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APPROVALS DATE ID/SIG.COMMENTS <br />Site-Work <br />Underground <br />Pole Bases <br />L ight 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 />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Rouoh <br />Ceilings (T-Bar Rouqh) <br />lvleter Release <br />Rough <br />FINAL +741(1*Lr(r(/r) <br />,(, ,L/o <br />(6A <br />7e.{\tot <br />oh <br />t?-9.+ <br />laA *atqeq Laa ,*-( <br />b-t . <br />+, <br />OWNER BUILDTtr DELCARATION <br />I hdrB lrm uda FuXy of Fjury rhn I m qdrpr [Dn rh. Co,rddr' U..u Lry ior llE touovi,'r t6)r (Se 70] L <br />&BitB .!d ProfdDn Co&): Any Cit or Codr, $nth .cquc . Fmr b odM. .ld. irp.Drq ddmlat or rqri rI <br />tuuq Fbr lo nr isumq lto r.qltB E pdkMi lor $.h Fnir kr frL. ri8n d rrtut thr l* or t! ! lica!.d F4crdr <br />lo rh. pinvilioB ol th. Conrrtcrd ! LiccnEd Lr* (Chlpra 9. ComdlB eitb Sdlio. 7000 or Division I of th. BBi6 d"d <br />PrefdbN Cod.) q rh.r lE M tE ir qdlq $ddro6 -d rh. b..ir lbr rb. dr8.d daFi,n. Any rbltrbn of S<rnn 701 I 5 l,y ey <br />!p?lk&l tor. Fnil $brci! llE +plioli to ! civil pdrty of mr mE ll5 liv. hut6.d &iltr ($m) <br />_1. 6 .lr@ .arh. Iropdtr. (, ny oployE *i$ *.gd a rhcn rh comFEdiod. *ill & tlE wt !d rlE n xle i! ml <br />rrd'.bl d otu fe el. (lid 7044. BuiE od PrDrdbB ( o& Ttc Cd{r.cd r Lale tw {r6,Dl {ply t6 d o*E oa <br />EFnF! $-lb hiildr d n+rr6 dEqE rn who rls $i ro niI&ll.. h!=lf or llFte! tir r ha o*,6rpht6. <br />Fordcd th'r luch nrFovn6n c d inroi.ri oromald ad $l. l( ho6E tlE hrildiu or urp.edEi ir &ld qidM uft ,6 <br />of.onpkbtr dE (nrE &itlc will IEE llE hrd6' oaF!{ig tl! lE or slE did ml hriU tr dqorc 6. F!Fr, 6r lll F,Dd. of <br />l. Bon6of th.Fopqry, m.rcluiv.lyco raclins with li.d.d co,irar6 ro.o rucrrhcFjal(Sa 704.1, Bubd <br />d'd h.lsd Codc rh. Conlr..lol ! Li.@. Lrw d(6 @i rtplr ro r om6 oaFoFny eho build! or inprevd thoatr <br />ud {ho odfft ror uh Foj.r15 u'ih. Cotrr*onr ltqEdl FrEld rorlECo.rrdr'r Ltog t $) <br />I dn d.mpr unJd Sdn) <br />D!r. Oi.d:$r|nx.ls ( ontPENiArIoN <br />DE('I ARATION <br />I hn try .rm undd FiElty oaFjurt o.. of rh. aolk wine d..h rB: <br />'ll tunbi. . ( (l,a.d. or coMr h s.lf-IM. ror ndldr conEtr.t.n B Fu dcj tor bt sdr6n 17oo .f rh. <br />th.pstolr@c.of rh.wrr for$h(hrh. pdnir ! isu.d&,.ril sill minrli. mrl.r conFMrion ilMBc s r.qoir.d br S6ion l7c{ olrh. l:td Co&. Ior rlE Fr.rllm of <br />td\hrhrha Fmn 6 i$.d M) wol[6 NmFdnn El]lalsE !i Flr] tudbq e;dl,- <br />N".r-.'VvcSo n\ea\7O I <br />_l..difyrhd i.!h.Ffo,fuftof th.*o f.r *hich thn Fmn i! iaeEd. I rhlll ml o.ploy oy pGen in uy nffi <br />s B ro bcom sBat ro tlE *. 6'onpslibn LB oacdifomi& ald +E thi it I rLdd baoc sl*tl lo rlEq$rt6 onpsu ion Ftr\tirB orsdiln l7m of rlE L.td ( cle I cdl rodh*nh onply * nh rbr FolBnN <br />WARNINC: Faluc ro s(* *s!6' c.oFGaion .o\das. B u.L*6rL .nd rldl $bF e oplols lo sinind Frr6 rd <br />cnil nn6 up ro oG hun<H rh.6da doll8 (ll00.0m), in rxnFn h rrE cor oa(odqEd'on, dd.ed 6 ForaLd lo. th. <br />sclhn !1176otrh. hbor Co&. Dr6.3 a.d.duE._'r lG <br />DTCIIEAITO! <br />I h@by rrtrB unds FElry ol Fjury rhd I m li@4d ur& Ftrvilio. of Chlptq 9 GomMciis wifi Sdlbn 7000) of oivilio. l <br />oa rlE ttlilB s'd ttofBiod Co<L. rld 6y [.a4 a h ul tor. rd.lId <br />Cro 1T\Klo <br />Ll zr ltq, <br />coNsrxlrcTlort r .NnING A(:r{(-Y <br />I hdlt ! riTm ur& Frhy o f Fjury thi lhdc ir i odru.iiri lddins lsdv for ,E Ffl]lll&. of lh. r!.t 6r stth lh! Fnil it <br />isu.d (sd 1097, ( iv c) <br />AITII(ANLTELTAIAIIO! <br />I hdd, .rm undd Frhy ol Fru!_r oE of th. folloqlr8 &rleabB: <br />Do@lnFn P@nr-Aib6r6 Nox6cdio. Far6.l RcsuLtioa (Tnk 40. Pd6) <br />R.qcnql L. 6 olNorifl .rid <br />-! <br />ca! i8 lhd rh. rcdsJ EgdaioB Es.dins Bb6lc ramr d e ml 4rlrrbL lo rhu Foj.\d <br />)4dry ,hr , *. ,o ,* qrrkdNn nl r . rhd dE .bow oro'ndi,n ii cffi I .tE ro oq y whh rll cny .!i counry <br />'6di.rl6,n srdc LftELiC ro hnldoE co6!.r. rn 6d!tr'litoi4 r.p.6dri!6 ollhil Cn, rn Cou ylo6nd+o.lt <br />!bor. Imlnln d pr.psry fo! <br />lppli(ml or.\*enl SiAn.l 'Z 1z-+ 1r1 <br />Id irN nrn.(pn ):X ,--MN <br />ELECTRICAL.INSPECTOR RECORD <br />i <br />Service Meter <br />Notes, Remarks, Etc. <br />U <br />-11/rltQ <br />-,'2-12+/ra1 <br />I