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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.OWNER AUILDER DELCAR TION
<br />I hcr.hy rlr'rm unnct p.nllry,)r llcrjry rhsr I m .rcf,pr rn,n rhc ContreroF Ltrtre l2* in, rh. nnbwn8 r.3rn lS..7U.ll.5
<br />Ilu!n.r\ rd Prcl.rnon Cdi.): ny C y or County uhi.h rcqun.s a pcmir r, .onsrtur. alr&, ntpovc. d.mkh or Ep.ir any
<br />nndurc, nNn' r F{ufrc. al\o rcquirc\ rhc apl Eanr ii)r sd.h l.dn tu tih. iSncd slllcf,Enl lhlllIor dE i li(n{d I'u6uer
<br />n, ih. lfl,vntrtu ot rrr contr.ltois LMnE! L,w lch0Flcr 9. Conmch-'iry wirh S.cbdn TOJ0 or Drvision .1 ol r,r Borin.i 2ft1
<br />Pn'l.rnon. Codc ) or rh{ tEorrh. RcEmfl rh.Rliom.nl ih. h.st txrh. rll.g.d.r.m on Any virhrir ol S(rx'n 701My .ny
<br />rmli(.nr t)r . Fmir .utFcrr rhc applic,nr tu , qll ,.mh, ot nor mr. lhln , rvc hunlrGr doll{\ 1!5U))
<br />-1.:r
<br />orftr ol rh. lft'Fny.,tr m!.qrloy.cs wnh *!S.s.r rhci sL omFnsron. w I(l) rlr s,it lrn ltr {rrE n fr{
<br />rtdrldl or oltcftl ltr sl. (56 7(X4, Burmt{ mJ Pbf-\rd CoJ.: Th. Cro.r&kr r lr.nE li* &s ( t t'ly k, r u! r ol
<br />rhc pnlEny wh) h{'It or in{FEr rtEsrE .d !l$ dirt luh mlt hmrlf or lretf ot lhmuah hs tr h.r own.npkr}ttr,
<br />p&v!.J rhlr tucfi nF)mnrr G dn inrcdol oroIrc..J fir el. Il b*eE. rlI hilluB or ir{hEftnr 6 sU *!hr rtr F{
<br />dlc.iphrm. ttE o*Er Bu!., * h,rrtEtkLndlFrvin!rhdtrdslE,jndlxi!dulIn{UxF,rdtrorlrFFIFE.l
<br />_1. r! owEr ol rrE ln'Fdy, d.lclunv.ly $.r&rn8 unh lMnsl ronlr-kE ro ondtur rlr F!.rl(sa.7044. EFms
<br />,n rh'Errrr Coi. Thc Conr6ttr r t.ic.n< L.w J*s rnly ro d owncr ol F,)ncny slr, hullJr or opmv.r rhcron.
<br />rnJ eh' conrtuk ld lkh FoFk w h. ConlRl.n!) l.cnEd F6@r brrrCodncrd < Ir..c L.*).
<br />_l rncr.nfr uDJcr S..r
<br />EIIEEIES-CqUTENSAIION
<br />DES.AAAIPE
<br />, h.rhy .fi rm uRLr lEmhy o( IEiry or ot i,E nnb$ trr &.ldp.s:
<br />_lhrE.,nf,rllE'nr.C.n'li.r.ofcotrenrroS.l!l@ldu*t6'onpcrerrn.aFovilaltur6,Sdrihl7c)orrrEt hi Ciri.. ld rlE Frfm. olllE k t f( *ti{ rlr l,chrr 6 srEn
<br />_l h.w .nt *rll E,nr.rn *orl.r' sEFtrerrn ururu.. ar Equr.rt by Sftlbn l?m of dr L.ts Caj., fr rk tErfrlmt ol
<br />rlE m* (r wh.h rh! Fmlr B i<rdl M, wl6 drp.,E ti'n N,ei ..lm rrl Fnry nuntE 8:
<br />Arvrtn.".,n Zr"' c!^
<br />N,.,.. W (6ocl 6() lB I
<br />_l .d y rhri n rtE FrfortrLr ol tlE $rt ix phrh rhts Frh E Erud- I rhrll n .try$l ay Fah r e! Md
<br />$ .r rt' ltllir {hFrr r. rlE kxt6 (rrtrriitrdu hs ol cn'fol@ Jrl +r rM
<br />'f
<br />I rlnulr tEod obFr ro rrE
<br />urt6 LuFnelrr pnrlillnr o, Sdrr,. ]7q) or rh bbd Cal.. l trElL lsrhs{n oq{! *'rh rlE. txohrx
<br />WARNING: FduF ro Bm *)rtn'o,Ftr!.lrD oElc !r ,nhwnrl tnl 3h.I tutFr u .f,q,bF ro qlttd FEI- rfl
<br />d'l rrmr up lo m hunJrEl rh.u$tl Jolbr (tl00,()00). u -Il M ro rIE .d ot Lu{rNlon, d.d!6 .r rD,rldl rq
<br />'lESer$n to?6 or rh. btrx Cql. i.rm{ .d rtrfty r 16q-L1 - t1 n&"cw Gt ^tbc.
<br />LICEISEECONIIASIOf,
<br />DECI.^X nON
<br />I h.Ent rittn !L!.. FMxy ol Frilr, rhr I n [6cl ulcr FIEEI of CtIFa 9 (sn1llhn8 qnh Salbn 7rm) of DIVNM .l
<br />ol rh. AulEs Bl PF(.!r-r GiL, !^t m, lr.M 6 r tul fou r .fiat.
<br />91\156
<br />-'21 -11'1'n\ $o\ar
<br />car$aIJgIxl!..LEBDINc-LaEl.La
<br />I ^\Nhy rtlnhlnl.r F.dryn, !.qury rhd rtE trr$nnNr!,n lcnlus ry.ftt ni rh. Frl!)lMt ,,f rh.R{t t)r whxh thl! Frnr a
<br />K\ucnrse $.)7, c'v c,
<br />AITLIIANLTTESJAAIIoN
<br />I hrrl'y Jlim uonr ptirhy or Frrury ok o, rh.lolnlwrn8 Jdhhrn,ns:
<br />I).ni,lnx,n Pcrm $Ashcnor Nor'ltrartr,n FcJ.ful R.$UrKr.r(T lc.l0. Pd6)
<br />R.quucn l.r.rdl Nor nrrxn,
<br />_-l (.d
<br />'ry
<br />rhrr rh. l.J$rl n lullr)ns F!{d r! a\be(o\ rcD)vrl am Rn {plrihk tu rhtr lln'J.d.
<br />l!.{rlyrrirlhrvctr'lJrhsipll(arrlnmlnrrcrhardrahkr I4r(loe.nDlyw hrllC yrxl(i{n,
<br />on,'unccs rnl S,!r.liwr Nlrry n, hudl EF.c.lrlivcs of lhn Ciy ul Cosry b .nr6 uF,n rh.
<br />D.,. q'a1 'A,.ti'vc mnron tl pntt' ny b, rsFrx,n
<br />ADpli.anl or A,!ol Sirnntun
<br />AnA fa\^l Gtc,.<r", <^t-
<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 />Buildinq
<br />Under Slab i Floor I ,ar
<br />Bonding / Grounding / UFER /q20r'l AAa/*,t ,{(5'
<br />Transformers
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinos (Hard & Soff it Rouoh
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough ,^t t
<br />Service Meter Itl4frol''l
<br />FINAL twtbffi 60
<br />Notes, Remarks, Etc.
<br />COMMENTS
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