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APPROVALS DATE ID/SIG.COMMENTS OWN Ei AUILDER DE1I AR IIOX
<br />I nalty dlm uidd p6.hy of Fr!ry rl'r I m darF tnm rlE ConrrroE LIGE ls for lhc 6lbr.s .aral (Sa ml| 5
<br />tluird ud Pbfdion aod.): Any City or Cou,ny whth r.qliG . ,*mn ro corBlto.t. !h6, imp.ov., &moltt or Ep.t mi
<br />tructEc Fir ro ir! islec.ho rcquG rlE +pl..n for *h F nn to 6h. $r.d lrrmt lhr lE or rlE ir li.6a.d ,oo{r
<br />b r Fo\iric ofllr Codtuci l-kou.d L.w ((ruFa 9, (omdds [nt S..rbn 7000 of Dir'!b. ] of lh. Bcin6 Dd
<br />PmadioN Codc) or thd lt or dE b d.nF lh@fmm &d llE b.rn for dr rlhs.d .r6n$ion A!, liohthn of Selion 701I 5 by rny
<br />.pplier tu r Fnir xbj<r! rlE .rpli.!.r ro . civilpdrty otrcl mE rh! fiv. tuDd &,lLB t!t00)
<br />l. s oen6 of rfi. FoFry. or hy mploy6 with *.sd s lh.t $1. @nFliion. will & lh. w'rt si llE !11u1r b t{
<br />i'rad.d d ofidld b. .L lsc 1x,1, hsiE -d Profdio6 co&: Tlr Coffin r LtoE L& &6 d @ly ro - .$E of
<br />rh. FoFly *tD hritl d inFnrq rEq[ in *b d! i*t urt hj,grf lExlf o. tlmwh hit or lE osr rr+10'6,
<br />Fovid.d ln.r u.h iEFovml! @ Dl inls'.Ld d o6s.d for f,L lf, howe, lh tlildrs or hp.wcd it 5ld wirhh o.c yd
<br />ofoqlain tl,t olrG hiEa will h.E tlE hrda of Fo\iE rL lE or dE did ml hild r rlFDw dr FDFry br tlE FrrG or
<br />l. 6 otrE oarh. FrFrr. D achliEly co rd"u siih li.!N.d GolirIlc ro co'dD{r rlE F$i6r ls( 7O{4. &a!B
<br />.rd hDkmCo& Tic C. r&roi.li.tu kr d6 er q'9ly ro , otrc orFoFr, rho bdli! or inpm\6ltF@n.
<br />lnd who olnfui for u.h pmJ..[ wnh r ( o,rEro(r) li.aMd pE!.,r ro rh. (bnlEdoas Li.M Le]
<br />I m.\dR undq Sdi,(
<br />l).r. O'r.r
<br />uoRl(Fiis ( orrPE\s{ilox
<br />Dl(tirf,Al]q!
<br />I h6.b! rrltfl und6 p6ahv of Fj'tr, oft ofrh. folhsmr deltrdioN
<br />I h.!. rn will roint.b . ('dia..r. oaco,gr lo Sdf-lNE ttr $rl* onFBtrnb.6 Foldcd lor t y Scrio! 17(x) of
<br />'hct hor cod., aor th. pdfoll1'ft. ollh. qo* for $ hkh th. Fmir ir isu.d
<br />I he.nd will n.! .h m*6 coeF6.lion iEdrc. 6 rqucd b, Sctioi lr00 of
<br />rlr wrt for *hrch rts pqht! sqr.d M) &'t6 onFBd.r tr1.llft.(6r ed pola
<br />..* - ZwttoV\-
<br />^-;":;fllp1rciLtr _ i;
<br />rlE L.tu code fd rlE Ffonra. ot
<br />4ltltr _
<br />I cdrily th.l in rlE Ffotuc of fi. wod for wh(h thi! Fdir i. i.ru.( I Jdl nor mploy D, pss.n in &y m@a
<br />s 6 ro hanr $q.d ro rh. errt6 of,rFEriotr !s of C.lif.mi. d *r rllr if I rbuld h<oG ltirr ro dr
<br />hrt6 ompauion FDr irioc of Sdbn 1700 of rh. lrtc C.de , dul. ronhrnh odrry *ith tlb- Fo\ith6
<br />D dphF b dni l FEli6 rnd
<br />cilil abd u! ro oE hui&dl rlbor.d doll6 (ll (hnur6 a ,,.\il.d for ihc
<br />sdbn l07o ofrh.llto"Code inr6d
<br />D..: .gl4lll
<br />l)t.( l,\k\Il()\
<br />I hd.by .nm !i<r, Futy of FJ{, r. rhi I e lt€Ecd urldd Ftiion ot OEpl. e loffiiis [nh S-ibn 7000) ol Dn irhn I
<br />of rlE BBiB.d kotdioB co&. di ny lhde b ii tuI ro.e ddcrar
<br />calirrusrllluJ.EdDllglcElq
<br />I fiolh, rlIm wd.. FMny oa FJury lha lnd t . odn dio. lddirr lsdy tu lh. Ff('ilMcc of 0E h.t tur *l ct thi! Fnt it
<br />ir$.d{s< 1097, Civ c.)
<br />APPLICANT DECI.ANATIOI\
<br />I hd6r' .fin un& FElty of Fjury oE of llE tolbwing dclrdioN
<br />t>mlnD. P@n!-A$.nor Nodrror br FqJ$l R.8uld a'N { I tr!. 40, P.n6)
<br />Rarrn d Ldl6 of llorifi.rbn
<br />I cd ify rnd !h. f.d6.l rqula' ioN tcga'linB 6h6ror ronov.l &. nor Aplicrbl. ro thn prcj..r
<br />lcali$lhilh&.'sdltEedirnnrnnn.thrl,E.bo!.intun n" . cmdl l tsc lo Nnpt *hh tll Cht .d Colnrt
<br />oijm.nc6 sn'l srarc lis Eldi.u Io blrldi.s coBrrucr authtrrz€ Epr.srd 'v6 of rhis ( ny.n!('ounrt h) dl6 uF,n rnc
<br />rt !. ndrNd rropqry for
<br />,\pplicinl or Agsrl Siinrt wf es
<br />&14u
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />Meter Release ItlLlll .z
<br />"/44
<br />( r,
<br />Rough
<br />Service Meter al4t7 u4' @
<br />FINAL klL(t1 rLuafu
<br />Notes, Remarks, Etc
<br />ELECTRICAL.INSPECTOR RECORD
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<br />Factory Wired Unit I I
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