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ELECTRICAL.INSPECTOR RECOBD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER AUILDER DEI-CATATION
<br />I hcreby rmrn u.dfi rtuliy 6t p.rjrr, rhrl I m cicnfl rn,m rhc Conroct'F Lkcne l,u for rlE (,11,*hE E,$n ls(.7011.t
<br />gusin.s ! ProL$hn ( nt I Any Cty or Cou.ry *hah r.quiBr ! Fnir lo orlnEl, rhs- itr!,tuv.- d.mlnh ry qEn sy
<br />1tfu, Fitr h n! i(um.. .lto Erllift dr .ppl-mr ld rkh Frtu b nh r \'8rn {{.ad in! tt o. rlE i! ltoin F!s!r
<br />ro rtE FrvNanr of rlE conr*har l,Ensi t ! (clu,'rq 9. conmNins *irh s<ri)n ?(ID ol oivirhn :l .f rlE ltlliFrs rn
<br />Pmrcsirnr C l. ) or th.! lr or rtE t .rc6fl rlEElren rnd rh. hri. f.r rlE rlk8cd .r.n{ri,n. Any vinli,n ol Sdr ir ?O.l L5 by r.y
<br />lnrlicanr r(, ! Fmir ruhJ..k 'h. 0mli.dr b , civil ll.tuhy of not m'rc Inai fivc hlndrcd dnllar ( t5(U
<br />l. ai owE orrlr rrFny, d nycr"h)E s *irh eis.r.( rlEn r'! d"qEndhtr * d, rlE s(t rn rlt rnlrE ii nn
<br />i.I&d .fi.Ed r qL rsd 70.!t, BfiiFr rrd Fnf6rirm C.<tc TIE Q'drsroar lire L!* &E! r{ {rly ro s orE.t
<br />r,r Fr{Eny *ho hriBr m ill[reE dr6n. rd *}n drB u_h Hrt hin(lr or hscll o rhmuah hi d lF o*n .ri'hyc.l.
<br />lrovd.n rhlr ruch inpn)mrns m mr i.r.nhd r ofi.id nr sb ll h*ei dE l iHrnS or inprovcnEnr k sld wthin ok ,r*
<br />orLbqthrb'l r,t O*Er Buildcr *ill hlt llE hidcn of trrin8 rh8l lf, or tlE 'jij ml hiill ff iqmt! th. tn,Fnt ftr tlr l,uryRof
<br />_1. .r o*rcr rf rh. F,Fnr. .m.r.hriv.ly .odrarin3 * h linrd odi(n6 tu mdtur rtE pn'Fl (SN-. 1X4. A6ilK\
<br />u'd hftr\inc('dc:Ttu Co.r.rlori Liccn$ lr* rB n, !!plyto mn*n.rofrop(nyDh,I'uiBror imnmvcs rh.rd'o.ond who..nituhrr,rucht6F.r\wiihsG,n'@kn(,li(n€dpurum!brtEContrElor\l-tcn$l]*)
<br />_l m .rnlpr uid.r seri _
<br />Drt.r OrR.
<br />usBal;&t:.LaNu;li5au0N
<br />uE(I, x.du9B
<br />I,rrchl rlrn r uddtr F--ntrlrr or Fyrxry or or rh. rnlk,Btr,F JNltrrrrinn
<br />I htr\ c dl *,ll tuinra'n r ('.n,rrak ol (i,n*nr ro Scl, ln.ur i, $orl.^ $qrn$r i)n, ,r F)fid.J !{n hy Sfrr nn .r7(ll or rh.
<br />tithr Grlc, tur rh. Fdormtuc ofrtc *o,k r whi.h llt',rrmn n nrucn
<br />_l h.E.trl *ill mm.in *0lt.6 otrFn{,bf, insurft.. rr rquidl hy Sdrih JnD orrh. Lb.r Cdh. for llE Frfuffi of
<br />llE strt fm ehrh lhn Fnn i! iser.d. M, rdr6 onFdbn in.eN (fir Jd Fiat Nmh.r c
<br />.,"".G.rargt trtla,+lP<--:Ss-
<br />r.n,., N,,,,,t., 16aolLl33{71 I lnL*
<br />l..nnyrh:rinrlEFfnrm..frh.$o*fff*iihrhillEmiinnsuJ.lAEll r.qiby inyFK,. n6rmn'E
<br />$ N |o lRn'E subj.rr k,
<br />'lE
<br />mrls( Nn{Ensr k'n h*r ol (-!lilomi{. rn, .8N
<br />'hd
<br />rr I {tnlld iEcom {hFl ro l,r
<br />to*crr conEn\uthn nn,vi\n'ns ofScdi('o.l700ofrhc uhtr Cflic.lrhxll. lnnhwilh !on{:ly *irhrh'r fln'vhions..
<br />WAINING !ilu* ir' sor rvicr' omrEndi)n NwEa. i unLwtuL un \nru \uttFr e dr'loF ro dini.d Frli6.d.Ml fiEr ot t, oE huBlEd !tr!s,n &llr (SlOo.IrI},. in .ddnhn
<br />'o
<br />rlE cN of (a'nFBltion. &tus.t rs Imritn ,or llE
<br />Sari,tr.11176olrh. L.trr C'{.. inr.6.rn dt,my. &!r-;",,;l*l,ii -- ;-"' =<,"ffi*-I lEEhy.mrfl u.dr FMtryrrFrjur, 'h!! I .'n liftr\.d lndd |'nrnbn of(-t,prr 9 ((,nmmi.! lirh sdb.7(ID) orD'v,rmn ]
<br />ot rh. Buridss ud PFrcsioni CDd..3d my liccns n in tullfoNan,.rfd
<br />6
<br />u*" Slu.ltb
<br />reetq4-
<br />IIIBSIf,ISIOAJ.EIDIII.AGEBCT
<br />I h.r.t, rflnm !'id tmxy ol FII, rhi l,E n .6nii!.ri,. lnrlit r$Ny fo. rh Fnd'lrm of rlE w,t for lnrh rhir trni ir
<br />a.rxcd (s- 109'r. civ c I
<br />lrdcrr \Eft
<br />Gnd.rt tu1d..((
<br />AI2LIIAILDECIJSAIIQN
<br />lH'yotrtrnund.r p.n0lly ol p.iiury om ofrnc followinS ddlualionr:
<br />Dcmlition PrmnsA.bcnor Mtiff,.lb. k nl R.!!Lri,nrlTirk {0. Pd6,
<br />-RcquiEn
<br />l.ncr ol N{,f.rrin
<br />I ccn'rrrhnrrhc lidrrxltuI lnri.n\ rakli"! n\bc{,a 'fnxnxlrrr nrrrtl,l(r6lc r) iha t)n'rcr
<br />-l
<br />.srif, lh, I IEE rc.d rhir rrpli1lion !n {x. thd rlE rh,v. i.forturr r cof,d I !88 lo o'qiy *nh rll Ciry . Counl,
<br />ddrN! !.d Srrr. t wt ElrrB
<br />'o
<br />tlildin! conMi)r rn hd$y.dhtrt EFc dilcrol'hi!Cny.rnCouryro..rsuFlorlI
<br />!t!,E mnri,mttn{rnyfr
<br />tt)t)lnrtrr itr \[rnr \ixntrru = \e/G
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monumenl)
<br />Lile Safety /Low Voltaqe
<br />Fire Alarm / Dam pers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Groundino / UFER
<br />Translormers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Roush)
<br />Ceilings (Hard & Soflit Rouoh
<br />Ceilings (T-Bar Rouoh)
<br />Meter Belease
<br />/1
<br />Rouqh 3-21-t{l ltltil
<br />Service Meter v
<br />FINAL I ?h*/t8 b/.v)M - /rtz-
<br />Notes, Remarks, Etc.
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