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ELECTRICAL.INSPECTOR RECOHD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNEN IUILDEX DELCATATft)N
<br />I lrrcb, trrm und6 pcnelry ot Fj!ry thd I m .x.npt fn'm ltE Conln 16 Lirna lr* ror rlE folL,rin! Er$n ( S.{ 70l l 5
<br />Busin.i\ {t! Pot r\ion c,rL): Any Cil} or Counly etrh rcaunB ' Fni ro NNffl. rhr. iqmE. d.rclilh or rct{n uy
<br />(Mruq Fitr r. nr is.ue.. !l$ rquic! rL .plltEhr rnr rh Fmr ir, nh. ii8rn dffinl lhrl lE or rlE k lirtrqi Fu{rd
<br />io rlE pmdrl,nr of rh. Conrtuors Li..nsn t,* (CtlF.r 9, ConEmi.s *irh Seri,.?fiI) of Divnhn ] of llE Bu.in.er md
<br />Pmra$ionr C.d., rr rhrr h. or lh. is .rcq ln Efrcn !d rlr lErir tor rL rll*.d .r.nPhn. Ary vbhli,n or s.dill ?0:t I 5 by .ny
<br />+tli.! ror { Frmir suhrcch rlE rpl'li.!.r i6 ! .ivil p.n!tr, or n mE rh.r fir. hundEd &llur (l5m)
<br />{4? o*r, orrrE I'lFny. nr my.q oF. rnh w.rs.r trEr $k !Tmp.Nri,n. siMo rlE slr !d rlr {nEe t br
<br />inrcdql oroficrd rr, sh Isd.?od4, Bosmsr!d Profa.iont Cd.: Tlc Co .dmsLirn*L.wdr!mr.polyb,.owmtor
<br />rhc J,nIEny wrh trirh or in{r.B rlr@ nd Bno da en sd hireror lERlaor ll$!3h hir d lE o*n.,rpLrrcr,
<br />prcliil.d rh.! sNrr irrlEEftdr e br in.ri.d doiGnd fdeh Il hrw.llE huiUiru s lrFEftlI i! sll *nhit orc Fs
<br />otm.+ha,n. rlE ow6 BriBcr wi[ h.w rh. hel.iorF in! r lE d rlE dil d{ hlild d inImE tlE FDcrry fDr rt ,,urfb* or
<br />L rs owrr of rh. F Fn y. m ..lorikly .odBrint wnh lk.nqd co, r.clo^ lo con{tud ih. tn,Fr l S(. 704{, Brrixs
<br />{n fiatsir C.dc TIE Conltror'\ l-i..n{ ti* der ft {t'it b .. oqrcr or pmFny uno bunds or i,{,mrcr lh.Nn.
<br />anrl *ts (d r rd ikh F,irls vilh r CodBkrds) li(cnsn ruN.,rl x, rh. Contdd s t-iHk trr)
<br />rn.\r ({ u"!.r S.rrh{'
<br />. slz\t",
<br />I h.rhy rft,mund.r FnlhyorFrury uE olrlE folr,ninf
<br />-l
<br />h.w ]n *ill minr.n' r C.nif(d. 6r ci,tr*nr ki s.lr.ln$R for !.rlsr' cnmrEnrdio., ( Fi,vided ror by Scrion 17fi) or lE
<br />llhd Co&, ffl
<br />'h. Fnlm of rlt 6t fir whth rrr tEtu, ir ilsu.d
<br />_l h!\r .nd *ill ruinrrin *ortrr' .o.r{Ersrl,n insurrmc. ss rcr|uird hy Scrrion I7GJ of !h. titxtr G)d.. fo. rlt Ff(llr1mr of
<br />rlE f,oll nr *hat lnii Fmir i3 irsud My uort6 comrEn.alron in\uram. cathr arn F,la, rumts e
<br />Vlficnily rl in rc narormx. ol rh. *oik lor *'hth rhi{ Fnii n i\\kt. I sh.ll mt cnplo, rr rErqi i6 my Mncr
<br />v, N (' bc$ft runFr h rlE kd6'onqEneri,n lt*i nrc.!ir{'mi{ rd +N rh.l il I {lhuu lBom \ubjflr h t
<br />mrt6' ($mF.Nr io. pmvirioB of Sr<rir .17{t) or rE l,h, CdL. I rElL lrlhrilh tonr0ly wiln |trs lnrviiionr
<br />WARNINC fdlur t. rtrE workcn .onlE.errn d,rc,l8c ir uL*ful lnd \trrl irbFr d cir?hFr ro ai'dn l FsLi.r rnd
<br />.ivil fi.o ry b oft hutrdird thruend dollm (slfl,Jx[r. in.dlnh. ro rlE od of (onFNrion. d.m8c! !s ptuvid.d fttr rh.
<br />S(in,h 1076 ol rh. trh, C.d.. lnrdr .rd dtrEv r fes.
<br />'-., - 3\u- \ tB aDp,ion,, )4 )
<br />I hrhyrmrrntrntld t'.Elly ol pcrrury rhlr L li.ctr{n und.r Jmr 'mftNin8 rnh SL{r,n 7ftx)] oll)ririrn.l
<br />or rh. EuaEs lnl Ptut i(bnr Cln.. !n ny li.nr n in full nrc drl .ll.tr
<br />(;oBl[81]cur}il!lDl!lil{iEllr
<br />I hEny rlfrm ldcr F lry or F.rrry rhd Urr. it . rnn{Mrioh Ldlin! t8cmy for rlE Frt(trrom. ofulE wtrt for *'hEh lhn Fna it
<br />isrkil rsd 109?. cit c l
<br />ATELTCAII.IEq.A8AIII!
<br />I hod'y lfrm uixr.r Fmlly ol tE rury oE of rhc louosing d.{lrhl6ns
<br />D.d'lirioo P.,6 sAslEnor t{diaE.rion trd.El RquLlir! ('l'ilk.ro, Pan6)
<br />-R.q!iEd
<br />Lrrrd .r Noliiidrx
<br />I6rrylh, r f.d.r.l EllhlioN rcasdina aih.dor tamvd rc .or q,fltobL l,, lhi3 I'nj.cr
<br />t&z.dir,rh,I h c rcld rhit 'ppli.srion ul {clc lhd rh. uh,v. ion'mrion n cotu I slG to mq y {nh rll Cn, d Colnry
<br />odiEEc! xrd srrt. l,sr Elrin3 ro huilding cun(Ndion. md ncEty ,urtpri& rtrc{dritd o, rh,r Cily nn Co!.ry ro ..ra u!'n rlE
<br />.trtrr Ntrri'md F,pcfly nr ir\prcrk,nrxtskj
<br />Appli..nl or Ag.nl Sla.rluF
<br />P.mx*mn.rpri r: *P EL-QItNT']
<br />.317-l W,
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lire Satety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bondino / Groundino / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouoh)
<br />Ceilinos (Hard & Sollit Rouqh
<br />Ceilings (T-Bar Rough)
<br />lvleter Release
<br />I 1 . .'ll.I
<br />Rough UVtVt ttrP,'tAu
<br />I
<br />FINAL (\cJ?-
<br />Notes, Remarks, Etc I
<br />-t
<br />)>
<br />Service lvleter
<br />t4q 'to,
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