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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE tD/stG.COMMENTS OWNFI BUILDGT DEI-{I f,ATION
<br />I hr.ny dllEn und.r tkmty (, Frrory ih.r I d .icq n$n rlE Co.rtrrm Lic.nr uw for E rolh*ins E $. tS..7U3l 5
<br />Buiimrt .rn Prefcsrnn Cd.): Any Cily or Coudy *hah r.itui(\ r Fnir ro $h<ntl, rltd. niorov.. d.tulirh or EFn uy
<br />nare, Fi, r(, ils nrls.. rl$ EquiB rlE +t'lad for *h Fd to liL . si8Fd rr.r.mnr rhr lr or rlE k li(m{d ,rulrlM
<br />nr lh. fmlisionr or rh C.nl .r"s Li..nsd tjw (Chlprcr 9. Coturmi.! *irh Sc.tion?(I[ of Oirisbn ] offic aurin.$ lnd
<br />Prnt-liont Cdd or i,Dt lE(.lE i(.r.ng rlEflmm !d rtE hlii rr, rtE dk8.n.nnprion Ary vioLrb.ofsdbnr0ll5tyry
<br />.Pplkrd roi r |idn $bj6lr lh. anrlicrnr ro r civ il F..ny or mt frft
<br />'ho
<br />fiv. hundr.d dolhr (ss(n).
<br />-1.
<br />.r owE ol E FoFny. n my .'it oF. rirh $r!d { rlEn $t otrtduirn. n[ &, rlE rdl rn ft !.ntie ir ot
<br />inrin dl or o,tsd ro sE (Ss 7044, auriElr Md Pf,rf.sshnr Cod.: Th. Conth.lm r Ltcnk Ls dE mr {rply to .n o*mr of
<br />lrr ,'sFny rhr tlildr dr i4mB rlEo! .,n *th &E rrt Btrl hirer or h.elr.. ttFurh hn n h.r oEn.r,I,hrs.
<br />trc!'d.d rhlr.th ir{rwdre d -r.rbd dolk td Et ll lr,M, rlE tturldlg q rqrerEd i nh * tinm)u
<br />nfcolrTLtioG llE OwRr Euildd wil hlE th hrd.n ofFrvhg rhdt ri or !l'e dit Dr trild or i,r{,mr rh. rFpqty for tlt FrFor of
<br />-1.
<br />or oqmr oltlF ln Fny, an.kluriv.ly $dk'ins *nt k.nEn ontrton ro con(tud tlE rror< (Sa 7(x4- BBirs.d l\,tsir Co& TlE Co.lrlq! La.nr t r dH m' .{?ly ro r o*H or l,sFny wlr) bo a! d imrroB th.m..lnd who $.rdi r sch F.i<r *nh. C6 arnt) ltcn{d llE@r ro rlE Coirrxloii Lt re L.,)
<br />_l m crcnFl uti.r Sdion-
<br />D.l. O*m.
<br />l1(tRKrf\, ( olrPi\s1I{rN
<br />IEqI.AB{IIO!
<br />I lErch, rlilnn unds Fehy ol Fjury om or rh. rolklr ins iE\hd i,nt
<br />Ihov..rd*illnuinrind(-.dift{.ofCon{ lo Sclf- lnrurc tn workcG c!ryEnqrbn, !\ pmvidcd lor hy Sstif 1700 ol ltF
<br />Utrr ( dc. f{r llE Ffiil'B[r of tli q,t lU rti.h rrr pdmn 6 nud
<br />_, hlv. . l uill n!nrr'. sorkcn h,mlEnrrrhtr r3urrE., &r Equirn ty Scr ion l7(n of rlr Llhr Cod.. fo. llE FrtilllrBr of
<br />llE srr rG rh.hrb Ftu B !N.d. My *nrl6' mtr+.dnr illrl,re (lm !n pnliy Nrrl.l E
<br />,*, \ A-nzn un ZqlLh
<br />e.r,.yr.r,.*, \ WC Sa460r3of ,**. l/ '//O
<br />-lMily'hd
<br />in rh Fnormeor EsorttdwhrhrhiFmiri!!sEd-trhallot.npt',u,FmninuytuF
<br />$ as ro ttam $hirr ro rh. *MlGr $,p.nerbn bw! of Ciliromi.. rrd rtN rhd il I *suld b..6tr flbirr to ltr
<br />fr,rtsi oritENlbn FovitirN of Sdh lru) ol rlr brr c.d.. I rldL rdh*ih 6npl, *lh rhot FovtidB.
<br />WARNING: riil@ t, ila k lnr'@!'ltclrit o\Hr. n urLrtul. nn ih.ll {birl u .i{'bF l.' ainind Frlii .d(Ml 6F. uD ro oE hundl.d rhou{d doll[t t!mulr,. r d !n ro rtE c.rl nl$cnsrnn. d.Eci rr mvd.d lm rtE
<br />sdno. rl}?6 or rh. lrtu c.d. .r-a '.a rti*. r- Z,/ , - -
<br />^--f,/:c/to ^""4,2frr<tZ-z-, rrtFNsra! (Inraracron
<br />DECI Ae^Tl(rlt
<br />I lEE-riy .ruh unds F ny.fFrjury lhll ! !m lirnsd u.dd Fvira.n orch9ld 9 (d'i1trftar8 w h Sdb. 70Cn) or D'virbn l
<br />of rlE BuriBr.,n Ptufc$hN C6&, rn n, l.oE it in tull roN !n cfld
<br />c4{o'a/o<Pola '^'
<br />7 7rb4A-
<br />gNslau{Jltl!'.LEduNli-AtiluqI
<br />I tE,trl, rrm !r'd( Fulyof F,rurt rh.r rhs. is. s'NnEiio. !'nin3.Bctry tor rlr FrfdIIF orrlE rst fo. whth rhn Ftu i.
<br />istld (sa ](rr, civ c.).
<br />APPLICANT DFCI {&IN(}
<br />I hftrry .trm undcr Fnrlry or pcrrury or of th. folhwi.S &rlrnr ionr
<br />t).mhi,. F6nnr.Art6ts t*hfrdii. turd R.BrLrbN tTirk .10, Prn6r
<br />_RcquiEd l.n.r or &iirnrim
<br />I rrdifyrhrrrh.lrturrl 3ulnri,,tr\ r3din3 r\tr\lo\rctrrtrrlrrc 0ur.pfl.r$lc n, rhi\ prt*.r
<br />I ccnityrhlr lhalt rdrhn rttt.arrn ani {ii.rhrr rhc ah'v. ini(nnErion i\corel I lgre n,comnly *irh !llCity!nd Coutrry
<br />rhi Cily lnd Counlyl,,.nls uFr rlr!n ltEby lurhortu rrftcnr.titc Dl
<br />lz.z-
<br />Q+rt<-
<br />'idiErrr\ rl srrtc I-'*iftL,ritrr rrhdiltlm3.{{n tihrh,L rn,x,mr ,!rop.nr nn ,n,r.lin"N\" r,
<br />n,Orr,-,", ^* rrrr*t"J a&7
<br />P€mir( Dm.,prtnt,, Z t Lr,'1
<br />z/z/to
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lile Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bo nding/Grounding/UFER
<br />Transformers
<br />Torqueing
<br />Air Conditioners
<br />Boof Top Equipment
<br />Factory Wired Unit
<br />Walls Co nduit)
<br />Walls Ro h
<br />Ceilings (Hard & Sollit Rouoh
<br />Ceilings (T-Bar Rouoh)
<br />Meter Release
<br />Rough
<br />Service Meter
<br />Notes, Flemarks Etc
<br />Site-Work
<br />Sub-Panels
<br />FINAL
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