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APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lite Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab i Floor
<br />Bondinq / Groundinq i UFER
<br />Transformers
<br />Torqueing
<br />J ).-G1 t0Q
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Solfit Rouoh
<br />Ceilings (T-Bar Rouqh)
<br />Meter Release
<br />Rough 7-B-e.JI-5H ndu)
<br />Service Meter I I
<br />FINAL Ll Ur IB aL6raTf
<br />Notes, Remarks, Etc
<br />OWNER OUILDER DELCANATION
<br />I hcrchy nllnnt u (Il. rhy of pcrjury rhnr I ur cr.mpr tn,m rhc CoitkroA Licisc lxw i,tr rhc l',lt,winA rraq (SLr 70.115
<br />l,u\inc\\ trftr l,tur.s\tun C(xlcr Atry Ciry or Counry *h(h r.qufts r Fxnir lo mnsldd. !lr.r. improk, dcmlish or rcnIn y
<br />{nrctrR. nrirn' ils is\urncc, rl$ r.quircs lh. lptlicant ln suchFflnn to filcasiSEd shtenf,nl lhal lror shc i! liensd puhuonl
<br />n, rh( nn,!nn,n\ oI rh Conra.nn i l-i..n*d ljq (Chaflcr 9. ci,mmrcing wirh SEctioh ?(Xt) of Divi\n'n .l of rhc Bulincs and
<br />llolc\{otrs(inn)or rhnr h.or rh. ir u(cmnr rhcr.lio$und rh. hrsis tur rh. dllc8cd cx.n]J,l$n. Any vhldrion .l Sd i6 7r)l I 5 by rny
<br />rppliranr lnrrp.mrir {'l,Jc.a rhc uppli.snr t, rcirillrMhyolnoi nrr. rhln fiE hundEddollxr\(!5({r
<br />-1,
<br />os owmr of rlE prnFny. m ny.q,loyas wnh wa8!s &s tl'il bk conFndion. sill &, d. wk aid dr nrElE k r,
<br />i.rorlxl or orcrcd aor st iS(.7044. SEim$ Md Pror.ssions C.dcr TIE Conlrrcitr r LicctrE Liw dft. tror {,nly ln rn o*mr of
<br />tlE ImFny stE t.ildr d i.FrEr llEEn. .rn rho &a uh wlt himr.lf 6r h.elf or thrcueh hii or h.r own cnploy..i.
<br />[oviicd rhi rkh irymErd! m mt i*s'&J d oltu for q!. lt tnkE, rtr hiildinS or irthEftnr ir sU eithin om ,.{
<br />of coq,l1ion. llr ol,ftr Buil&r w h.EtlEhln.ofpr.vhgthnlEmslEdidmlhildGitrlrlEtlEFtElyfordEnorlIxof
<br />_1. !\ (wE. ot tL F)rEnr. 0m crclusiEly cor r&r hr wirh lkcnEn conrEr6 to @n(Mr rh. Inortr (Ss 70,14. ButimK
<br />rd Air6ir Cdh: T1r Cont&rol s Li..nr h* dB mr rpply ru e o{n.r of ,roFny wth builds or imf,mwr rh.ron.
<br />.nd *ln .u'Elr for rsh pmFlr *nh. Conrdo(tl li.nsd |lUB6r b E Co'ilre1o. i Laue b*)
<br />-l drcxcnu lnds 5d1i
<br />laaf,Els:tqlltEtarlQN
<br />DEII.Af,AIAN
<br />I h.r.bt rliirm !n&r p.mhyorFFryo ol r rolLrin8 d(hErbN:
<br />I hrk rnl sill flinrin r Cdif..k drcotr*nr ro S.lf lGlE fq wqt6 6n!rMio.. as Fovikd fo. by SFrbn l7m or rll.
<br />Litrr C{xL. i,, rli Ffdltl!6 of rlt wl fq ,nth rli Fnn i! i3ru.d
<br />Ih.vc..irrllfri.rlin10.16 lor{En ioninur.B..!s ErllirdhySdhnlrmolrltt tFr Cod.. ror rlr F,rolrrm oa
<br />l,x tr(rl n,*hah'ht lErnir ir tral MyrMkdr o naio. insurrc dntr !,n Fliy numtt. m
<br />-l
<br />c.nify lt r in llE rErro.mN oI rlE *ort ftr *hth lhis Fm i! nqEl I nrll ml .flphy lny Fmn in .ny MB
<br />$ * ro b.t E sbFt b rlE *dl6 orFdbn h*r sf Crlitomir rn *ft rhd if I rlbuld tlrom rubFr ro rh
<br />elt6 oqf,Nri{ pr,{\hnl6t sdbn ]Tm of dr L-hd c.d.. l rtElL fdh*ilh srrplr wnh rhx porisb6..
<br />wALNlNC l;.rtu.. h (e wtrk(\, onlEnqrnn smlc-ir unLrtul. rd lll.ll 3uhFd s cqrhys lo flniml Frls .,n
<br />ch-rl nn.r u,' t,.E h!.nrcd lhousd dolldl l3l ,ldirion ro th. c.{ ol.o,qENlhn. d.n
<br />Sdrr,n tlrr6 nl rtr lihtr C.rL ,tud ril dt**, ?-//6Zi ^*
<br />I lrrhy rmrn udLr Jituhv of p.rluy rh:r I mr [Nn{n un!6 F$i\an ofchlrrd 9 onmmi.8 w h S&1rn 7{X$r ofD,risb.1
<br />*
<br />I h(mt'y rlrirr u,ricr FMltyof lErjury rhar rns. ix r on{Mhn l.ding .3cEr,or rtE FfotuN of rh. wrk fur rtah rhr Ftni n
<br />n$<n (sft l097.civ c )
<br />AIILII]IILDEII.A8AII{IN
<br />! H', lfm undd Fn.lly of Fiury oE ol llE f.lt wing .L.&rl ions
<br />txmlnbn P..oir$AetBto. t{orili.,a.n R&nl R.gahrin! (TnL 40, Pan6)
<br />R.rllird lrrr6 or fi.,r ifk.ri..
<br />-l
<br />c.nify
<br />'hd
<br />rh. redcnl EluLlions Eg.din8 rstE$os Emv.l @ mt !0pltlbL lo lhh prcj.a1
<br />_l cdiry rhlr , hoE Erd rht rprli.rrion &!d srat. rh.r rh. !bov. infomrior is cnNt.IrsE to otr{,ly wirh rI Cnyr l Counry
<br />,i,ltrrtrEr.\ rnl Srnc ljq\ rlntnt ri
<br />uh'v. nPn(k Ed pn,Fd, for nr
<br />,\ppln nl trr,\!rnl si[ h'n
<br />iv.s ofrht Cjly."d Counryro.nrs !Ii'n rrE:2/e
<br />I
<br />ELECTRICAL.INSPECTOR BECORD
<br />of llE BuriBr ]n Pmf6*rE Cod.. rn my ltcn€ k i, frrll foE ud .,Ial.
<br />Sub-Panels
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