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<br />ELECTBICAL-INSPECTOR BECORD
<br />APPROVALS DATE tD/slG.COMMENTS
<br />-1.
<br />trr orrcr .f r hc norEny. m cr.lu{vcly .ontrdin! wilh lrc.nEd conrnckr^ t, tun{rud rh. tini.tl (Ss 71x4. Bu\irrc$
<br />rd Fn .-incdt Th. conr-rof I Ltcns l r* &B d !flrly t' rn o$F ol lroFn, *lF t!(ild! nr in{tfur.s rlEr$n.
<br />rnd *ho .onlmls fnr ith F,j.ts with, G)nrtuorls) lirred Punud r,, rh. (ildrd.r's l-r.ns li*r
<br />I rfrctr{ utr(l.r S.lrkr Il & l'( k{ rhtr n.Nrn
<br />l)rl. (rrftr
<br />UOBIE&T:g)TITENIAIIO!
<br />l.ndcr\ NanE:
<br />-
<br />APPI ICAN'I DECI ARA'II(IN
<br />l hfth, itrnn uftLr Ftr.hy ot n ,rurt nr of rlt irrlhr trrB d.{ Lr.r!'n.
<br />l)cmoliri,)n tr.rnir\ rhc{or Nortic imlirdcr!lRc!ultrti(,nr(Iirlc11r.P0nr)
<br />k.qumd lJnd ol Mirltari)
<br />-l
<br />.mify rh.r rlr ftnc.d egaltrirG Elrnint $lE roi Em r! m d qr..bk
<br />'o
<br />lhn F.j.n
<br />-l
<br />cnify rh,r I trr E.d rhs .pdrrio. rn !k lhn ltE .6ot infintdi,n i! .n(1 I o8E ro orrily Pi'h .[ Cnv .d Counrv
<br />nd'n!N!.ndSrrkLr*ELtUroh'Hm,conrrudhtrirdlrEh,drtbrEE,tdd'E!nf'htrCnyrnC.unrvhcnhuFnrrE
<br />rlnE mnrhrrl pmFny ror ingj.(rhn N,roJ.. - -;,;;;:;"^VGJI/ m , LJQR
<br />^,. tD 2le
<br />Prm,*Em,Dr,n,):,*crUtCR €<<z
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Siqns (monumenl)
<br />Life Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bondino / Groundino / UFER lt ).,ls l/Uil4fr
<br />Transformers
<br />Torqueing
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Soflit Rouoh
<br />Ceilinos (T-Bar Rouqh)
<br />Ir/eter Release (\r{/la,l n r
<br />Rouqh
<br />),/,t fr,,
<br />FINAL tL 1 tq t 4efr.
<br />Notes, Remarks, Etc.
<br />OWNER BUTLDSN DSLCARATON
<br />I h.chy dmrn undd !.n.lry of pcrjury rhlr I u cr.n{r fn'd rh. (.ntEdm l-tcnic li$ fitr rh. ri,lbwint EN}n (Ss 7031 5
<br />Bu\iE\r .d Prorca rn cld., any cir, or CN y rhah cluirc! r Fnn b o.rtul. .n6. inFrw- d.ftnirh or ttFir uy
<br />nru.run. prir ro i!. issuarcc. .lw r€tuiEs thc lppltlnr aor such Fmir ro lik . s'sftt rl.rcm.l lnd h or slE i. li..n.d tlurunl
<br />ro ih. F viri'ni of tlE ConkErd'r Lianrn lls (clrrrd 9. Codftrina w h S<lhn 7(|Il of Divaaio..] nf rh. Bu.iEs lrd
<br />Pmr.srr\ (nd.) or rh.l lE.r sh. ir.r.q)r rlrErrcm lnd ttr h8n ror rh. iLrcd lrc,prr,n Any vk lnhn of S..lbn 7o.ll5 hya.,
<br />epplic&r ror r ltdn rlhiyr rrr rppltrd to . dvil ,rMhy of ml m)r rhan rih hudrd dolht(S5ml
<br />-l-
<br />al owN orrl! pbFny, or mycD{,hFes,irh wos.{ er llrn {*.on{xnsario.. will& rtl *r un llE ntu1m n ml
<br />ii{sd.d oroll.rdnrel.(S(, a.auriGirndPrn ri,6 Cd. Th. CodLldi Lare l.r dB mr .llry to.. orF ol
<br />rhe InlIEny *l$ hilds or inln*s rhcE]n. lrd *tr' dmt sxh H hi'n*lf nr h.r€lf o. rhmu8h hn or h.. un .mrloFcs
<br />Fovid.ijlhd lEh n{'.ffid! m mr d.ttiLii ofl.N! (tr qL lt h'r$t, ilt llrrhl n inrn'Er i1$U rttd {r F,
<br />or sq,Lri^ llr olxBr Duiltr *ill tlE rrE hnd.. or F,vin! rtd rE d nE dil mr bild o iqbk ilr rn,tEry nr dE Fqr ot
<br />Sub-Panels
<br />t7n
<br />Service Meter
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