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ELECTRICAL.INSPECTOR RECORD
<br />OWNET AUILDER DEITCARATION
<br />I hacb iltm utda pdrty or Fjury $i I a adB tod rl* coitrflod Lad* Ir*' rol rlE f.llosin3 16). (56 70-l I.,
<br />Buiin ad Prof<io. Codc): A.y Cily or Cou.ty *tich rq!n6 . t6nt ro @nntucr. !ha, inFor., &mli!l' or E U oy
<br />nddr., Fbr ro irt h!@.. .t r.quic rh. lpplicer for 3u.h Dd'ni lo 6h . 3,ei.d llloMr rtd h. or ,E i! li@!.d Fislr
<br />ro rl'c Fortn6 of rlr Co rxrd! L(dt d t w (Chrp6 9. Com,ll*irs n'nh Scrion 70m of Oiviti.r I ol rtE BsiB &d
<br />ftlfdioa Co&) d r$d lr nrlE ii adr. d'a6.o &d E hGi3 to,0r.ll.ecd donFbi Anyd,IIio.ofsdbrT0ll,bro,
<br />4plkllll ror. Fnil $bjdrlh. @li.u o. ciii, p hyotmt mE 'hr fiv. bIndd.t llf3 (timl
<br />l. a oMd 6lrlc ti.pdry, or ny .mployG uilh wis6 a rhct oh sordsrioo. will do ttr *dl a{ tlE llidd. ! ml
<br />inla& orofis.d ad nh (S-.?O14, Bci,B Dd Pmf4ioc Cod.: T1Eco rdor3Lhmt wrb6ml+Clyloeowof
<br />rh. FTqry *tr bild d insDrn oEe d *lb &E un xlrt hiMltor lEslf or lEoush hit tr hs otrn 6rph!6
<br />F.\ ij.d tld sh lqrcrsn d. n d -rod.d d olk frr 3.L. l[ rbr6r. r hlitllv isBqEr ir $ld *'ar'n ( ]-olMr,kriE x (rc tlijlda wi! lr\r E hddr of F.rt tlt lE c nE dil d hild or if,pow ttE FoFiy to tlE FlFeof
<br />l. aour6ofth.rnpdly, ecrclBivrlycof,r.dins *nh licdE d .oilrlo6lo .onrnd tlE Fojcd (56 701,4. DG'6
<br />.,rl h.lsinco&'Ih.Co.tdroril.i.o*h*(kBFr.!pllrososnnoaFopdtr*hot{iktorimF|.!6rh66(
<br />d uho colndi rm uh F!j.(r *nh. Conn.(r lroB d rrrlJM to th. Condtr rlioe t,rI
<br />I m.r.nbr untld S(riJn
<br />llrt. Oinfr:
<br />tl Oru{r RS' COnlPEl\SAl IONDfoaail&!
<br />I hd.n\ imrm undd p6nhr ol Frln onc of rh. lolkr$ nr 'klear F6
<br />I h!v. ad wiu niinlrin a Csrilic.tc of CoBar kr s.lalBor. for $ o.16 compcnsl nrn, 6 tmli(H lor by S.dio. I700 nt rhc
<br />t tbr ('od., for th. Faolru.. of th. tro for whi.fi rh. Ff,i a isuel
<br />Iha\..nd urll .m'!'n s0116 6 rc{un.d q( s.nhn l7m orrh. I jtFr Cod.. tor rrE Dnfoll,@. of
<br />io. iEu.R cri, rd rFlb runbc, r.
<br />C ,',',,,'C)E'l'l 'nItu-b
<br />l..niry $d in rh. Flo,Mc of rh. *6rr h, qh.h rhR Fni ir iq.d. I sldl mi mt .t my F$n r my maE
<br />ir Bto taom lutrdl lo lh. uvrd'compcrqio. hBorc i6mi.. ud .3rihal
<br />'f
<br />I!n uBt coNrub<l loll!
<br />sortd' conpNr ion prcvitioro of Sdion I700 ot rh. l,h)r Cod.. I !h.ll. fodhuilh compty wilh lhoe IJFvBioN
<br />$ARNING hhr. ro su. $vt6'Nmp6dr.
<br />.r'l lin6 up lo orc hu.d,.d lhourd d.lh6 (llm
<br />SatFn :1076 or rh. l,b. (-o&, inrcd .d rbrr._v'r
<br />thdJr rtnrm unld |\nih\ ofrsl
<br />.f rft lluen6!nn(l l1rl6,on\(
<br />\\U
<br />*" o7'M.
<br />DTGIASAIIO!
<br />ury lhd I h lis!!.d un& Fo\ tbn oa (bFq g ( rcffiins snh
<br />od.. dd my lt# t m alll fore ml.f[fr'qn
<br />80".,".Mar
<br />CONSTRUCTTON LENDINC AGENCY
<br />I hs*'y amm utrds p..dly of r'6jury lnd lhs. i! . NtrrMlior k dins i{dy fo, $. Ftomd. of ltc *ork for $hkh thit Fni b
<br />iisudj {56. 109?. ( iv c )
<br />Atfutalr_D[ct Aalllax
<br />I hdd1r dm uda F!.lly of Fju'
<br />'-
<br />.m ol llE folLr inB .L(h..1ioN
<br />Ddmldion Pmil}Atb<36 Norifi..li,. F.d6.l R.guLrioB tTirl. {0, Prn6)
<br />R<<rui.d I-drd .l florifi.{bn
<br />I cdif_v lhsr rlE tai.rd r.8uh'ioN r.8idinB 6lBror En.\il,. fr{ qrli.$L ro rht p.oj*t.
<br />I cd'ryrhd I ha\.r.drh6 rpgl*dir. r'd ro mmd' rnh.ll Cn'"..d (-ou.r]
<br />odinlN6 ud Sl'i. Irtr] rcldi,{ k' b(ir rhis Cir y ,nd ( 06r) ro ard
<br />ah.\. morioncd pmp.n' for
<br />APPROVALS DATE ID/SIG.COMMENTS
<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 />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueing
<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 Rouqh)
<br />Meter Release
<br />Rough
<br />Service Meter
<br />FINAL / 2,//i
<br />Notes, Remarks, Etc,/ - /(-/u
<br />t2.17.tu
<br />q
<br />,tppllcrnl or A*dl SlInrlurc
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