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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE 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 />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER ,-la -19 rl*d /o.t
<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 />Meter Release
<br />Rough
<br />tt-/2-t,hrr>t /o)
<br />FINAL t 1 -o,'-l ,(9,*4/!>
<br />Notes, Remarks, Etc
<br />OWNER AUILDT.R DEtI'ARATION
<br />I hd.l, .rrm uiA.r Fn hy of Fjuy lht I m 6nnB 6nm llE (-o 1116'Ia6eIr[ for rlE folhsi]s,6:n {s< 70!I J
<br />Buin6r rd P.ot*ion ( od.) Ant Cn, or (ouriy trhEh EquiE t p6mir n' Nldtud. lna, mFoYc dmlnfi o qn uv
<br />ntu.r@, Fitr b h! isucc. ctr. rcqut6 rrE iprltld for 3urh Fnni nr fiL r sisncd nn.:6l rhn h. or iE i licdtd pll!!@r
<br />ro rh. Fsrur6 ol rtr (i,tudd r Lto*d l:s ((1uF6 c, ( o.jffin8 $nh Sathn 7(100 ot lrliti,. r of $. ltBlB &d
<br />Pol*i.ns Cod.) or rn lE or !t ir d@pl rh6drom .nd rh. h.rir foi !n .lks.d doFbn. Any \ hhio! of sdiion 70! I 5 t, .nv
<br />lpplicrnr for ! pdnn subrcr th. .ptlicanl to ! civil D.dlly ol.or mr. lhr fivG hundr.d drll&s (St00)
<br />l..rn$ndorlh.FDFny.orn)onhtG*nh$ls6 rh.n$tcooFBdiln,$ill&dEqd!idinturfti!Fl
<br />int6r&j oroll(.d forsL(s{ 701,1. BNilB ed Pmldijont (nde Tn.( onlE ioi.l,icdc lrn {t6no' lpPlttouosnn6r
<br />rlE Fnfdt tr h. htill tr !+016 rlEq in sh. dE $+ r.* himr.ll o, hdrlf.t llmuah hs r lE om dpb)6
<br />Fortd.n lhd $.h imF!\dlEG c d -nri.d dolIa.d 6. -L lr. to{6r. rlE hildin* s inFfrqEr . $ld rihin @ la
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<br />l. N osnF orrh. FrErr, m .rrlciv.l, co ndins s'nh licded.odBloB k' $tdruci rlt F.jcl (S( 704r. &!i6
<br />.d lbisin (-od.: Th. (n mroi rLicN.Llw&)6 mr.rplrlo &oq'ndof lfoFriy$ho build! or ihpNvd thdd'n.
<br />lrd *'lb d,nBlt n Mh FDrcli $htr ( orrr(o(rl li!,.d Fllld bilE(tdr&lor'! I-i..M La)
<br />I M, c\cn,l, trndcr S(a!tr)n
<br />D.r. Of,n.r
<br />\\oLkr"lls' ( ()Iriirr\sAnoN
<br />DECTABAIIA!
<br />I h-.h ammtrn.Lr tmlr\ of p€D^ oEorrh. n,lk,r 'n! d(lddir6
<br />I h.v. &rl $ ill minllin . C.n ifr.t. or(il6l ro s.lf.lBur. ao anl6 comFdi.n.s F.rit.d [orbysdti.n37(Doflh.
<br />t kx (ule lor rlE Ff(Irffi. of llE *6t fr trnth lh. rEmn B iBu.d
<br />IhaEi \vill n,0inloin rork6' comp.nrnrio. iEor.nc.. .r rcqun.dbysdrion:l)oooilh.lnbo,(i'd. tu rnc psfomtuc. oI
<br />rh. qnk tor *hrh rhi! Fnlh i! isud Mr {ml6 ohrEE ,on iBu,e. (sit ,'d Ix)lEy nudl r.:
<br />l..niry rhlr in rh. Ffomm. otlh. soll fo,*hich lhi. Fmn i! nsd,I lll ml 6rhry My F$n in uv idc
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<br />'. rlE
<br />$orta' conFdlt iion FDritio6 6f sdir. l7fii of rh. rltu (-odo I {6ll forny ih 6ird, q nh lho. I,orniiN
<br />wAnNlNG F.it!r. r. sm *qtd Nnqrrlnh. 6\6s. . uLrtul. a'd tull 3tbi.< x opt'F lo oinir.l Frlb ad
<br />.nil lin6 up l. om huftH lhoust! doll6 (tlm,ooo). in iddnion lo lh. cor of .omFMirn, ditus6 B F.vil.d ror rh.
<br />( (!lc. inls.sl Atrdilkmct s ltn4ft1{
<br />I l( I,:NSID ( (lN l R,\( lOll
<br />utr(L\&\r(.llI@.frmu ldF ntof Fr!.yrh.I m li<sud u!& For iri,t.l (14. g (snffiins *Ih Sdirn ?000) of lnrtbn!
<br />of rh. BBic! Md ProfdioN Qrdc. &ld ny !ic.@ n in full frncc t'd.[..1
<br />'f i"l* l,t f
<br />callragcualu.Ellllc-{c$Lcr
<br />I ha{'} lllm lBtr Futy ol FDor} tht rlE. L . oldDdnn bdilts Arc! for tlE Ffclle. ot th. sst for *nah lhi! Fni ii
<br />t.u.d (sd 1097. ( ir c)
<br />AP?I I(]AN NECLATTA NON
<br />I hddt lrm untkr Fnrh y ot p6ju.y .n. ol
<br />'h.
<br />f.lh*i.8 &tl[.l ioB:
<br />Dnnndh. Pmis-Albdc NotilEdht r'd.r.l R.subtion! (rn|.40. ftn6)
<br />Ratuiral Idra of fidi6ciit
<br />I.sritrhr rhc Hd.ln!!L!irB r.lrdins 6tcr rm1.la. I.rPlk.bL b ihit FoF
<br />- Icdif, rhar Ih.vc rftd rhk spplicrioi er! !ur.lhd lh.ltort i.aom hn is cotr.d I aBE io ompl, whh,ll ( il, !.d Counlv
<br />onliDnd rd Sr.r. t {s Ehrf, lo buillinr .oilit!6ift !n hd.tiy .ulhd. EF*ti6 oiihn Cnv !d C.orv io 616 !F. llE
<br />."",,.",,..."-,;n.,,,* 1-@--
<br />l,em r nrmein,in,,: bco*t[. n Co,,.,1\^ t.1
<br />I
<br />ID/SIG.
<br />to lz+l n
<br />Service Meter
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