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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE tD/stG.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 / Dampers
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rouqh)
<br />Meter Release
<br />Rough ///or/t7 .#/i)
<br />Service Meter
<br />FINAL (/>t/t / .vM {,/
<br />Notes, Remarks, Etc
<br />OWNER BUILDf,R DELCARATION
<br />I hq.t, .rIm ur& Frny ot FJUrt lhi I - d6qi 60r rlE Cofi.r6- Li(@ tn for rlE lollort l6,n (S< 7011 5
<br />Bai,B !!d Prof6ion Co.L): Any Cn, or C(My *hth r.qliE . Fni ro otdrud. .na. rprove dtDlirh oi .q.n ,)
<br />rru<lm, FEr lo tu isuucc .Lo r.quic rL +pliul for 3uch Fnir to 6L.3isicd .ldffir rhd h. or .h. b li..N€d puMr
<br />ro rhc Fov;io6 oadc Codr*rd! Li..tr!.d t w (Clqra 9. comftiD8 wnn S.<rio.7000 or Diririon I olrlE tldilB td
<br />PrcfdbB Co&) or lhd lE d.lE ir d.EF fialf,oE !d $. bci for tlE rlL*.d qd$ion. Any rbhitn ots€rbn 70ll 5 t! t.,
<br />lpplicur aor ! Fnn 3ubjEr! rh. lpplicrn ro . civil p.tuhy o f nor tur rhd fiv. hon&.d dollur (1100)
<br />l. 6 NE oflh. FlFry. c ny dtpb)6 uilh v.r6 ! tlEi $L onpdlrbl! *i[ & lrt $dt rd ',t tuG it ml
<br />iiai.d n ofa.d ad rL ls<.7or4. Bui6 md PDi6riiE Cod.: TIE (tl,rrdoir LIGE Lw &j6 rcr +ply 'o - o*ffi ol
<br />rh.FrFly *tF hlilrbor inF.v-tlEstr rrlwh do6*tw hiMllor tclror iteuSh hi! e ha o$.f,lploy6.
<br />ForiLd lhd $cn idFoErE c,Dl irad.d d otu 6..r. I( ho$!€ E hrildq ( !!s!vuEr i -ld \'ahii @ )d
<br />of.dtllaia Eo'EB' E*itthErlEhlttaofFlrt$.lEdtE(Htu{hilddinvrcw0tF!F,6rtlEF,r.*ol
<br />l. B NE olrlE FlFry. 6 Bcl6iE .onrdDr rilh lkq!.d.odrrrd ro Ntu rlE Ftj.( {Sd,Nl. hN
<br />ind hlkbn ( od.: Th. cod.-loir Li.d. L.w &E mr .ppl' ro u ovns olFrFny rho burldr o. inrm\6 rhron.
<br />ed lho conuxr aor .(h !.ojdt wrh . C. ddo(.} lt.G.d poB6l 10 thc Conr.rloar Uc.@ L!*)
<br />I e crnF udd sdrir.
<br />D.r., Om-
<br />woru(rts' co PENsa'rroN
<br />DICUXAIIAT
<br />I fia.by.rtrm ond6 FEltyof psj!ryon.oirh. followiry &.h..lirB:
<br />I h.r. !d vrll rj .in . Cdi6.d. ofcoM io s.ll-ltue 6r !ori6 otrrpoErioq a Fnrd.d ftd b, sdi,n !7m olrlE
<br />Lrtff cod., for rhc Ffo,lre. of rh. m for qtkh rlE Fmn ir i$.d.
<br />I h&..nd sall min.in {ort6 Equircd br Sdio. !70o oallE L.bor Co&. aor llE F({rjac o,
<br />E *..t lor whkh rhi! FEi ir iE!d. My eorta orpddirn ilslltm. cai, !n ,olE nuhbq &:
<br />roricyr,muo,-| ;1Ef lr"j L9 e,p"*, Ql '-Al - /E
<br />-l cclify lhd in llE Flolille. of rh. sorl r( *hrh lh! F(n . sE{ I rlDll mr oploy .ny F$n i! u! dsE
<br />b 6 b tEft Dbid to lh. 10116' omFs5f, Lu! .acdifomiG .tn {e ihd if Lbuld b<.G sb,6i
<br />'o
<br />rlE
<br />m*6' omFsllion pmvirioN of Scclior !100 of lh. tlbor Cod., I Jall, fonhsnh .onpl, *ith rh.r pn'viiioE..
<br />W RNING E h!. ro s(. ertd' srrp< iirn 6rd.g. i! unl&tul lld rh.ll rsbF ! dploF lu oiniMl postnr.id
<br />$il lnE up h onc htrndr.d thousand dolhn ($l 00o), in dddnDn ro rh. cosr ofcomp.nqrion, ddm!36 rs Drov'd.n ru ih.
<br />Sar ion 1076 ot rh. trbor (ixlq inta<r od dt,
<br />,, /r4 ,, ,
<br />I H^ rltm uftl( Fdly of FjuD I
<br />DECI4S6IIONud6 Fov.io. of(hprd 9 (frmffilv wnh Sdion 7000 | of lrir di,n !
<br />ol lhr lluind Dd P6ldnrE Cod.. ad rylic$. it in full lorc. md riTd
<br />P %:A1a!
<br />l- 4r l) (-6>-t-r 1'7 lL t tl rtll (o
<br />I ha!6r .rrD u,rla Frry olFi'ry ll[ tha. i r odru.lb. latdils .gd, bt 0r Ffott.N of dE {sl 6t $nit fii. D-in ir
<br />is!.d (sc 10e7, civ. c )
<br />t5da.! Nme
<br />AITU(ANLIISJAAIIA!
<br />I ha*r .trm uqlq F,h, of Fjor, .R of rh. follo$n8 &rLd ir.3
<br />Dcnolirh6 Pd're&b6ror Norifi.dhn Fcdr.l R.ru ld rnr (Tnk 40, Pd6)
<br />R.qur.d tnrn oltJoiarii..
<br />- I .diry thd th. t d.ril rcsul!|ioB Esadin| abdo! roov.l e ml
<br />'pplk.bk
<br />to rhn prerci
<br />C-'fl, *. * ,* .-,.dbn -rl r.. rhr tn..tov. inhldbn ir otrtd l.sr6loonrrl, rih dl cnr.,r.t cody
<br />odh.\q6d Sfi. t.w Elrrns ro hrld'lB conirud'oc trl tElb' .lnhori4 r.F6ardiv6 oirii! Cn, ud C4lny lo orrE lpon tlE
<br />.bo!r nfl!,n d FDpary t rqcrior pupoc.
<br />l*(.or * 116r sr-r.* D.t.
<br />"i}Vt,.; Lde I q- 17aTe z
<br />Communications Cable I
<br />I
<br />I
<br />Air Conditioners
<br />I
<br />L/ A vr-
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