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APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Lile Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bondino /drorfi-fu i UFER 6-z>a,t 2-c-- Z D
<br />Transformers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipmenl
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinos (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rough)
<br />Ivleter Release ,274 A<- ts "zn
<br />Rough ,4-2.1 /(-<,-7
<br />Service Meter
<br />FINAL 5-?r4)Q-e, s r-Yir9-U
<br />Notes, Remarks, Etc
<br />oWNFI BTJII-DT-R DELCARATION
<br />ud.. p.mhy of Frr.t rhI I m .rnpr 6on rlE ConElon lirne L.w for rlE rouowinB q;h (se.7ol l.5
<br />Codc,: Any Ciry or Conry *hth rqon s . Fmn b $NM. .11s. i,r{,ole d.mlnh or EFn nn,
<br />it klllrG, .l$,tquiEr rlE +tli.or ror kh Fmr io fiL r rgn d (.r.cnt rhar lE or dE i! Ii.cn.d pN.l{
<br />of tlE ConErrq! Lilnsn lie (Chrrrcr 9- ConftNin! wirn s(ri6n ?mo or Divi.ion ! of rlE BuriEs ..d
<br />) d $rr lE d .lE !, .rcmpr rlErcton rnd ttE b8t ror !h. dL8.d crnflion Any yhhlbr of S.clion 70ll.J 6y.ny
<br />subj(rs rrE rrtli.r to ! civil p.Mhy of ml mrc lhu 6v. hun<icd doll.r ($m)
<br />orrh. lfi,Fny, or iny.q'bF.s *nh *08$.i ih.t slc.!mFndb,. xil(t) 0t *d( rn E tuE it Dr
<br />Ed lor slc (Se.7o{4, BueiEs ud PDrcriotrr ('.d. It!. Cdniard l Litn. t r .LB d rplly lo r oarr of
<br />hrilk d in+rD6 rtEm ad *tn d(E uh w,l hiNlf d lEr.ll or ltmu8h ht or lEr o*n .not,yc$.
<br />nr{m\mdr e d tu.id{ r ofi.ft{ ntr sh ll hrww. rrE t{ildir3 or iryDEcnr i\ Fld *ilhin onc J.s()|E. Build.. *iU tuE rtl burd.n ol pmvin* 0u tr o. \hc drl Brr borlt or ingrn'E *r IrDIdy for 0E purF* nl
<br />orrnc rmFnr. 6 cxcbsarl,.o.r-ring *ai lirtu rl odrf,'B ro on{nl:r dr FDii-l lsc 70air. Baiai
<br />Codc: Tt Co Broii l,rcnr L.s &B ml si,ly lo ro$F ofpr.p.ny*ho boildr o. in'proE3 rh.rNn.
<br />s rd rEh FFs *tln r conrtut,lr) liq€d |'!BUl h'h. Gdrdor! Ltcns ljw)
<br />un&r S6ibn . B. & P.C.lotrhn rcaro.
<br />OrFrl
<br />IIOAf,E&LCT'UIEIIAIII]N
<br />DACI.ABAIIII!
<br />unds FMlry.f Fjury.m ofrhc lnll('sitr3 d.chdrn,ns
<br />uillrEinrai ! C.n ifE.r. ot Con*nr !o Sclf lmE n xrk6 Lr'tr ctrqrbr, at F,yiLd for by sarbn l7m of rlE
<br />r rrE Frdm^..c dt
<br />'h.
<br />md lor th.h 'rr Fn E ns!.n
<br />p ill minr.i. 9ork.6 conp.. rrn irur.rc, &s rquir.d by Sd bn l7(D of rh. Lrbor Cod., f6r thc F,forllee of
<br />inrunrcc cetr rid rDla, nudlrr ealL +lL I ?(I L
<br />rhlr in rh. r.rlorlBrcof rn surt ntr *hi.h th'\ Nnnn A ir\ucd,I $!ll nor cn{n,y JDy ,E6on in 0ny runmr
<br />subJc(l h llE qoltd{ onqEndil'n bu\ot c8litumi!. lnd d3r rh( irl sbuu b.<rft subFr ro thc
<br />ion pDvnFnr or Scdn,n 1700 or rhc Lrnn Cod., I \h.lL ronhwirh d,iply wnh Or€ pmvtilns
<br />F.ilur 'o Ec@ *oIkc^ cotr{r.un,n oecdgc i1 unlrwrul. r.d shau rubF! u cm0l,)rr lo ainnd D.fliii !d
<br />!p tr oa hundrcd rhoui d d(,lldr ($lm.flD), in &lddbn ro rlE .oc ol or+.Eli.rn. d..BX!r B F)fitn for lh.
<br />S<-
<br />uq:llxtlcllNtlulLQa!lrq"l&llll])
<br />undcr pcelty of ,crJury $.r I am l&.rn !.&, provnaon orch.prd 9 (rllrEi.8 $nh Sdion 7(tl0J ol Divtbn 3
<br />liFss $d Prlfc$hns Cod., ort my lacnc n in full rod rd.,Ydr
<br />(
<br />E
<br />L vr,5"'@ Y{/c'x|
<br />q)Nlirx.LlIt0dlnuxii-ecui(I
<br />uDdcr Fulry.lFrlu'v rhi rlf,r. N r.on{n{ir)n Ltunn! rgr r ra' ilr r^_rforutr(. , 'i rlrc rork h, trhihrhtr lirnri !
<br />rItulL}Lt[!r.I&ula)
<br />lnibr F.rlr, of FrJ! , oN orrlr loll0*18 .L(l,nr hrs
<br />n Pcrors-A!bc{d. Nd'fK{hr tu hlL.g!,ri'n. (Tik.O, PM6)
<br />iri rh,r rh. fcd.rsl Elulnrirnl Egmli.8 ,ihc{os rcm)vdl dc fr{ rlplErblc l{, lhi\ pDFl
<br />rhor I h.v. E6d fiis .,r,tt!rion !,n n.rc th.r E .lDE inromdi,n ! <rd I +rr kr otrply rnh r[ C
<br />uin Stdc li*! EllilB ro billins cotr(nf,rbr .d h.E6y dtr,.in ft.In€Miv.t ol rhir Cny .ri
<br />J2r-t 4.L -1
<br />L/11..
<br />ORDELECTRICAL-INSPECTOR R
<br />::r-4#d
<br />tr{.dle. .lo9?. C'v. C. ,.u*Ix*.-
<br />L.nd- AddrBr.
<br />-
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