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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER AUILDEN DEL( RAN('N
<br />I hercby afiirm ufldcr Fn{lry ol F.rjury rhd I .m .r.nlPr fnm rh. (-ont(rF l.i.cn{ li$ tn lic r{,ll{,wiu r.sr (sc.70:rl 5
<br />Burin.s rnd Pnrf€s\ion Cndc): Any Cir, .r Cornry *hkh r.qurEc r Fnni !' r,nrhrd, rlto, rmlJn*.. &Bnnh.r rprn Jn!
<br />slructurc. rrrior h irs nsuurf,.. dL. r.qrtci r h. applicanr in rNh n , nrir t, tiL ! \i8n.d irr.tEtrr rh.t lr or fi. n li..iql t)ur{rmr
<br />k, rh. tmvhi.n\ or rlf, Co"r,ritr r L,ic.nrd L.w (Ch!pr.r 9. ConrnEmin8 w h S.dfn ,lrx) or l)rvtrr)n I ol rhc B!\irr.rr rnd
<br />Pnfc$io.r (idc) or rh.r lr.rsh. k.r.nfl rh.Efmm d rh. hstir nn rh. 'lk!.n .r.nfli,a Anyvi(nlronofSdrrnTlrll 5t'!Liy
<br />artli.anr ror tr ll.mn suhisl! rh. lpflic.nr ro . dvil r.mh y ur nor fr'ro rh0n fiv. hun<lkr! d.lld1 I l1(D)
<br />-1.
<br />as o*8. of lh. I'trFnt- or my .nploFr wirh s,s.\ 8 rrrn vrk nmFn{ri6n, w,lr iL, rh. $1rl .nl lrE (Blw n r,
<br />d.nlcd or oll.En for $b ( Sc ,04t. SuriBt rnd Phf.si)nr cd. TIE Cnnrrdol r 1.t..€ tr$ dxr mr q' y n' rn o]N ol
<br />rh. FIEny wh. tlildro. inl'UE lhdr)d ]d whr d- srh enrt himk lI Dr h.rkl( nr rhn !t t hn .r h.. own.r{'hy..t.
<br />pbvn.nih.t Mh r{ro1tftnk E d nkdkd uold r$ nt lr- h,w. rlI hiltil{ r inl'ffrd ir qfl *rrhh oE FU.rornL{i,.- rh. ol,mr Boi&r *ill h.i! rlE ttr.d.. of Fovi.E rrd rr m.lE dn n{ hru or inrmr rlr Fqdt ft,
<br />'lE
<br />tforFE.t
<br />-1.8.wmorrlE
<br />FoFny, m.r.lu\iwlyco rxrins wnn laEEn.orrrrtE ro.nn{Mr rrr r6F (lqL ?0lu. BFirs
<br />,d ADtsi. Cod. Th. ConrEior t l,i.c.< L.v &Er m' .rtly ro u o,rc. (f FoFny *h. roiB. or inpmkr rrErm..
<br />.nd rrb odtur r(r *h pmj.(! *iih r c.dddn lt.n dl tud b rh. conlrdr\ t*rc Lr*l
<br />-l
<br />.m .r.mB uflLr Sd
<br />lfllafE&LcoltrEtraltau
<br />D[Ct.Af,Arlo!
<br />I lEE6y.Lum !n<rd Feh) ofF,lryoft ofrh. ft,ll*r3 &.Lhri!.\
<br />-ltuE!nf,ill
<br />inl.in r C.nfr.l. of CoIsr h S.lf.lru. nr srts onFuti.r .r Fnvirl.d lor by s(ri'n lTllr o( rrE
<br />L.&r Cod.. fd rlE F.rm ofrh k t rtr ah rlE Fni 6 (.rEd.
<br />_l h.E.'n *ill minlrh *ort6 corFNlhn in.ur.r.,.i Eq!!.n hy SEli,n l7moa r llborcod.. for rlt Fr(lifuk. or
<br />rl* at ,ry *nih lhi rEmn i\ irqxd My rork6 d:.qEd{ion inrurhr ori, rnd rDlay tu,i't- &
<br />Polky NumlEr
<br />-
<br />Idnifythlinrh.Ffomnrofrh.wortrrwhthrhitFrnnFn'Ed,IrnIft.r?hyr.tlrrq{iIr.yd.B
<br />$ .! lo t or rubF{r ro rrE *rrt6( orrEnr.lhn Lv. or (iliromn. r.d .aN rhd il I dDlld l!(rft q6Fr h rtr
<br />$o s' onrEnqrion rrDri,6 ol kion ]70(, o, rlr llhr (in - I rhll- tdhw h 6nily rirh rlh-,t tnnB
<br />civil fims up ro oft h!.dEn rhouqnd dollrr (3lU).(tnj. in rtr rn ro lrr co( ol smFn{li.n. d.d3.\ tt Ihv .n ro, rh.
<br />'::^:""-l+lillii
<br />^pprr*.',.K
<br />!!qld&u!r!
<br />I h.Eby.ftrn uflkr FnalryorFrjurr rhd I rn lien*d udLr t,olari'n or(hrrrd 9ldinmrin! eilh S..lhn 7{rx)).t t)ivnhn J
<br />oI llr Aurircs ud Pmf.$ionr C.d.- ltn my li.nE t i. tull forc rd cild
<br />gNsrB.utrlr!.tE8DM-ati[!.gr
<br />I hcrcby.flirnr undcr FmlryofFrjuryrh.' rh.E h. $nnrudi,n Lndi.8 08cry lm rhc p.rloi'ruh'c olrhc uorl n, *hi.h rhir Fmi k
<br />iqru€d rS.. 1097. Ci! C I
<br />hnJ.,'\ N,m __
<br />t[rtlrlNr-D[rlaarua!
<br />l)mhy llfinnuRldr Irtrrlry oflrrltrrr- oN.l rtu l,,ll,,*inE,l.(hrrritrn
<br />l)cnn,lirrn,I'cnir\ A.t {o\ Norili..ii l.(l.rilll.!trhrtr(\1lirlr.lo.l',trr6r
<br />R.qrircJ l.crrcr ol N(iilrrii)n
<br />I ccn,ly rhlrrhc fcddrsl,rlrlnri,,n\ ruSrdlnI r\h.not'.nt^rlnr. turrmltr lcr'rh^nn,X.t
<br />I ccn'trhar I hr\r rud rhn rfl' 'ra.on rftl{rr. rhrrrtu r\. i'rftnn nn, N.on(r lagrrrr'(o {'lrrnhnll(-iryiM(i nrt
<br />ordidrc*.nd srircLlssrhrnlroh{ild'n8.(ri)n. ul hcrc6! rurhtrn. r.lf.enhntr.\ol rhncnydl c.u.ry b.nrd u|nn rlf
<br />rh^t mnrxrftd rn,Fnt nn inspc.ri'nPrF)
<br />,tppli(ml or,\$ntSi*nxlur
<br />Wl,Ul-'
<br />l4zt ltt
<br />Site-Work
<br />Underground
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lile Safety /Low Voltaqe
<br />Fire Alarm / Dam pers
<br />Communications Cable
<br />Building
<br />Bonding / Groundinq / UFER
<br />Translormers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilinqs (Hard & Soffit Rouoh
<br />Ceilings (T-Bar Rouoh)
<br />Ivleter Release
<br />Rou gh
<br />Service lvleter t,\a
<br />FINAL tll ct ll"I /$W t)
<br />Notes, Remarks, Etc..t t t
<br />I,""*tlffif ,.,t
<br />Pole Bases
<br />Under Slab / Floor
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