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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DE'T RATION
<br />I hd*r.frm u.ttr pd.lty.r p.rfy lhri I m ddpl tum lh. Co rxlm Licm L3w aor lh. follo*iry 16r {S(.70-11.J
<br />Buin* &d Profdior Co&) A,y Cny or Coudy ltah Equt6 ! Fnn b 6tdtu<r. .ta. inproe doDlbh or r+.n Mt
<br />3rtu.rE F,r lo ru Buftq .to ..qun6 rlE .ptltdr tor 3u.h rEm ro 6L. tas..d niffi' $r lE or JE ir licda.d tuB!,n
<br />lo rhc provitbE ofrtE Conlrtorr Licm!.d Lrtr,(Chlpla 9. CorM*irs wnh Seriotr 7000 olDivilb.I bfrlE B6i,< ud
<br />PmldioN Co&) or rlut lE n 3tE b 66rpr lhd.fiod .!d rh. b.r. for rlE rlkr.d aaprio. a.y vir,ri.. oasdion 70r l.J b u,
<br />3pl,li.et for r pmn sbjal! th. applical to a civil p.Ehy of not mor. lhd liv. hln(lt.d &ll&t ($500)
<br />I. a os6 ot rh. FoFry, or oy @plotc $nh *!n6 6 t r $L omFsdion, *ill.L tlE sdl !d dE rn,.lG i mr
<br />i,ncrj.d tr ofrq.d lor sk tse.ror!. BuiB rd ProlaioN Co&r I1E Coftncroar l}.e t- d.6 ml 4pry h M o*c df
<br />th.FrF y rft' hilib r irv..!€ dd@ rn rlE dc id $dr hiIelaor lE*l t or rllold hli d lE om mdolc
<br />provid.d lhlt .ucn inpmrqEn! e ml htad.d or o6ql aor sL l f. h*a6. llE hlildins or i,prolEE iFldqthin.ft,s
<br />ofrof,pldhtr tlE O*G E{ilda Ull h!r. tlr h!&r ofFrvrB tl! h. d tlE da d hild n i'rsow 0E p.DFr} fq ll! ruDo* or
<br />l. . orE of llr FoFry. 6 Gt.lutr.b conr*lnlg $nh licd!.d.onG16 ro @dtu<r rlE Foj.tl lsd 704,1. [16dB
<br />a,'d hoki{ Cod. Th. Contrdor'r Lr6* llw do6 n .rply ro 4om6 otpropcly who build. or inprcvd rhson,
<br />ed wh. .od,.<lr fo, tu.h Fj6r fi'h . Codrtio(, lka!.d A6ud ro rh. codrdoar l.i.oB L.s).
<br />I m.r.mpt uni$ Sartr\n , l] & P.( ilr rhir rd)n
<br />D.r. OiiE
<br />WORKI:RS-('OMPENSATION
<br />I&CIJA{IIQ!
<br />I hs.l]y lmnn und6 F dty of,sjory om ofllE folh{'n* &(hr!lhB
<br />I lIrc trd Eill rd.h ! Cdifxd. of CoEn b S.lf.rBe 6r $.rt6 orpqlrDa a Fovil.d 6r br Sdlion !700 orllt
<br />t bor Co&, for rh. Ffomft. of lh. *nI for *ti.h thc Fmii n isu.d
<br />I ha\. and tr n I nr.rira'n u ortqr' compffitFn rNur.m.. a r.qurcJ h) Sdr nn .17oo of rh. I ibor (id., i, rh. Ffonmk. oa
<br />rh. \ork ror which rhi! Ftr,il ir isud ,ilv$o.L(s c6oFlel'o. iBuranr! .sE ai Ftli.y numhd e.
<br />I calify th.r in llE Flor,tlm. of th. wort to shth lhi! Fnn ir iu.d I thlu nol qrgL'y uy Fsn in,nr 6aE
<br />$ 6
<br />'o
<br />bd!ft suii<t ro rh. *n r4'LrmFdrn rr*: olcdrfom4 4i.8rR rhd rll nEuld h..or flbrd h
<br />'lE$o 6' omFdul iof, pmvllioN of Sa.lion 1700 ol th. l,bor Ode I ddl fodfiwilh comply wilh lhos DmrilioN
<br />WARNIN(; F.ilur. ro B@ sorl6' .ompdldion cnv.dc. i! u.l"*ful. od .hll subjct M 6Fhrq lo aimiml p<Elli6 lnd
<br />civil nn6 up ro nE hurdrc<l rhosd d.ll6 (t 100,00()), in .<td irn ro E cd ol qrmFrua ion. d.me6 I Foril.d ror lh.
<br />SdNn 1076 olrh. ljbd (ii.. hr.d.nd dronr,-s rc
<br />Irrr.r_ ADp[qrrl
<br />t,r( r \ttla!!_2]
<br />I hGcbr rlfim uid.r Frny otFJury th{l I m I'cdE d un& Fovnrn orourlo
<br />of lhc tluind !.d Pmfdios ( od.. lrl my laG b ir full foE. &rl .ficl.
<br />(onjll4r,B {nh sds.7000,.f Dndi'n l
<br />/=l
<br />ca!fltrtr(Ilo.lrtElDtac-dqrdcr
<br />I fid.t^' lmih lBld Fnrlr ol Fr!!_ rhi rns. s ! odtudion Ldin! .s*r nn lh. Frol]rw. ol rh. u o* tor tr h{h I hir Fni !
<br />is.J {sa 1m7,( 'r (-)
<br />attucAxr.lEcl48arq!
<br />I hdq aJrm unda l6alr! of Fjury on. of rlr followins dclr.r t a:
<br />Dnturhr. Pm'ti.A3bdror Notifi.dioo t.dsil R.suldFnr (T l.40, P!n6)
<br />R.qun.d tnrq of Ndifi cr.iE
<br />I cal iay
<br />'hd
<br />lh. f.d.r.l r.luld irB rqrr diu .rtdos r6no\ .l e. nor q'plicahL lo thie prcr.d
<br />I !.r'l\ rh,i I h,nc,rrLl rh \ r rnnn,,nnl rh rhc xr!. 'nlann n,n i!.oft..r Ii[rekrcomt!snha]l(iij-ond(-o(nrJ
<br />ordjMk6.rd sd.l,u3 EltrA ro trildin3..6ddnG ofrhi! Cdr.,!d Counr!
<br />'o
<br />drq lF)n rE
<br />.hor lmhi..i pr$Fny for rBpni$n
<br />,tpplicrnr or ,rrdr shn.rur.Y.-*!?/r,
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Si gns (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<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 (Rough)
<br />Ceilings (Hard & Soffit Rouoh
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough
<br />Service Meter
<br />FINAL +lte//( .{qv(q
<br />Notes, Remarks, Etc
<br />-a
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<br />I
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<br />I
<br />I
<br />I
<br />l
<br />I
<br />I
<br />I I
<br />I
<br />I
<br />I I
<br />II
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