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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<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 / Dam pers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Groundinq / UFER
<br />Transformers
<br />To rquerng
<br />Sub-Panels
<br />Roof To p Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough V,(L(I
<br />Service Meter /-I
<br />FINAL v -lE -\ /t,
<br />Notes, Remarks, Etc. _t tL t1 :1flVrt4) 10 l-to/]^,t tl
<br />O\TNER BIJILDEf, Dfl-cARAI'ION
<br />I hq.l, lrm udn pqut, of Filry ti I m 6.rF( nod rlE cb.r.-t6 Lt!@ tis 6r .fouowrglEli(s670!l5,
<br />Aard od Pror6ion ( od.)r
<br />^try
<br />Cny or Co{ty s'tih i.qlirq r Ftu 'o
<br />ordtu.r. .ns. inForq &El!h or r4.n ay,
<br />3ro.1@ pru to il3 i!6cq .l$ rcqciB rh. 4plic&r for tuch Fmn lo fi|. ! 3i8n d ndcl6r rhld lE or 3t'. i liodr.d punlmt
<br />to lh. Fovnid 6f tlE Cotrrrld ! Lko!.d L.w (CtudE 9, CoIj,lEinS wtt Sdirn ,0m of Divirio. ! o( it BGind &d ,
<br />PtDEsbN Cod.) or rtn lt n iE a dartr rlE.6oE ad rlE t-i] for rlE nb.d 6orFrn. Aly rhldE! ol Sdrbn 701 Lt lD u!
<br />lpplicrit lor a Fiir eubjcr th. rpplica ro !civil psllyofmr not.$6 fiv. hundr.d doll6 {1100)
<br />l, 6 NF of rlE FDFry, d m! oplolG wnh w.86 ! r,ri $L ompsE io.. *ill (l' llE *st id dE rdrG ! hr
<br />,n.id.d or offd.d tor sk (56.7044, B6ilB dd ProfaioN Co&: IIE Co r-ld . Lrdg t s <b6 ({ {plr ro E osffi.f
<br />lh. pr$p61y vho t!il& or irq.6 rh.!tr d *lb d6 rdr m him.rdn Blf or lhmBh hi! or h( om anphyB.
<br />Fovd.d rh,r sh n!q!EEr! c d ndd.d 6 ofisld 6. 5]. lf. ho*6!, tlE h,ildi{ m itr+wEr n hld {irhi ft !d
<br />ofcoraLi& rll O*E &rld- will llw tlE hd6 ofFsq { lrortEdrl mr trdd r rFlr dE FnFrr tu llEF,FEof
<br />l. . orG of rlE FoFiy. u dctu!'Eb.o'rErilts *nfi licdE d 6'rr-lm !o codtuct rli Folet (s< 7O{-1. h6iB
<br />.,i Prsftsi6 co&: Th. Coddoir Licd.lr* &6 mr @ly ro d o*n6 of FoFl, who boildt or inprot6lh66n.
<br />!trd sho conrrxl3 for ilch F$jdi wnt r Conrrdo(r) lhar.d poller ro rh.Cofi.!.1oi! Lic.e lrw)
<br />I m dopl undq Sclsn B &PC forrhnlarn
<br />l).re Ornu
<br />t!!aLLB::1!llltlt ula!D};q.r&ulor
<br />lhd.hr rnn i trnd.r porlr! orlx1]r\ on.olrh( tull,\\tr'! rlslrJrn)ns
<br />Int ed }ill Didrn. cdifdcofcongr ro S.lf-l6a td $.rt4'@oFdrn. a FliLd 6r bt Sdbn l?m orth.
<br />Labo. Co&. ftr rhc pcfotu. ol $. ert lor $tkh rk pqnh it isu.d.
<br />dha.. "ill mdri hrt ,.q!@d bysdbn l7m of ln. t t'or Code fqllE Fn]llrl&t of
<br />lh. *ut for vti.h thir Fnn ir i$.d My wdld onFsion trBrlE ffiir rn Flty nut- e
<br />\ / (l-,
<br />po,,()NumrE \p1A5tOOA31$-07,,,.- GllillY
<br />I diry lh.' in llE Ffolrm oiilE *od f( shih t[! Fmil ir i$.4 I Jdl d dlpro, e, F$n in uy tffi
<br />s a b baor iluer ro tlE wr6 on{du.iotr lN! of Cdifomi." r,'d.sE rhe ill .lbuld bqor $tirl ro dE
<br />wort6' enp6!.l6n 9rornioc of Scl ion 1700 of rhc l.tor Codq I JEtl. ronhrirh .on ,ly wnh rho. p.nlbioB
<br />nAl.NlNc: F.ilu. to gu. {rrt6 FmFldirn corrr*. a unL$tu|. .nd sl'd! iubrd a mploys lo simiEl FEbB uj
<br />civil nn.s up ro.n. hun&.d lfiousd dolla (Sl00.0(xr).[n. d.mg.! .s lroviicd for llE
<br />(ine in'qd ei dlorEy s f6
<br />z
<br />DICIAEADSB
<br />I hsttry !,In un& Fdy of Frury rhd I d I'cqE d u!x,a FovitEn of Ol+rd I ($n.B4 *ih S.db. 7m) ol Dn isrn !
<br />of rh. BNindr md Prct6rioB Co&. !d ny li.@ ir in tull fore od .il*t.
<br />Li.m. CLs: B
<br />^,, vp'!tt_
<br />71 7{
<br />I hdrtly.rm urla Frry of Fiuy lhr dEr L r ddMb. lddlB rSsy tu lh. FfGlE. of llE wt tu rnth lhi! Fta a
<br />isld (Sc. !097, Cir. C.).
<br />AIIII(AtrLDI(]JAAIIAN
<br />I h.d'y riin !.& p6,hy ot Fj!r) oE of l,E folloq'in3 rkcllnhN
<br />D.nol on PmiB-Asbcrlo! Notificltion F.d6.l R.aul.lions(Tnl.40. Pd6)
<br />R.rtur.d 1.116 ol Noi'fri.n
<br />rono\al . tr.r rpt'l'(,blcb rhs prerd
<br />.t * inrorrnhn ir (rrEl I +r lo mndy snh rll Cny .nd ( ounry
<br />arlhdrix r.lr6ddi!6 oarhi! ( nrrd Cou.ryio dr6 up.n rtE
<br />rt{rc .mrion.d rh)pdly fo.
<br />,\pplion( or AB6l SlEMtur.
<br />nc*irc"r.rru.rr, D
<br />-,. ofzlfD
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<br />I I
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<br />Air Conditioners I
<br />I I
<br />I
<br />ICeilings (Hat{& Soffit Rough I
<br />t.
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