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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS oW,NER BI]I!-I)ER DEI-('ARATION
<br />I hd.by rfim lndo ldilry of pdlury rld I d dmpt filn lh. Coliidr6' Lie l$ for !h. hllouins r.en (s< 70ll 5
<br />uulinBr ad Prolsnrr ('od.) Any Cny or Cou , *hth r.qu,6 . tsi ro NrdNct .11s. itrFlrc &tDlith rr rqrt .n!
<br />srruc1urc, rrior ro il' Burftr. rh. r.qrn6 rh. i?pli.Mi aor su(h Fmt h fiL t i'sn d ndffir thd lr or JE it lic.!.d ll@m
<br />ro rh. For6ioN of rtE Conrrrroi! Li(ded l$ lclrlljrd ir, c.nmdinr Nith li6l6o 70(xJ of Di!i!io. I .f tlE ButiK ud
<br />ProI*Nns Co&) or rh,l lE d sh. t (opr dE.fr.n sd fi. h6ir for th. all.s.d 4dFhn anr 1iohtun ofs.dff 70.11.5 hy m,
<br />rmlicrd fou Fnn .objrr ltr +plic.nl lo r cn il r.uh! ol Fl m( rhe 6\. hon&.d dollar ( ltml
<br />l. s os6 o[lh. rmFny. o, nycnDk \6 trirh !486 N rh.n $k NmFns0iron. q'll tl' llt tr(,rr d rlE nME u m'
<br />iirqdcl or oIr6.d aor sl. (sr 7044. ABind od Prof*ions ('o& '1h. ( o,nndor'! t.K(c t& dG mr +t,lt lo d 0\6 ol
<br />llE rnrpdo wllr hrildr or ifir.\ 6llEon, dl * rh d6 sh uod hilMll or lErl f or llmush hir ( lE o{n mphlc
<br />Ford.d ihir r(h rrFlqcn G mi - or&l oroltr.d ftf, $k I[ lbu6g, rlE hrihry or rsn\!6r t $ld sihin.ru tEr
<br />of co'lilrin llr (x E ttrilb {ill hr!. rh. trrda or F\ina rh, h. or JE did d hrild .r i@.o\r lnc D.!Fy fttr rtE FrFE ol
<br />l. s o$c ofrh. IiorEry. e.!.hBiv.lycodrr.riII| trrh li(6sd codrr<r.u lo .odtud llE FoF tsc 70,1-{. t}i!rl6
<br />od,hr6rilCodc:'lhcC6nr&rdr'sl-icd..L,*&Enorrrp\romosn.ofr.Fnt_shoboild!orinpmr6rhcon.
<br />and sho $di.dr ad !!ch Foj.<r $nfi ! ( oddo(rl lr6E d pomlrn hirE(.odrdois Li.M lrs)
<br />I ctmpr u.dd Sdh,n
<br />Drrc O.Nr
<br />\t oRJ([RS' ( O1\t PE\aA ll(rt
<br />DI(ITIBAIIA!
<br />I h-ch) amrm un'16 t6uh\.ltrju^ otu orrhr f.lk(in! d(..lddoB
<br />I h!!r lld *ill @art,in r cdiicarc ofc.nst ro S.lf-lmur. ror sdt6'oEFstn. a F.riLd fot t4Idion !700.ti,E
<br />Ijbor ( odc. fo! ric nqIotui.. ol rh. $oil tu sni.h rlE F n n isu.d
<br />I hrr. .nd tr ill mrid.rn r 0116 (omrm.l hn iMr.m.. B rR|un.d hr s(rin 1700 of I h. kh.r (i,dc. tu rh. pnfomd.. of
<br />rh. tr.rr tu whih rhi! pdmir i! isrd Mr \ortd comD.rs.lion 'curecc cdri6 dd p.lrc! nlmbq Ecl
<br />I ccnil) rhd in rlE Ff..mn.. of lh.snrt f.r shih lhis Frnil t irs.d- I !h.ll..r dpty rny PcEon in ffy FdG
<br />s 6 ro b<om. rutiet ro rh. soda NnDas.t ion la$ ofcrlifomi.. md .gr rtd rl I 3hould tE.ft sub.icr b rlE
<br />wort6 comrEsl ion proririoE.rs..lrco 17(x) ot lh. lrh.r Cd.. I sltrll. fodnN nh ond) * nh lh.t F.t bB
<br />WARNING Fnibr. ro su. rvorlEd rcnrl6.dNn co\ffigc Lr unl!\i!1. .td ltBll ubJd o a,)h)( lo oihdl F i. lrl
<br />( il lin6 up lo on. hundr.d rlhlsd &lld (tlt{,.00(l1. 'n.ddir6. !o rh. cor of co,qENlion- i,nnt*6 a Forid.d foi lh.
<br />s^rh,n rrJ76.trh.l lhn a.rk 'nr6d.rd**.a-l-DJ1
<br />^
<br />DEclJAATqB
<br />! ha.by .fttrn trad6 Fnnty o I F.Nry lhn I o lns!.d un& Foltnn of (tqid g (otffiins * nh Sclio. 7mo) ol Dlvtirn l
<br />or rh. Bu!i.4r 4d Pr.f6h6 Cod.. d my ltG ir in tull forc !i.lTdi
<br />i""'+'ia" /,r *"";uo=
<br />(alil8l]Crll)!.Il,lDlAlirrcl,A(I
<br />I h.,.by sttu'n undr rEahy o I Frjury rhd rhdt ir ! cuBrud ion kldils ardy aor rfi. FalruG ot lh. trFll lor * hih ihir Fmi i!
<br />isru.{(sa r0e7. civ c,
<br />APPI I('ArIT DE[-LARATION
<br />I hod, lrkm u'td6 pd.!! of Fjory oE oa rh. n,lhtr in3 dcloBln,.r
<br />I).mlirhn PmnvArb.rd Nori[..ri,n F.dn lR.snldhn! (lnb40, Pan6)
<br />Rrqut.d ldr6 orN.ri6cdr.
<br />t .d 'fy rhn rh. f(kr.l r.luldi.B r+rd'n8 6tE{o. rffi\ !l r. erli.tbl. o this,'roj.d
<br />I.6riryrhd I lEr. r..d rhir !D?lt!rn'n &rl d.r. thd rrhr. infonniii0r ircond I tsrc ro.onp! $nh rll (-il, tnd Co@r'
<br />orJiffid Md St.r. L!$s Elditrs ro hu,d'ns .oftnruci iod .nn hd.nr horn,qr6.ln!lt6ofrhiCntrnd(-o!'n)lo6trsl4onlL
<br />:;"-:'-'-j;;-:^w
<br />r'.rnr,F n.m. ipr,n,r branAo n U.4^rt'a ^-+fs,fit
<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 />Bonding / Groundinq / UFER ,-/2-t7 F,/ara" >
<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 Rouqh
<br />Ceilings (T-Bar Rouqh)
<br />Meter Release
<br />Rough
<br />zed/o,
<br />FINAL t2-4-1,\
<br />Notes, Remarks, Etc
<br />Under Slab / Floor
<br />Service Meler
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