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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNgR B!II-DER DELCARATION
<br />I fidhy lmrm nndE Fslry of Fjury rh.r I d ddpr 60r tlE Codr&ioB Lr.c lrs for thc foiosir8 r.!n (sR 7011 5
<br />Bcins atd P,ofsion (.&) Any(iryor(\u y sh(h r.qut6. pdnn ro cotrnhat..1i6, inp.ori ddmlbh or EF, u,
<br />nrudw., Fnr ro irs Bud.c. rlr. rqrun6 rh. rgpl{er (ir ruch Fmn h 6k . siSEd rdmal thd lE or JE i l,co!.d pus!,i
<br />ro rhc Fovi'ioN of rlE C.nrr*ror r I (d4d lr* (Ch!pr6 9. conhfti4 rhh sdh. 7000 of Diviri.n I otlh. lrui,B ad
<br />PrelBirN Cod.) or tha lE or rh. b .rdF rhd.I'oo xd th. bGt for llr .lkg.d qmFion. Any rhhlhl ot ser.n 70r I 5 b, e!
<br />lrpiic.nl for. p.mn JubEt!rh. .!rlic..r ro.c'rrlF ltofmr mErh& nr. hund.d dolh! (S1m)
<br />l. s oqG.f rh.,FFry. d m! .q,hr€ snt *.96 6 rlEn eE onrpdiion. * & tlr rdl ild d! n^(E it N
<br />iddx,.n .r otu fd rL (Sc.?0.1.1. &!iB od PErgnE Co& nE Co,rrrld s tilE lr$ &6 d +d! 'o
<br />n .*E of
<br />rh. F{Ety e{n hi'l&or in4 '16'lEoa rn rho dcsn m hiMlf or lErlf or llrcwh hit u h6 o*r dplols
<br />FoviLd lhn e.i inFElEt ft mr -.diH or.firal6r sE I( lbtroq. r bildirB d itrpoqEr a Fld *rhn ot yr
<br />of orpldinllr (xE D{'ldE {r! hE llt hr&r olFirB thr lEd tE dn d hoild n irFlE ln. FlFty 6r llE F Ftof
<br />l. a0B6of rh.FDFrt, o.rdqn.!.onHi.8 $ih lir.c.d co r&io6lo o,( .1llE r,ljdl (56 7(x.1.46i6
<br />rn PDtsi. (-on fl'. (.nrk-loir l-icre l,w &16 mr rp?ly ro e otrnq of FoF y rlF b{ild..r inprord !ha6..
<br />od sho simcl' i, s.h Foja1. *nh . (t'ddo(!) ltc6d Fllld b th. Coddorr Lt@ Lw).
<br />I dn crdrr, unla Sdron
<br />Drr. ()nnr
<br />noru(rRs ('onPENsAiroN
<br />Dll].dn^uo!
<br />I hd.bv rm,n undd tm.hy oflEj0ry on. oiilE idl(Nin* d(lmalions:
<br />I h,\.dxl\1il,nrinrriha( dili..r.of( oNd h S.lalnsur.for $ 0r[6' comDoplion. c rrovid€d lor bySdion:r7mollh.
<br />trb.r (ird.. forrh.Ffom&c.orrh.{uk lo. *h(h rh. p6f,i a i$u.d
<br />I hav. md sill nninl.in qo 6 c.f,FBrlion iNurinc., s r.qun.d by Sanon 17(r) of lhc Lrbor Cod., ir ih. Ff.md. of
<br />lh. $ork fo. which lht Ff,rit ir iE!.d. My{orld omFcrioo iBurucc car6 &t! Doli.y nunbd @l
<br />Policy NMbd
<br />-Erptd
<br />t l.d'6 rh urlEFlnm4of rh.$ort lM $hthrhi!Fmn t ie.d- I rldl ml aphyoyF$r hrymr,c
<br />s B ro tEor uhid r. rlx *vt6'otr9aldbtr lN! otcrlitomir &d Ce lhi if I rrbuu b<oc st!.{
<br />'o
<br />llE
<br />$rtd'of,pqEdionFlviriodolscrb.lT00oflh.IllorCodqliElLfdrh{ino6dtenhltorF!viti,6.
<br />wARNlNc F.ilrG to Fe $nL6 onp.Mhn 6vd.B. i unLrnrl ed rlull sl*<l u drpbF lo d6rd F$E rd
<br />cisl 6.d up ro.oE h,r&ul rl'orn &,llqr ttl00,o00), h tddnih b rlE cor of @Epaadrtr dd.s6 ! FoliLd tu rlE
<br />sdbn 10'16 .r & IrtJ cn& hrd .,n atxrE ! fd; -"iil;il a ---^,,.-.'*
<br />To 6 no v r ,.' t{-
<br />I r L UCE!$A-COEITACIIA\ DECIdaana!
<br />I tdlby rmm lnda Frly ol Fjur, rhd I @ Iica!.d 6di proEbo of Cl4(d I (@Mi.8 *nh S<lbn 7000) of Dlnnn a
<br />of rh. BuiIB.,rd Po6*rioB Cod., -d ny licde t n! tuI torc -d cfi.n.
<br />@)o.(. Lt
<br />861tt L
<br />[,ul ? oVt r'r14. (on'r..r,r
<br />(a!$al(jlloM.!!D.uc.acENcr
<br />I h@by 6mm und,n lqilry of pdjory lhd lhcc i! E $dtu.ri,. LmtinS agacy lor rh. pdlomancc ollh. wo fo, $hi.h lhi. F6ir i!
<br />islu.d (56. 1097, Civ. C )
<br />ATTUIAtrI.DICIAEAIqT
<br />I hddt dtoi udd pd.x, of Fjory oB 6a rhc tolh*inB d..lraioG:
<br />&mlirion Pmnr'Ath6ror lloriforEn Fcd.dl R.slld ioB {Tn l. d!, ?ar6)
<br />R.qun.d L.llaorNiificrm
<br />i.^^
<br />it rhd rh. f.dn.l Esuld tuB Ggrd',! ah6rolmrd e. d lrplr.bL
<br />'o
<br />thi F!j.(
<br />rhd I h.r. r*i llB rrrlrd m rn tld. lhd fotun. t cor.( I tsral
<br />ordinlM6 rd S.r. l.st alditB ro hl ildin8 auhonz. rcF.srdtr6 of
<br />rbor. n6'b..n FoFnt ld inrpd
<br />,tppli.rnl or Atmr shn.rur.
<br />JDT Dov1P1,1
<br />o$moh { hrll ( rnfrl(o!nr\
<br />rr," r ir. -'a r',-I,' n' -r" ,o,n rr.
<br />,.. ,,(,q/q
<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 />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<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 />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />Rough ////s/1 ? trz-zlza
<br />Service Meter
<br />FINAL r / /'h /ta trL7L /of,i
<br />Notes, Remarks,'E'id L
<br />Meter Release
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