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ELECTRICAL-INSPECTOH RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OlYNER BUILDIiR DELCAN TI()N
<br />I h.'$, trlfirn undc! p.nalry o, perjlr, lba' I !m cxcm {mm lhc Conl.rcroF l-ic€n\c Ij* for rh. lollowin8 rMv,r lsc..70]l 5
<br />Bu\in.ss nnd Pn,fcr\ion C.d.): Any Ciry or Coumy which rcqute\ u p.nnir k, .onirutr. alrci nryi(,!c, dcrmli(h or E|{t . ,
<br />slruclm, lritr to irl issuakc. al$ rcqunes rhcaptlaatrr hr su.hl.nhit b liLr shncd slarcnEni lld hcorsh. n li[n.cJ ptr{rnr
<br />to thc nnrvkiotrs ofrh. Codm.ror's Lionrd lnR (Chdprcr 9. Cd nncncine wirh S..riotr 7(XD oi Divnion :l ol the ltusioes rnd
<br />Profc\sions 6dcJ or rhar h. or shc hcxc,.fl rncdionandrhc b$t f(rhc rllc-scd cicmrrion Antviolarionorsc.rionT0.ll.5bya !
<br />llnli.inr r{tr r pddit slhj(h rh. rppli.rtrr kr r civil pefulry ol nor nDrc rh fiv.hondicddollrs(1500).
<br />-1.
<br />$ ourc! ollhc DmrEnr. or nrycmnloyccs silh wr!c\ ns Ihct {,lc conrrcrsrri{in. *illdo ih. work ud ihc srflcrm k nor
<br />inrc h! oroilcrcJntra,lc(SE--7(!4.Bu\itu$andtirtcs\ionrCodc'llf,Cotrrrcntr\Lirtr*tlwdocstror.F!lyro0no*.crol
<br />rlrclmlEny who huilds or inpDrc\ ltEron. a.d who dNs \uch w,* hlnrsclfor her{ltor rhrodgh ht or hcr.wn cnfl.y.cs-
<br />provi,icd rhrr such iml rcnr.rs m .or inrcndd or or.El n, {k Il h,sc\rr. th ttriklina or nr0Dvcnrnr is bll wirhin "nc }rrr
<br />olconqrhrir. rh.Owncr Auilds sillhurc rlE hndq oirmviu lhar hc or shc d nor huild or improk rhc lmFiy ror rlf Neosc or
<br />-1.
<br />r\ oNrc. of rhc !tutdy. trn cx.hsncly conracrin8 wnh li.crscd .ontrd.s ro con{rucr rhc Drcrcct (Scc 7O$. Bu\inc\!
<br />lnd Pn'fssion Codcr Thc Co acktr s Lic.nsc Las docs nor arpl, i) anowncr oIl)folcdy who huilds or inrpnvcs rhcrcon.
<br />nnd who comn.k f.r su.h pmj.cls wilh a Gnrhcro(9 li.cnsM puNuMt k, lhc Contmctoir Licensc L!$)
<br />-l
<br />.6 cx.npi undcr Selhn-, B. & P.c. aor lhis sson
<br />D .: Orftr
<br />t!aa$i&r:(auf!:Nta.IloN
<br />DECLAT{IION
<br />I hcehyam nDDds r.nrhyof Dcrury.ncof rhciolbsing c.l fl i.ns:
<br />-lholcund
<br />wrllrornlli.! CcnificareolCons ro Sclf.l$urc for BorkeF comFnsartrn, $ !rcvidcdlorbtS.crbn1700ofrlr
<br />Llbor Cfilc. aor lh. lnformrce oI thc *o* for which llE permn i1 issucd
<br />rho $ork lnr shi.hrhi\ N ir is,s\ucd My*ork.^'o 't{rsxrtrr, i'rsurr .c.nfnJ tx)li.t trunrbcr d.
<br />P"licyNumhs-
<br />l.cnifyrhrr inrhc n rf(flnurccol rhc wo,k Lr sh,.hrhi\ p.nnir is n\ucd.lshtrllfor.nll'loy rnyprrvn, in rtry rniNr
<br />v, r\ t, hLdDr srhjd io ,r *orkc c. rt nsxri(,n lnw\ ol Crlibflria. Jidn|ruc rhxr1fI {bu[] t .orN \ubjcd 1,, rhc
<br />wortcr\ codpcnlrri.n pm!i\n,h olS(ridr.l?(x) olrhc Irfir C{rlc.l\h3ll. n)nhrirh coilne sirhrhr* [ovisions
<br />. il iin.(ott,och!drcdIh.tr\dkldrllrnrSlrX).(XX)r.'nrddiri(nrturlr.oi.fcorntrn\rrior.!rN,8c\J\pn'vidrdnnrh.
<br />sccri(r 3076 olrh. Latxtr cldc. inlcrcn Md nxorrcy r lcc\
<br />"",", Zlr.?=.|+u
<br />I hcrchy rr'ltm tr crrcntrlryni!crjtryrhnr I r'! lien{d otrdc. pn,visionotCh,prc,9(..'n rncing wrh SL{tion ?OO0) oIDivi{ion:l
<br />or ihc ttusiDe$ nl PofesioosCode. nnd nryli.cn* is in rirlllorce rrlcltccr
<br />5-D Etz-#<-
<br />.qANSIBUCIIONIENDINIIAINCI
<br />Ihcrc$y alltmu crDc!,llyolr.rjuryih lhcrcisaconsln'criotrhndirsaBcncyrorrhcpcrrorindnNorrh.workiorqhichlhkI'cnnitis
<br />hsucd {S.. 1097,Civ C.)
<br />APILICANLIIEIL/8AIIQts
<br />I tEL$y afiim und( pcillry.rp.4ryonc or(hc rou.wins &clefli.nr:
<br />tlcmliliotr Pcnnik.Ash.slos Notincorion Fcdcml Resll0ln,ns (1 irlc,l0. Pan6l
<br />-Rcq!ircd
<br />Le rrcr of Noriarcarion
<br />I .c iry ihd thc rrdcful rcgulatioff rcgddin8 .sr.sos otuvJ dc tr.r rpt,ltnblc lo lhh pm,c€t.
<br />, ccnifyrhll I hr\. rcul rhi\rpnlicdion xDd (rrc rIrrrh rh\c iffirnnlior nromcr l]gr(k)cotr\)lv $irlr rll(-irvnkiC!{i rrv
<br />vr C.ntrryr, errcr trtirrrlr
<br />7az-P
<br />iirJi,'rmu\snJ Srirc Lr\s mhriry h hurJi
<br />oh.vc trrnrFncd fnlci! tu in\nclyld
<br />Applicn or s€nlsisnhltrre Y
<br />Peml(€e mnc(p.inl):
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Bonding / Groundinq / UFER
<br />Translormers
<br />Torquerng
<br />Sub-Panels
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soflil Rouoh
<br />Ceilings (T-Bar Rouoh)
<br />Meter Release
<br />Rough
<br />Service lVleter
<br />FINAL I J,-llt& -\Y Yx.t\^eK)i ?a/
<br />,)tflNotes, Remarks, Etc
<br />Under SIab i Floor
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