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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS Ow-Bundd Deludo.
<br />I hE.by tnjm unds p. lry otpdjury thr t M d.ip fom rlE Conlo6o4 Lic.e tre fo. dr followinA l!.e (F 70l l t B!.i,B
<br />rnd PmfBron Cod.) Any Cty or Cou.ty vhich r.qui6 . Ftn b @mc. dts, rmproE, dardi.n q Brin !, rd*. Fid io itt
<br />i.u.@, .le r.quiB tlE +plid for a.h Fnjt !o 61. r ngrd r.laEn tn.r L d r& . l@@d F,.{d lo 0E FDs.ioB of dr
<br />Cofirctdi Lr*E d Lr* (Ch.F6 9, Co@in! Mh Sdi* 70OO of Divi.ion I of rh Auin{.!d ProdqtioB C.d.) d d[r lE d
<br />4. ir aofl |ha.tro, !i dE bui lor lh. .ll.acd q.oprib Ary yiol.lion of S.dDn ?Ol I 5 by ey .9pliot for I D.mi $bjc.l! rn.
<br />tpplic.d ro r civil p.Mlty of nd mr. t r fr!. hudrcd dollB (ltor)
<br />I, u oma of rh. prcFry. o' my .odoy6 snh e.06 s dEn sE .Mp.di6r\ will do rh. hrt .!d dE.rtuc4 't rDr i ond
<br />o, olfa.d for !d. ( Se 7o,ta, BqE..d iroe.ritu Cod. IrE CorM! LieM L.w ds d +ply roe ow old!. po!.ny
<br />*lD b.il.l, d iop.o6 0Eer\ ..d rtb dE rei worl hidElfor htrll or rluorBh hir or hd M .nployel prdid.d rh.t Nch
<br />ihproEn.nr. sc n r i c'dGd or oflqcd lor al. Il ho*.v6, th. h{ildii! or hproffir i. iold s'nhin m ra of coaplair\ t
<br />O\lM'Suld6 will tuv. tlE b{rd.n of provi.S lh.r hc o h. nd b{ild or imp.@ fd tb. ltr,Doe of d.)
<br />l. s owG of dE D.oFrr, e a.lutiv.ly @tuin8 wnn Ic.E n co.rlifun b 6n nd rlE Fqd ( Sa 70,14, Burn.r .nn
<br />Prof.lion Cod. nE Coffio/r Li@r llwd@ mt +Dl, to.h oau of proFr, *ho buildr iopmwr thd@.. ud who
<br />@^tr.(:l! for *r' poj.dr wnn r Conlndo(r) lim!.d ,urEmi b tn. Conrndor't Lie@ L& )
<br />, I !h.t.hpt und.r Sdlon
<br />WORXERS COMIENSATION DECITRATION
<br />I hddy .fnrm u.dd Frlry olFj!ry m olrh. louownr &.lr.rid
<br />_ I h.w .,!d GU ditI.in. Cqri6qr. of Cot|6 r. Sdf-hr. fd srta' @oFui,l\ u prcvid.d for by S.di6n 17m of |hc
<br />lrbq Codc, fo. rlt pdfollt|.e 6fdr srt for wni.h dE Fmi t iu.d
<br />_l htv..rd will mindn mrtdJ @np6rrion n$nnc. a r.quircd by Sdion 37OO ofth.lrbs Codc for rll FfaIM ofr,E
<br />rcrt ao. *tich fit p.mn it 's.d M, wo.to' 6,lc.n .rnh illtJri@ nid.!n policy d6!c ,c
<br />_ trpict:
<br />CnR cli6 E d tur b. cmpld.d '{th. F6l ir fd OE h!!dr.d dolld lllm} d k!)
<br />_ I di& tMl in th. p.rforo@ of th. *orl lq *tich rhn p.rnn n ts.d.l ddlnor aplo, rny Fsn itr rny nund s sto
<br />b.cta. sbjer ro th. mrkd omp.nIron lD, oac.Ifohrr, rd.src rhd if I drdld baR obJd ro Ewt6
<br />@mp.nrtion provilou of S.cr,on ,7@ oa rh. Ltbtr Codq
<br />D.r. _____ ^pphtur
<br />!prF- I yl,ll\->;L-ry -'-'W
<br />WARNI]TG F.ilac !o ldE mrk6' @mp.n ion @!q.3! ir unl.ptul, .rt rh.ll tubj*i d .nploF 1o ci6i..l p@ni6 ud civil
<br />fin6 !p to oe hudrld lhernd .lolld (l lOo,OOO),in tndnion ro rl! @r of cne6llix\ d.mr6t u piovd.d fo. tu Sdid 1076 of
<br />r L.hd Cod., i a.i oa.naar'3 fB
<br />LICIIISID CONTR (]ToNS Df,CI-ANATION
<br />I hqdy .fiim und6 p.n*y oa Ffury fir I 6 li6nt d uda povi.ioi of Cn pr6 9 (@d.! rirn S6ion 7@) ot Divition I of
<br />lh. ButiEs .nd P.o{6ioB Cod.. rd n, lic@ n ir tull b@ ..d .ff6
<br />CONSTRT'C'NON LENDING AGINCY
<br />I hq6y |ffi6 lidc ,.ndIy of Fjuy rh.t rhd. i3 | @Dln.ti6 l.iding .S.icy for th. pdfomrne of rh. wr for whi.h $n Fhn n
<br />i.&cd (Se ]097, Civ C )L.ndd! Nrn.
<br />APPI.ICANT,S D'CL BAlION
<br />D.mlnio^ Pcmil}Alb.nor Nd'Rc.no. F.adl R.Blhiont (rnL,l0, P.n 6)
<br />R.q!n d L.n6 of Ndiliarion
<br />t diry (h.i dE ftd.r.l r.sultrionr rcBriii8 lb.nor roov.l r. not rrph.tbl. b rhit n,ojd
<br />I @nit $.r I h.v. od thr rpplic$on lrl n.t..hr rlE $or infotuim ir @!c I r8E ro @ply rirh rll Cny.,!d CoxryddEn6 xi s.r. rrE rdnrq ro borldint turho.ia r.?..glriB of $n Cny .td CorDry ro drc uF. d!.
<br />.tov. o.n.iomn prcp.ny for n+c.rb.+-D.. bLst lL{
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Building
<br />32-
<br />Under Slab / Floor I
<br />Eonding / Grounding / UFER '1lklr4 ')-raa
<br /><-
<br />Torquing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Facto ry Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough
<br />Service Meter
<br />FINAL ot/t,v/r<-_?cM thnh))
<br />Notes, Remarks, Etc I
<br />M \WP51\Pm{-hrp.cuon Fms\El6dma]nsFdrm R6@d d@
<br />Spas, Pool, Fountains
<br />Communications Cable
<br />I
<br />Transformers
<br />\lr'
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