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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<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 A
<br />Bonding / Grounding / UFER 2-zt-{1 xr/#0
<br />Transformers
<br />Torqueino
<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 Rouoh)
<br />Meter Release
<br />/^\
<br />Rough pLnL z.z|-t0l )W()l
<br />Service Meter
<br />FINAL z-zL-lol
<br />Notes, Remarks, Etc
<br />OWNER BTIILDER DELCANATION
<br />, h6cl,, lrm onds FrXy of Fju.y llli I a .rdpr tum lh. Comdm Lic.nE t * for lh. folhwua l!&n {!ir.?01 I 5
<br />Bultld an Prcf6nr Co&): Ary Cn, or C@n, *hih rcqunB . Fnl to orErrl. ds, hFo\'., daFlilh or lF., iy
<br />3riaciurc Ftu to (3 i!.i@q.l$ E+i6 th.4?li.or for.u.h Fnn h nL r sis..d rrrqGt lhd h. or nE it lrcsu.d F,$d
<br />to rh. p.ovilioN of tlE aonnidor! !ic.n*d t!* (Chrfla I, Com..cing with Salion 7000 of Diviion I oflh. BuinN &d
<br />PmfdbE Cod.) tr rhll li or llE a 6arpl the6on -d rh. b6! for $. .lkg.d ddFion. Any violdio! oasction 70i L! b, uy
<br />@lKer hi.t6n $bixr rb. e?li.&r 16 !.i!il FGty olmr mE rha fivc huid.d &lld (1t00,
<br />L u own6 of th. p.orEny. or ny mplo)6 wirh sis6 s rhdr $1. conp.Ndion, wiu do lh. worl dd $. lharm ir ton
<br />i,rdrjcd dolf(.d for rlc lsc 7044, Bsit6 dd ft!ftsioN Co& TIE codn..d'. lidg Ls do6 d 4'9ly lo u ow ol
<br />lh. F{Ery *'ls hd& c inFlEoEs -drlb <16nxh x,i hi .llor lEslf.. rlloosh h! o lE omdploy6,
<br />proli:Ld rhd ru.h imp.flolEa e mr i.di.d G olH 6. rt !f. lE$w, d. huftnr or i,4.rllffi i! xrll *ith oE )r
<br />of..nlpldioh, tlE (xM Buillla will h.v. lh. hd6 oaFovin* thn h. or 3lE dd ml hnl{t or np..E fi. FoFy 6r lh. P'4rE of
<br />L s of,E of rlE D.oFir. 6 dclu^.ly conrdlrr *nh li(!u.d cotu cr6 to oMM rlE F$F (Sc 7or{, &.ir
<br />&l PNisim Cod. Th. (-onhcloar l-icN. L!* &6 nor .pply to e osn( of ,mpoly uho boildr or inprcvd lts@.,
<br />ud {ho onllIrs fo, tuch Fnjdr *irh a Cofu&b(, ltdB.d pu6d to th. Conrr..1d 3 Lt6E l!w)
<br />lm.rdrr, und6sdhn-- B & P( forrh6rd,n
<br />D.1., Ornd:
<br />ItlratrE8ii:(l}llrllsar1a!
<br />DECIAAAIq!
<br />I t6.t,y .llm ondd Fnrlr, ot psjury om of lh. tollof,trB ddLr.lio6:
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<br />hdr rd $nl mini.i. r cqtifrd. of coMt ro s.lt-lBur. fd at6a @rp..qrio., a FDtil.d for b Salbn }TOO orllE
<br />uEtr codc fs rh. Ff(rl]r.N of rh. *orl for r'lth rlE Fmr i i$:.d
<br />-l hr!. ed will naintlin work.B cortrFNathn iNur.nc., d Equtoi by Setion .\r00 oalh. tltxr ( o&. lor th. pdfortm.. of
<br />rh. *ort 6r shih thie Fhit i! isrd My wdtdt' otrpqlrbn ilEu,e criE ltl Pli.t .untE n:
<br />-l
<br />cdiry $.l u th. Ffo,I1@. of th. *ort for shth thi! Fnn Lr isuc! l 3lEll 'r dploy xy F$n i! xy mdF
<br />s s trj b..om. obier lo rt m*a' o'rFNsIhn l.B ofcllifo ir. tnd lsE lhd il I lhould b-onc subj41 lo llE
<br />so*6' mmpdu.lion pro tioB of Salion 1700 ofrh. Lsbor Code I dtrlL nflh*nh onlPly wilh tln- proyilioB
<br />WARNING: rnLrc |o suc *ortd smFldhf, ovd8. n unhlrul. d !h.U tubFl & @rloF io Eimin l FEl6 lrd
<br />cilil lin6 uF ro onc hunilrcl rh.Md d.ll$ (tl0o.00o). in.ddnion lo th. con ol cooroE ion, drn {d a Fovid.d for lhc
<br />:idrhn 1076 of fi. Ldu ( c{q inrsd !d ddr.r! ie1zlla
<br />DEgrtarl0!
<br />I h6.b' 6,Im un& Fdry ol Fjur' dr I m [.dE n mdd F.r'irion of (t Fa 9 lsffibs * nh Sdbn ,o(y.l) ol h sion ]
<br />of rh. Auins.rd PmfdFB Co{te ,n my lr6u E D tull foN id.ltn'
<br />t?bLl6- .-,,*".{
<br />colslallgto!.lrdDaglcEl(}
<br />I hdby ltnm uds Flhy oaF]tr, thd th@ir. odru.li.n Lndins q6y 6t lhlFaolm..fllE ssrk tur snth lh! Fn. a
<br />islcd {SE l(y)?, Civ. C )
<br />L.ndd r Adt6
<br />AITUIABI.DICIIAAIIOd
<br />I h6!b, dfim unja pa.hy or rEjury oe of rh. follo* ins dclaahN:
<br />D.mohion Pdmtu-Alhdro! Norificltion F.ddrl R.ruhtions (TnE 40, Ptd6l
<br />-Rqut.d
<br />lnra of f{oiincdM
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<br />csliilhd thc tqjqalr.Bul6rio es&djn{ artBro$d$vddc nor,,'rlic.blc lo lhi prcJ..l
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<br />rciiry thr I h.r. @d rh! lpplan ion ai sn. th, llE tb.\. i.fotuhn u .o.d I .sre lo mnd} r nt .ll Cny .d ('oonr'
<br />ord!1m6 dd S[,t. Ij*. Ehnlg ro hiilding .orEMbtr .n lE.t! .dhE ..Irenrtr 6 of ihi3 ci y Ed Counry ro da ur.n in
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<br />Site-Work
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