APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monumenl)
<br />Lile Satety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding / Groundinq / UFER
<br />Transformers
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soflit Rouoh
<br />Ceilings (T-Bar Bouoh)
<br />lvleter Release
<br />Rough
<br />Servrce Meter
<br />FINAL *t4.2) .o &v)J) cll
<br />Notes, Remarks, Etc
<br />OWNER BUILDER DEI,CARATION
<br />I hcEby.lIE undcr F lry otlErJlry rhd I e.rcrFr nlh rE C.'r,rxn Li..n* lle r.r r,x followinS Ea$n (**?0ll5
<br />Blri6r .rn PrcfBsion Cndc): An, Cny or c{{dy *hih Eaui6 ! Fni ro otrcM, .lts. irt ow. d.mlnh or ..Fir ey
<br />{,llfu. Fi,ro ir. nliltE..lro r.quiFs ln..prlid ror ikh Fd h nL. stEd n.LBr lntl lEq aE ir littn For{n
<br />fi' r,r. FDvnioni o{ rlr ConrrErolr l-k.ned l,w (Cllpiq 9, Conmtrint wiln s..lir 7m or Oivision I of lh. BuriEI md
<br />Pn,r.$krn*Cnl.)o.rhrtlEdsh.is.x.rprlh.Efn'mrirlEtrlirforrlE.lLgcd.tctrrrlion.4.,ri ili,.6lS<ri,n 701My any
<br />.pdr, tu r Fmil ruhFtr tlE .Irrlt.nl ln r citn p.ulr, or mr mE th., nt. lEd,.n &,Lr( Ilt(tr].
<br />_1. .! .wd ol rlE l,nFny, d n, .r{'hFr wilh figc. ! rh.n $t sn{En{lhn, *ill & llE *(d rd ft nntrm ii br
<br />inrcnd.d tror.Ed for rh(58.7044. Burims $d Aofcsbn! ('odc Tlr Co.rrcroir Ltcnc t e di.r.or.pplt lo o*E ol
<br />rlEF,pdiy,lDhirkd!'trcGddftrd*tbdBnrn*dhiNllorlEr*lfo.rlmu8nnnn16oh.rFhy6.
<br />FoviLd r!.t rah irsmlElds c mr i..r'd.d 6oltH ltr -t Il lEffi. rlE nlildil r itrsGcd t $U *ilii d ,r
<br />ormnpllbn, th. o\.ffi Bdlhr eil hE rh h,rkr ofF.vin, illor!&dndhild.rirFoE ! F!Fr, f., r,! F,FEdr
<br />_l- f,\ o*F oarlE I'orEn). m.rcbirly.onllul! ailn litnsd codrdrK 16 d,NM1 rlE FrF (sd 7Ix.. Bhrs
<br />,i Pbtsin Cd&: Tlr co.ka.. r I-E.nr trr &s mr .prly
<br />'o
<br />u oeE of proFn y *h blildr or inpbEr rhcft..
<br />rl {ho .onhcr\l,r{trhtoJ.rr\*irhr(i ons) li..n{d portunr r,rh.Conklcttr's l-Ecnrc lrwl
<br />,"a;\ff/il".[ t'^,'r-|\ru.,u
<br />I1j.:lr,Its.lllLl]
<br />I h.Ehy .rrn ud.r Foly of Frry oE of rlr follo*iE &<Lnritr
<br />_l hsw !!t aiu minriin ! C.d irE.rc nf Conc trS.lfldurforw dr' conp.nsri,n, !s Fotid.d fm b, S(rion l70o ot rlt
<br />lrtn Cd.. fc llE rErftu 6rllt qrt ld whth rti D6mn ir irrkd
<br />-l h,E.d rill minr.h sort6 .onFNrb. iNrft., .i EquiEd t'y Salbn lrm of rlE lrtbr Cod..lor rlr FndIrN ol
<br />rlE mrt for whth thn Imil is isnxd. My wntd sqEndion inrurlmc cuit ird lblicy nunb.. cl
<br />I ccniry rh.r an rh FfolrrlR or rh. wort ld whi.h rht Fmr is nru.n. I .h.ll n .,ploy.ny Flu i! uy tu6$ $bb.qnEstrdl.llEm s'otrFrErhn L*of Cniromi.d.aft rn rI dsuU b.c'ft l'i{r io rrE
<br />u'rts o,mFcnslhn pmlni,nsolSdion lr(t)olllt Lrhn C*,I {!ll. nriheirh onrply rnh rb. pmvtiff.
<br />WARNIN(; l,ilu.c h sur wnl.'\'rr,tr{f,nr In
<br />Iril finc\ u,) b.E hurrlrcd rtx)uun! dollm (11(r,
<br />. '\ lnlnrfll. r,rl ctrll ubFl M
<br />ftil;ldn rn n, rh ..{ or .or
<br />;i;-,t4bltt,tliu/
<br />Dl.( I \'a\ I lrr\
<br />I hcrcb, !flthund.r Fndlty ol p.rjurr lh0l I a'n lttnrd und.r rovisir olCh.plq 9lco'trmNi.B wirh s.di,n 7fix,) ofOivtrrn l
<br />ol rh. Buli[ls d Pn'fc$bnr cl'd., rn n, la.n( r i. tull f(,Rr2n.ltiit
<br />coNsrRUCTro{ | n\DlN{: a{:EN('v
<br />I lEEbt lmrm und.r FMlly of F,jury ltur thqt n r mdrodion !di.r !s.(y tor
<br />'lE FrrmEN .l lh. *wl tu *nt,r rhir Fflt i!
<br />rnf,d tsc 1l)97. civ a ,
<br />d.Ef!IIATiLDE!LAIAII(,i{
<br />I hrr$ldlirtrrutr crl.ndhyof rc!u,yokof rh.,,'ll"qrg d.(hturi,)ns
<br />lxnrlirl)n l,.,nrirr a\h.(01 Nor'r(!rr)n tiil.ral R.!llarr)n\ iI l. {r. Ird6r
<br />R.qutr.,l l.rrcrol t{r'lf,nrrnl
<br />I drry rhd llE rd.rl E8llri.n{ E8&din3 .rt$bs rcB)vrle. ml rlnla Lt,rhnpoiir
<br />I.rn \,rr, lh}r rr.rlrh^ rFr$. ilprl{Jrrrru rh.rhr. 'in I !8rex'.oDnr\ eirhrllt 'ryrnd Crunr!
<br />*=**$,:ffi Hk. o ]l,I,@il'
<br />- " "
<br />r
<br />ELECTRICAL-INSPECTOR BECORD
<br />tar&r'! A(hr$:
<br />-
<br />I
<br />=
<br />I
|