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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE rD/srG.COMMENTS
<br />Site-Work
<br />Underground
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor lt
<br />t)|E",baBonding / Groundinq / UFER kltl70 ,1Y{
<br />Transformers I
<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 />Ceilinqs (T-Bar Rouqh)
<br />Meter Release It. j'7t Utuia htt
<br />Rouqh
<br />Service Meter
<br />l*\alnsE .gFINALll'?'7,a
<br />Notes, Remarks, Etc.
<br />()\\\t R llt ll t)r.Rr)r t1 \fl \rx]N
<br />I h6cby .mm und6 ,@lly oa psju.y rlEl I d .rmpl nw rlE (bnlncloE l,tce le lor rh. tolloEs ,@]n lS* tol I 5
<br />Bcins Ed ttof*ion Co&) Any Cny o. Coudy uhi.h rqtuic , Fnn lo olEn.r. .[a. ihFoEhomlnh ot .q.n sy
<br />sru.rG Fbr ro ir3 lsuRe rk ratun6 th. +Dlic&r for tu.h Fnn lo 6b . lisi.d $do@l lh,l lE o, !h. is licd[n poNrnl
<br />io lhc F.riiioN ol $c Conkroit L(.n!.d Liw (Ch!pr6 9, Connocin! *nh selio. 7000 of DivtkJf, I of llE BNitB ed
<br />Pmf6io$ cod.) or rh.r h. o, lhc 6 d.mpl rhg€alm od th. b.r6 for fi. all.8cd ddFion. Any violdlbn olsdio" 7oll.J !y d,
<br />.Olic. fff!Fniiuqclsrh. rpplic.nr lo.ciril poElryof ior llm$- liv. huidEd dollc (J5001.
<br />I. s oMd of lh. Fopqry. or ny @plot6 wirh wag6 s th.ir $lc ompdalion, will do lh. srl !d iE stucc a Dr
<br />im6&i or olIo.d for s]. (Se 7O{4, Bshd od PrDfGioN Co& IE Co'nrdoi3 Li.dg L.* d(B n<'l @ply 6 e o$G ot
<br />rh.FoFry who h,ild or iipo6 rlEotr !d wl[ d6 n l @rt hiNlf or [*lf o. lnnuh hn or hs oM @ploy..r.
<br />provitht rh,l $.h irtFn€Ei! e nol ddLd 6r o,rsld 6r sL.l( ho*wa, tlE l,riBir{..r imFsEEd ir $ld viIhi. oE,r
<br />otconpktio'i. tlEo$c a.iti. willrf,E riE hrilar olFrvi,E ud n tr slE dn d hrild or inq.E th. pmFry for th. pllFlr of
<br />, l, 6 ovE of rhc FopEry. M qclutiv.ly.o hcli.s wnh [c.N.d co,nrrcroBto6drudllE Flial (Sd. ?044. &BnB
<br />ard hofsi{ Cod.: TIc (lr'n,rcro, s Li.tu. Lrw do6 @r ,ppl, lo o otrtrc ofprcpcly *ho b{il& or inpdvd lhdm(
<br />sd who so,n 13 tor N.h F.Fl! wth r Conrrcro(s) licolsl Dull@r ro rh. C.ffa.roit Ltc@ L!*)
<br />I m .rmF unla sdion-
<br />Drt.r Ornd:
<br />tloaaEf,s:cotallsarla!
<br />DECIJAAIIA!
<br />I h6cby amd uidd p<iixy of Fjury oE olrhc folb*ing dctr.rioBl
<br />I nrv. d *ill tuint.h . CqlifElr. olconsn lo S.lfJa@ fd elt6 conp@ldion. B Fovi.l.d for by Selior !?00 of th.
<br />lrbor Codc tor rh. prfomM. otfi€ worL for vhiclt rhc pq6n ! isucd.
<br />\l h.( .nd tr 'll mii u worl6 .omp.M ro. Eud.. s r.quir.d try Sel aon ]TOO of lh. t lor Code, for tn. FfomD.. oa
<br />lhc wor\ for shnltlhi. D6ni! ! iqr.d My worl6 compdEnrn slfucc (!ro dd p.ltrr nun
<br />.,*, Pa| c l! l tXar u -u ,r c
<br />P"r",N,.b-, tl.rC OZq{q57ry2 **,4 Jc 2
<br />-l
<br />carify lhd i, rh. FtoIiMr of rh. worlt lor *h6h U6 p(on a au.d.l sh.ll nol mploy my p6$n in &y mMnd
<br />$ s ro b.<.nc lubjd to rh. *ona'.onlEsdion lrw orciitomi., ud ts6 lh, if ! tlb'tld baom $bF1 lo 0E
<br />e*6' @trrFNrion pmviiioN ofsdiotr l?m of lhc L.bor Co<L. I shrll, tonh*nh @mply wnh thos FtrvieioN
<br />*ARNING Frlur. kr sr. snrld' c{npeEalion covols. ii unlasful. ud rhlll subjdr u @ploy6 ro diniml Ftrhis Md
<br />.ivil fin( up ro on. hu.dr.d rhousd doll6 {t10o.(x)0). 'n idd io. lo rh.codpoMtion, d,n'36 a prcvildj aor rh.
<br />Code inr6c( a.d dlorE)rs rc
<br />I ll c2c
<br />DECIJSAIIO!
<br />I h@by llftrn uldd F.shy of Fjry lMl I m lics!.d un& Fvnion of Ch.pl6 9 (@nMcDg "th Serbn ?m0) of Diviri,n l
<br />of ln Bcind ed PmfsioN Cod., sn Dy lk.@ n h tull fore nd.ltcl
<br />-. c ''o
<br />L lzo?P
<br />c176a16
<br />I
<br />caltrBucrlo!.t! DtlllcElcr
<br />I hctby .fm ud6 Frty of Fjury rnd $R L . oilru.lion L!di.8 ,sft, for llE Fbllrlre of rh. wtt 6r "trtt thie Fri a
<br />igr.d(Sd 109r, Ci!. C.),
<br />lddd t Nm.
<br />ATIIISANLDECI.AEAIIA!
<br />I hdibyalIonuidd Fnalty ofFjury on oflhc followiq d..brlio.r:
<br />Dqtuliriotr Pdirs-Arb6rd florin.dio. Ic{6d R.suhlioa (Till.40, Pd6)
<br />-R.quilrd
<br />L.lra of Norifi clri,n
<br />x
<br />-l .diry rhd 0E fctlnl r.guLtioc r.Bdin8 Btdor r6mvd e @t Tplt.bL lo rhh po,*l
<br />carityfid I hov. dd rht applicalio. ad . $al thc.tov. irforhrlio. L cortl. ! iscro ooplywth.ll Ciry. Coulny
<br />odmm6 and Sr.r. t,B rchtin8 l,' hi'ld'u corrrud$r ,urtb.,. r.F.ddir6 o I
<br />.hotr mdliorcn prcpGty l*
<br />'Gpetiotr
<br />Apptlorl or gdt SlsmruF
<br />P.mrlld nrn. (rrlntl:rr5 e4- Ofut'o
<br />:;il*-:
<br />Rev.0B-07-2015
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<br />Pole Bases
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