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ELECTBICAL.INSPECTOB RECORD <br />OWNER AUII,DEf, DEI,CARATION <br />I lFr.by amnn uRr.r Ftulry of Frrury rh,r I m .Esp' rmn rlE CodEroF La.nc t w lor rlE folh,in! Ersn ISN ml l I <br />Buritr.! .,rl Euf6.io. Crrcr Ar! Ciy or Cddy lhrh ErluiEr r Fni l. d,nrrm. .lrs. inprDt. d.mlirh o, .tFi v <br />u1r. rir ro ik nsur. ds Eaud rh. rl'||lkur fn iE,r Fmr rn fik. \isrd ni.1rd rhrr tr or rlr ir liu<n ,rullst i <br />l. lh. Imvttr'N or th. (i' Ertr! t,rcn.d trw loEpl.r L Conm.minr *nh Sccrn,n ?(xx) oI Divirbn :! or lrF Buri.c$ !trd <br />Pmlc.rimr(od.r or r,'.t lE ir iE k.r.q, ltftlio rnrn h.!is aor rh dL!.d.r.qti.. A.y riohlhn .f sdbn ,o.l I 5 b!any <br />4nlr. tor . Fmn {hj.rr rlE .I,t'la!nt r. r .ivrl p.Elty.f Lr m.. rh.n fiv. hundr.rl &,lLF I $fl)l <br />_l, ur owB ot rhc l!n,Fay, or dy cnDbF\ eirh *rsr3 !\ r hct $L d,nFnt.1i.rn. wilr do rtx r$t srn llE nrElE n ml <br />dmLd aroihrd ror{k(S(7fl4. autiE.. rd Ptr,fdirn C.d.. TIE 6ndr.l til* t r.tEi[n{tlyro!nosEof <br />rtEF)Fi, *h) foil} r irFbB rlEd d *lb d{E.ri krt himsr h.*lf o. rlmuah hn c h.r owr.q'hFi <br />pmvi,.d rrf rEh inFoffis E r, irr.ndol m olY@d ftr .L lt E'{(c. llE hillint d itrttuld ii $U wihin ,e F! <br />or.flplclbtr E o,E. B!i&r *ill hrE tlE binnfl orroving tur tE or rh. dn d hild n iryn,E E FotEly irrlir{qhEol <br />l, .r orE ol rh. ProtEny. .m.rchlnrly cod,il ina wi h l(rnrn codr&1(F io N.trfut rlr Foj.s (Sd 70dr. 8!rik( <br />trd lh,fs\hn(irlc thc (innr&tn \ l.'..n\c I n* (toc\ noi <br />rid !th' (ontJ(Bnr n'(htmArr tr hi(iintri.t,n(,l(+ply 16 m own r or tr.Fny wln ttu ildr or ihpmEi lhmon <br />.Nd eurtd frh <br />c.dEB.! Lit* u', <br />1J3lt\^=---, rncx.np ud.r s(ri'n- <br />I hcr.hy !ilirm undcr p.mlry ol p.uury <br />-l <br />hlE rd vill minrth . C6rif.r. ofc(llmr ro S.lf'lmE lr rrrt6 @r+andbn..! rhriLd lor by Sdrin 1rfi, orllE <br />lltxr C.d..ld tlr Fltlffi of llE *dt fn stah lh Fmr n n{xd. <br />_ l t.E and *ill minllii *ortcn corfcNarion inluErc...t r.quircd t, Seri.n 17{ro ol rlE lrl*tr C.<h, ror lh. Frftrmm. of <br />rlt krl fu ah-h fin Flni n ir*d M! krtsi onrEqrDn itrs,lN.Irn rnd F ty nnnlEr,.: <br />l..nifyrhrt inrh. pcllornurEnlrh. wo.k kr rhrhrhr l.rinn r N{rd.l \hllfr{ cn loyrny pcr$n n!n} ronm, <br />s' Nl" h.drnr {uhict ro rhc *.rkcB d,mpcn\lri.n l{!s ol( olilhrni.. ! n!rcc rh8i ir I \h)ukl tf,com subrd ro rhc <br />ro*s\, on{Enqthtr n(n ti,6 .t Sdirn l7{x, ol rlt Llrrtr (ir!. I {!ll. l(hhr h ('rrr'ly } nh !lrr( tnn nrrm <br />WARNINC: lilor. ro E(trrc wo,Icn <br />.iYil fi.c\ !t t' om hu(n.d rhournJ <br />sdl r'. 10 76 0l !h. bh, (ir].. i.kE{ <br />rotr'PcnL ktr' mrcrrs. A <br />s <br />drnhru t) rimiml Fulri\ lnd <br />i.n. dr 3.t rr prnYil.rl lnr rh. <br />I lrEl', rrrm uri.r F ty or Frirt rh, t .m lirnr.d u'!d.r Fsli3ih of Ct t'a I lmmnfti.8 rnh Sdb. ?G,or or Diviibn :r <br />of rlF BniiErc .nd Pn,tcr.rnr Cod., !d my lt.nF r i. tull r(rN un ciT*r. <br />g0llilB!]clltlr$Ed li-&Glul]l <br />I hEhr rmrn und.r FMlt, or Fcrlury ln{ rhcE n r consltuli'n tendinS.t.Ey ror rhe FrfomE.lrrE krk nr uhih rhk Frmn k <br />tlkd(se .llrJ7. cit c, <br />Rrquf,tal l.nd ot N{'turrrm <br />'!trlrr. nur all)ri.uhk k, rhnnmFl <br />AIEIIIAIiLIIETJJAdIIi <br />I lrariyrlrm,urtlo !.nrlr\ ol Frlur, (t ol rtr n,lk,f,nrs (lnlirxnr <br />I)( Ilirion|. nih Aitr{o\ Norill.rriifl Ir.rl.rrl R.SuLrlnr IIirl..l1r,I\n6) <br />onft'@rir rcoRr l rlrd ro orflr r[h.llCiiyrrrl (i'unr)_ <br />f,.htrurktrir. rctrc< .rrcr.frhtC y.rnC u.ly lo cnto uF,n rh <br />DATE ID/SIG.COMMENTS <br />Site-Work <br />Underground <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Life Salely /Low Vollaqe <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bonding / Groundino / UFER <br />Translormers <br />Torqueino <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Solfit Rouoh <br />Ceilings (T-Bar Rouoh) <br />Meter Release <br />Rou gh 4-lrt7 r-vtil <br />Service lvleter <br />FINAL tt- t(-11 x-\ulu)) <br />Notes, Remarks, Etc. <br />4rE,^eo <br />.. d <br />^.nt)ttut:D7 <br />/1 ,..1-- <br />\ <br />APPROVALS <br />t:>. _)