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APPROVALS DATE ID/SIG.
<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 />Bqnding / Grounding / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof To Equipment
<br />Factory Wired Unit
<br />\ lalls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough
<br />Service Meter I
<br />FINAL Y///// .-zlatn
<br />Notes, Remarks Etc.77 -7---Tc-
<br />OWNER BUILDI'R DEL('ARATION
<br />I hqcty rftm uB.l6 F ly of Fj!r! rhr I m .rmF fiom
<br />'h.
<br />Conlrtrlm l.m< l.!tr tu r,E aollouo* rd,n (Sa.70l l 5
<br />Bdi< &n ftotdKn ( o<|.f Any ( iry or Coury sfith r.qun6 r Fni ro sdru.l, rhs. nnF.\c &mnirh .r Ep.j. D,
<br />rlruclue Fi)l lo ir! isMcq !. r.quiE lh. q,plicer lor ru.h Finn ro 61. ! !i!n.d rlddffir lhd h. or $. ir lic.B.d pulla
<br />ro $. Foririoc ofrh. Cont6.rd t t-i.ftsd L.$ (( h!F< 9. ( omnd.'nB $nh sdr'6. 70() of lrnir6. 1 of ih. B6ind ed
<br />l}ofdioBCod.) or thi ll n!h. ir.r.r{ rh-.tom d 'h.tE6lor rh. .lk*.d.tmFion An,\n&lhn.asdio.70ll.5bys,
<br />q'pl'.{ for!Fn $bjdtrn.roli..,rro!ciril,.dhyofmr@r.rhdlir.hun&.d&'ll4(1500}
<br />l. a oec of rh. FtrFdy. or o! dplolG { hh $+d a
<br />'h.ir
<br />ik.omFdi'n. \illdr rh. r t n[Erndcaml
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<br />'h.
<br />prorEly sh hil.l or inrrcv6 rhssitr Md who d(E ru$ M* hnn..,for h@lf orrhnnr*h hk or hn o$n cnl['loy.6.
<br />Folid.d 'nd
<br />r(n mrft\ffir ft mr nddc, orofiqqt 6, sl l[h 6s- rrE hrilrls.r rrr!\rEn n y'B \ irh'r "E ]aof.onpldiitr E ()*G BdH6 {iU hN rlr hdb ot Forin8 thd lE ( JE dn mr tliu s irrm\. th. F)rdr ftx rh.IirFE oa
<br />I.f 0\6ofrh.F,F!.,n.\.lNn.[.on'rdi'ur hlr<s.i$ rcrNnr (odrd rlE F,jd (s( ](!r. BBrn6
<br />and h!,6ion( od. rh.(o.trkror'sIr.€nr.L6$do6norarrl!-romo$n(ofrk,l.rrv\lrhrildsormfl.\csrfi6Fo,
<br />ahd sho conrB-rltrluchroFlitrtrhr(odBl.(\|licm\Glpun@htfi.(i,nt&l r'r I ro5.1..\|
<br />I i,n.r.nr und( S(r$n
<br />Drlt ()rn.r
<br />\t uRt(r R.r' a(rnt PfNsa tlot
<br />DECId}.BAII1A
<br />I h.r.hJ- ailinn und6 pculr! ofpsjuryorc oIrhc lnl[N i"8 'ldl !liotrr
<br />I hd. .d tr ill dinr.ir r Cdirf,.r. oacoMr ro S.ll-lMr. nr * o.td cotrqEMFq 6 For id.d fu I'r scr tun r 700 otr,E
<br />L.bo, Cod.. for llE Ffollre ollnc snt lm \tth rh. Fnil i! isal
<br />I n*..,i *ill m.ifl.i e!rt6 ohpoanon rNnrc, 6 (qun.n tD s<rion u(,.a F l,l0 (_od.. tu ilE Ffllffi ol
<br />rh rsrt aor shkn thn F.nir i! isr.d My $orld' onFldion i6ura. .nir nd Flky nunb.. s.
<br />PolicyNumbcr ExptB
<br />>?td!'D rhd in rlE Fromr.otrlE *nrt frr *hkh rhi pqnn i! ie.d- l.n!u mr dDloy dy rE$n in.,r,n'n6
<br />N 6 r. h6rm rubjcr ro 'h ertd snFu.ln,n l.q or Cit'lomE md .*r rhi rl I rhuld tr{.m. ttd Flhc
<br />mlta' omFdion ForirhB of Sdi.n 1700 of rlE trbo. Cod.. I JEIL f.dll$ nh 6rpl, r ilh rh.r pr.\ irioB
<br />a
<br />wARNINC: Ijrillr. ro su. $o 6l
<br />c rl fin6 up to om hundcd lhourind
<br />Sdi.n 1076of rh. trb Cri.. iddd
<br />co\da!. n unk'vf!1. ..d sh.ll i!6id .n
<br />lo(l.un). in oddiiion to rhc cor of co'.rc.sl
<br />ALe r' bu n-zc
<br />l,!1r \ll \ r r_)l
<br />! h.Eby itum u.dd Fmli' ol Fj!ry lhd I m li..iEl !nd.r Ftrrlhn of ('h.Fas e (mmnmcin8 w h S(1nn ?(xx)l of Divirion l
<br />ol tlE BaiIB dn Pr.fdioN C.&. nn m) lite a h 6ill foR rn .fid
<br />4
<br />I harb rrm und.r Ful'y o r Fiur-, rhd
<br />i.ruai (S< 1097.Civ. C )
<br />i! . $Idru.r i.n bdins rsfty lor rh. F nhn&. of rh. $ o,l for \ hf,n rhn FEi i!
<br />ATIII(ANLDES4EAIIO!
<br />I hgdtdlmu rd Frhyof Fjury oE of . tollo*ins &.hrdioc
<br />D.mliion PmitlArb6lo! Notilicltun Fdlgll ReuhtbB (Tnk !0. P[16)
<br />R.qtrtr.d I ar6 or fh,frdiln
<br />in,6.ond I lsraro(rn, ) \,irhall (''rt rRl ( unr!
<br />n7. rlfr&ddtrs olrhr (\rr Mrl (\runry kr drd uF)n t}.
<br />LA
<br />,,.,, a Z\'1C'
<br />ELECTRICAL.INSPECTOR RECORD
<br />COMMENTS
<br />Site-Work
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