) o har tror rh. i\cxcnfr rhcrfiomand rh.hdsi\ f(tr rh. rlhgcd cxcnprio. Any lidlrtun ol SNlhn ,0:l I 5 b,trny
<br />"ppli.rnr tor r!.rmil suhjc.lsrhe apllicanr ro 0civilpcnrhyofml nhrdhrn tuc nuDdred doll.s($500)
<br />l. \ uRmrofrhcnn)IrnJ",ornrycnpk,y.r\wirh{r8c\tr\ihrn\n.co f.n\dr i('i. will do rh. trnk ldlh.{l!-tEisr[l
<br />i cndcd or oil!,cd l'or s.lc ( Sa 7(},r. Busincs 0nd P(ncqotr\ cdl. l hc contrclor's Liank ljw docs mt aDnly ro rn osmr of
<br />rlk|ln,I,tny who hild\ or inrr(,ElrlEE,n. arxl sln, dtf,s skh *o hnnsrlforhcr{lf rrhn,ughhi\dhfinwtr.nrDl.ycc{.
<br />pn,vided rhar s'ch i'npro*,mnn rc nor inr.Bloi or otlcRl lbr qL ll: txwc\.r- rh. hrildi'B or improvemnr is $kl wirhin om ird
<br />olcompbrir. ltE owtrs Buildcr sillhlE rhc t{rd$.fpnnm8 rlEi h. or shc d mlhuiUorimpm!! Ine pn'Fny tu rtf, puqnyoa
<br />l.r\ownqolrhcFlEny.ur.xclu\ivcly.onrrlcrir8sirhli.ctrscJ.onrractrsn,.on{ru.rrl{p(,Fri(Sc.7(Il.l.Bu\iN-
<br />lrrl PuJlil\inr C(dc ThcC.nrn.r.f\ Li.cn\c Ltrw doc( norrtflrni moBtur.fnnir y who huildr.r irnthv.s rh.rcon.
<br />rtul Rho.ontad\n)rsuchnR,jdswirhr(inm.hn\rltcn\cdpu'\utrnrr{irhcConrrrci(n\I-icci\cl-rw)
<br />I rDcr.mfl undcr Sc.rn,
<br />}iIIBf,I8S:IIJIIIENJ|AION
<br />DECI A.BAftQ!
<br />Ihcrcbynltu uidcr trMky ol j$lury o colrh.lnlLiwi'rgd.clrrari,nr\
<br />Ihovcr $1ll nrfldifu Ctn rtRar. rf (irr{nr n, Sclf ln\urc tur sork.h- .o rtctrsriion. rs pftrvidcdlorhySecrion1700.llhc
<br />Irh, Cdlc. ntr rh. l.rfontui( ofrhc $ork l shihrh.Fnnir is is\ucd
<br />! hrrc rnd will {inlrinworkcr\conrpcn{rtrin\urrn.c.r\icqunnhySari,rll7lx).lrhclihltrOdc.inrhcp$rnnnnrc"t
<br />rhc rork for $hich rhi\pcnir ir is\ulrl My *q&cr' c.nIEn\ut inr in$En.eericr rftt pliuy nun,hcr rrc:
<br />RnicyNumhcr-
<br />l.c'rifyrhnr i'r rh. pcrtuflu d{)f rhc wrrk lnr Qhth rhir rnnirn i\\ucd.I \h llnor c'nfl.vr y t^-^ r innny rirE
<br />{i!\x'hc.otrx{rhjccrt()rhcn,rkcr!dnn|rtrso.trLrs\.lcoliiotrir.nnla!rccrhrrrll\h'r[lhccorRsubrdn,rhc
<br />\r*c^.onD.nefurtfuvisron\olSccrionlT(r()olrh(Lhr(ixl..llhrll.lonhslrh.onlly$irhrhornrovnion\
<br />llaRNlN(; r ilr. n, {cu'o \,tr|.^ $nr|X]rrriim o\.'a!. '\ utrh*ltrl rrl \, ll {a|l.r {r cn
<br />t, fn. hutr{l'rd rltr{Nrn'l Jollrr\ rll(xr.lrXrr.
<br />sr\rr{ 1076!n rlr lrrx, (!rl(. ' .,.nr (lrr,!
<br />/o-t o-7 7
<br />I hcrcl,y rlltrundcr pcn,lry ol p.rjury ttur I ro liccnkn udcr Drovi\tnr ol( h$rcr g (commncing wirh Ssri,n 7(XXD of Divi\n,n l
<br />ol lhe Bnsincs and Profc$ionsCodc. a mylicctrr n ir tullf.rcc ond cfilcr
<br />c(b C@ 4 -a) "rL- .t
<br />b-tr:tt urn* sol<r
<br />CAISIA]J.(:IIONI}:IDINC.trAINI:I
<br />I h.Eby nfln tridcr fFntrlrt orl.rjurr rhd ih.rc is ! conntu(i,n kmli'rE rlrmy r,tr ihr p.rturnDrE.lrhc wo.k tur trhi.h thn [Eirnn n
<br />issucd (S.c.3(rr?. Civ C )
<br />I.rnilj-rhrr rhcicdcrul'r3uhrtr) \rctrnli',9r\h.no\rr n\rlxrcnorrl,!h.r
<br />-l.crrllrrhd
<br />I havc r.ro.nnDlv *irh nllCiry3nd Counry
<br />orrhn ciryrnd Coutrry r' cnrcr trFr rh.
<br />z ^,,, b-/0-17
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Si gns (monument)
<br />Life Safety /Low Voltaqe
<br />Fire Alarm i Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bondinq / Groundino i UFER
<br />Transformers
<br />Torqueing
<br />Bool To p Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Sollit Rouoh
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rou gh 17W P,/$z?.rZ /o/
<br />Service Meter (Zj\/llritl 'A, '6..b..A,x.^ I v la-,o1a ,1kl4D
<br />FINAL e/z/r4,1{z rd ))L
<br />Notes, Remarks, Etc.
<br />Site-Work
<br />Sub-Panels
<br />Air Conditioners
<br />AII!ICA![II&;I.A8AIII}N
<br />I txEh, nlimn und.r pcn! h y of p.rjury onc of rhc nnkrwitrs d6h,6l t,n\
<br />n trnlilion Pcrmik.Asbc(or Norificatiotr Fcdcrul R.euldions (l irlc4r, Pan6)
<br />-Requncd
<br />llller.l N.rifi calioo
<br />tt
|