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ELECTRICAL.INSPECTOR RECORD
<br />OWNER BUILDET DEI{ARATION
<br />I hd.by llIm lida Fnrny of ,Gtlry ll'r I rr dd!$ nm dE Cofiidm'Ltr Le f.f, tb. followiB lei (Sd.rorl.t
<br />BuiB rd Proftsu Co&) Any Ct) or Cdny *tri Eqni6 . Fmi lo Nrrrkt dla, ihFovc, d@lilh or Ep.n dy -
<br />.ttucru.. rbr lo iri is,e., .h. r.qriE rhc .ppli(er for $.h Fnn ro 6L r rgf,.d rtdd.ir rhn lE o, .lE i li.q!.d l,uRd't
<br />to rh. EovirioE ol rlE Conr*id! l.i.o!.d k* (cllqtd 9, Co@irg ritt Scrbn 7000 of Divirbn I of llt ttaind dl
<br />lrntcsbB Co&) or rhd lrddE b q.npl rhd.to6 !d l,E b..ilfor lh. Jkg.d crdplio. Any vioLlion ots.nbn'7011.J b.ny
<br />.ptlk! lu ! Fni lubjeB ifi. +plic.nl lo . civil F.!ty oa mr mE lh& fiv. hud<i.d d.ll6 {$m)
<br />l, 6 o$G oftu Fop.iq,, or m, arylorG wilh *.t6 a rlEir hk omFEnnr, wi[ &, lh. rGi rd llE ,nnG n mr
<br />iddrldl .. ofiq.d for sk (Sc 7O{.1, EutiB ed Pniis6B Co& ]l.| Co,ft-ld 3 LtlE t^ dod d ?ply lo d osE ot
<br />rh.F,Frt *t$ h,ilt or ,ts!6 tldd\ id wls &E rd! @n hi@lf or h*lf or tltrougn hi! or hd oh mpkrrc.
<br />,,6ri.ldi rhlt 3!ch mF.Effi @ br nai.d dofidrd fd xL tt h*cq. E bildns * rFsqEr ir $U *1tlE @ tdor@l9bia da O*G &il& ril L\r dE hdd olFrin* rhd h. d $. dil ml luild or itrs.mr 6. FrFy tu lh. IlrF,r or
<br />l. 8.$,6 of rlE Fopsry. m.rclui!.ly conrruti.s wilh lird*d codntud ro.ol!ru( rh. pFrel (Sq 7orl, lilB
<br />.i hol!.ur Co& 'rhc Co.t..lori Lic.@ lr* do6 mi .r?1, ro r o*nd of FoFry qho build. or i.pN€ 0u6tr
<br />rnd $ h. c.ffir for sh FoF'r3 *nh ! (-odEclorlr)puBur ro rh.co.r.doi3 Lrd.Ir*).
<br />r ,'-l"d ,*kls-,."
<br />:y:/:!!!' r]rttlr'!l
<br />I h,!. rd $ill mi .in . cdili..t. of ColMr ro S.la-lBlrc for uorkd conFBdh.. 6 F.vi:H tor tt Sdion 1700 of lh.
<br />lrx, C.dc. fo, rh. prf(nlle. of rlE $orl fd $t.h rlE Fnir it 6!.J
<br />I h.vc !.d siU .ri.l.rn work6 conFerrcn $!.mc.. 6 ..qurcd b, s6r b. l7m of rh. l.bor Cod.. 6r rh. Ffolll@. .f
<br />rb wt 6r *ldct lti Fdi i io.d My rqid @&pd!rir iffi -ia !d polic, Mbq e:
<br />Caii-
<br />P.lk, Nmbd.
<br />-
<br />-Erpc
<br />I cdrry fi,I in rnc Ffolrr@. of th. *ort a- $tah thi, Fnd n iii!4 I lhlll mr dph, !o, F&. a &y .mE
<br />b E to bE E $bd
<br />'o
<br />tlE $st6 odpdErion LBr of Cditonir, .nd .3c rhd ill iblld heom. rubjEl lo lh.
<br />m 6 comFurion !rcvniotu oa Sdioo .!700 ot rhc Llttr a.d..l JBll rdh"th onDl} *nt dr FDrilioB.
<br />L$tu|, ed rhsu ebl(r M dplord to lrimir.l IEDhi6 Md
<br />thouend dollG llloO.mO). i.tr b rh. coll ol conF{rion. drnusB a Fo\iLd fn tlE
<br />I hd!6t.lIrm Jd Fslry o I F)ur! rh,r lhr$ion ot( hapr6 9 (.ohm6.r8 rnh Sdion 7ux,l orl)Nuk,n 1
<br />ol lhc Bus'K ud Prot6nra ( o&, ald nry !ic.e a in tull f..E dn.ft6l
<br />c.tlliurcratrIluDuiclc.E!(a
<br />I hqltt ilTm undq poEtt ol FJury rhr dE! a . ol(tu.iih bxE* *4y Lt rlE Ffulm. of lh. wrt 6, *tth lh6 Fnl h
<br />ilred{sc 1097. cil ( )
<br />ATTUIAIifDES.6BAITO!
<br />I harby itrm ulda porlt, ofFjuy on ofrn aollowinS d.cla.lhnr:
<br />ttnohDn Pdny^$dror tlorifrrlf. r.ddi R.8ublilB (Tnk .r0. Pd6)
<br />Raluir.n Lnrd oatldiftnir
<br />I .d iry rhn rh. ro,6!l (sullri.B r.sertins ab.lror rmr al e. .d .pplElbl. ro $n pej.ll
<br />sr.r. rh!! rh. dbor. inromir (n i .oGl I 4re !o orlpry N nh .ll C )
<br />hs.t) lulrbri,! r.F6.dir6 of thn Chy .,n
<br />APPROVALS COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />lrleter Release x -70-t7 Y,IIL1G,u \_/
<br />Rough
<br />Service hrleter I {
<br />FINAL Y-Z'f't / v"vJ$a
<br />Notes, Remarks, Etc Z
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