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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER AUII,DER DELCARATION
<br />I hcrcht alfirn !.dcr l]{ulry {,f pcrjory ih I o cictr{,r tmm Inc G,dracroF Lien* lj* for rh. fouowinS r.,$n rs(70]! 5
<br />Buq,n.\s (rl Prot \sion CcLl Any Cny or Counry whkh rcqun.i l Fnir ro $nrtdcr, iXq, rnp(,v., d.fr,lnh or r+atr.ny'
<br />(ructuc. FDr lo ils hxustre. als rqutes lh. {plicatrl ror su(h Fmir to liL o {i8tr.n rlal.mnl rh{ ,E or {t i lic..Bj lunuml
<br />lo rhc pr,visi,nr of tlr ConrEcror's Lacnscd bw lCh0fl.r 9. com'*mini wnh Sc.rion ?(xx, or Divnion I or rlE Bu\i..s lnd
<br />lbfcs\ii'n\ Ci{lc ) or rhlr he or chc is crcmpt llErciion ud lhc blit lhr rhc llLs.d .rcn ri,n Any vi,hrioiors.dinrT0ll thrlny
<br />llrlra for a Frflir subr.{h rh. appl,c.nrroacivilp.ulryorR fl'E rhd fiv. hu.drEd d.lldr 1150,
<br />-l-
<br />ar osrcr of Ih€ pmFny. or my cmploye\ *ith wl8cs us Ih.n s'[ $ryEnvl bn. will &, llE *mt .tn rh. dnttft a rur
<br />inr. i.d or oft rcd n, eb tS€ 7044. Bdsirsr and PrDacsri.,ns C{n : Th. A,nrBioi\ l-iccns L.* dms B +tly h m o*ffi ot
<br />rh. F)Isy vhl turldr m irF.6 rlE@n. rid slrr &B uh q,il hift.lf or hrelf or rhmuah hi\ o. h.r .*n .tri'l'y.cr.
<br />pk'vidcn rhnr skh inl'o\m semr inr.ii.d or ofr6d fM s|.li hrklv, rtE h{iEina or inln{km.r k sU sihnor tru
<br />or.\,rl)ILri,r rlE O*ft' BliHs $ill haE rh h.rdflofl'r,liry rh.r h.or rlE dil , tliU o' i'Ilk,E rhr I[Idy fd ilr InqrE o(
<br />l. ,\ .stur of rlf, F,Fnt. m .r.losiwly cudrkrin8 with ltcn{d .onhdou h d,n{tur rh. th,Fi r Sc. 7(X-1. Bu{F(
<br />rd h!6{\in Cdc Th. Conrdor s LKcnr tjw d*s frn {Tly ro !n or rcr of pro,{ny *ho hrrdr or rmpov$ rhss'n.
<br />nnd slx, conrtrt\ fq skh F,jrt\ *nh r G)delonn lkcn.n purlBr t, rlr C-onrdoi\ li.n{ lr*,
<br />I a .kipr und.r S.{ri
<br />Ilaaf,};&r_rauflia5al1ari
<br />DEI;LA8d.II!'!i
<br />I h.rrhr rfiirn, unJcr I'cruiry ol pcrju4 om ol rnc nnl'"Dg d.rurtrii'n\
<br />I ht\r !d *iU minuin. C.niaknc of C6d*nr to SclilFuE ,or srt6 onlltndin. ri F,viLJ ror h, sdi!..r7(tl or rlE
<br />L.txr Cod.. Id llE F.f(imE or llE Ent fd *hih
<br />'rE F,rri' ir Nud
<br />_l h,rc rid *ill minrrin *orlcF s@cnr.rion inqnr.. .r Equrcd by t<rirn .r7m or rlt lrr,or c.n . fi, UE |Erfolrier ot
<br />ft *,r ror shi.h lhn Fmn is iqE My$ort6 oqEn3.lioo i6ulu!.dir dn lblty nuolF e
<br />.*, \l^,1 Vu "(t Cc.r \ r-\9
<br />B ru trr,^:t-o l:rr o1-\ . \. .'r."
<br />I (dirr rh,r in rlE FrformE otrtE *o* tu *hth iht Frm( il EsEd- I rhall dn.'r+by rny Fmn r r.y .sm
<br />o .rro h.om iubid ro tlE r'nt6'6rp.ndion Ls. of Crhfomi.. lid r8ft rh, if I rlhuld lf,<om slFr to rlE
<br />u)rt6' onFnsrbn pmvtbB of Sdion lr(I) ol E tjllx a'{ld , I s,rll. ldhrih stq,ly rnh rhc pmvnhnr
<br />WARNI|\C l;ailurc to suc so 6'mmrEnsrion oEnac r\ unhrtul. !d rh.ll \unFd !n n{,b}n lo (]mnn Fuli\ .,n
<br />civil firc\ up
<br />'o
<br />om hudrcd thouEnd &lles (slur.uu.
<br />'n ,!nh. b tll 'f.or{x.urio.- d.NE.( rr provd.d rff rlE
<br />Sdii,n tl)76of rh.litrtrCflL inrdc( rrl lrmv'rli{r
<br />"t{AR 18 ?0ls LM }LlL!t\l-ts-!!L!lB
<br />DICIIXAItr]N
<br />I h.r.t y offrm uid.r FMxy ol FrFry rh8l I m lirn d u,*, F.vir.n of ChrFd 9 (mlnmEir8 *nh S.dion ?ul)r of Divi{i'n l
<br />or rh. Bt\iEr\.d trDrcari,m Cde. dd dy liccnE is in tull are un cfisr
<br />t7.
<br />,"{4AP +Ol (l nl Vo4-.-.-.
<br />t!)!ttlatcll1lNtll|llBc.AliEdcr.
<br />I h.Eby .mrfl und.r FMxy of Frjury d, rlE. is . mnqMhn kninS .8.trt for fi. Frfmmx. ol rtE w.rk tu uhth rhn Frmr ir
<br />i\$crl ts$ .lm7.cir c )
<br />AlfurAlflllict dtAUr.N
<br />I lfl{ry rlim undcr prnllry of IErjury ore of rhc folbwing d..lulrii'a\
<br />lbrnirn'nP.rnrih AshcsrosNolificalion lidcnl Rc3ulurion\llirlctl). l'trd6)
<br />-kcquncd
<br />l.ncr.f Norilicdion
<br />I ccnilirhri rhcfcdcralrrgulnri(,.! dg[din8 r\ti{o\rnmhlrrc nor rtnli.$lc b rhi\ pb]..r
<br />Y4-iry,r*' r rr* ,..,u ,r'F {flf,J, ntr .nd {J,c,hl, rh. rt$vc nhnn i,n,$.odccr I isR!r,'.omnlywirhurl( ,r (hunry
<br />ld,0n.c\trrdsrdchs(mlarnsr.burldrnpc.nnrurmn.a hcrchy iulhoriz rc0cscnrdivcs oirhir (!ry rnn (i nryn,cnrcruFrrh.
<br />3lx!!r nf, rtrnul I(,|rnt lnr nnt .rn,i
<br />,\Drtifftrr trr ,\Fnrsirnrl,,n 1)'
<br />1., fl f\ 4'rr1
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Satety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bondinq / Groundino / UFEFI
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Solfit Rouoh
<br />Ceilings (T-Bar Rouoh)
<br />Meter Release
<br />Rough BtB-r *-A 4n */,s 9,W,It';<:v-$(a
<br />Service \ileter
<br />FINAL l,4tur J+j( <l tlq t.Da UE'il*"6
<br />Notes Remarks, Etc
<br />\(r1q o,.1
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