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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER AUILDER DELCARATION
<br />I hcrby .rtr'h u tuLr Fn,lr, or l!.rFry rhsr I 6 .r.'q fron rh. Cdnr{ton l.i.ns II* (tr
<br />'h.
<br />ltlL*ing E&sn (Sa 701 1.5
<br />Butinc$ orn Fror.$i,n Col.) Ary Cily or Coudy *hich Equi6 r Fni ro a,n!rxl. rlls. iwDt!, d.n[in or EFn tuy
<br />(Mw. Irii r0 r iriuN, tk 'qtuiE! rlr el'!li&r fm rEh FrBr ro filc. !!En ilrr.rmr rhd Ir or rlE 6 licNd tulta
<br />t, rrr F.iri'n! olrlt Conrairi l Liensd lrw lo!fl( 9. Co.ftain* wirh S..'ion luD ol Divirbn I of lL Burim$.nd
<br />P&rcsbns ('od.) oi rhar tE o. sh. il.rcipr lhcEfb'n rd rnc burir tur rhc rll.g.d.r.,rpriotr Any vhhlhtr ol Sdion 7(,1I J hyrny
<br />.ml.ani for ! Fmr suhjck rlr q,plt.nl k, . civil FMh y or mr mr. dr. fivr hundrd doller I l5m)
<br />_1. I oeftr nl rlE lrFnr. i, ny.nphF. *irh .r!.! &t rh.ir iE (strp..d i,n. will do th. rrl .rn E(ffiird
<br />inrcftkn or ofcr.d for sL (Sd 7o4.t, BuliEs .nd Pr.rc$rns Cod. Thc C.nrrrrtr.! Ltse L.* &B {ply tr m 6wr. or
<br />rhc F)Fn, *l& hiiltr o, i4hB 0Ed'n. dd *t! &ri ch hn hinrla nr lxkltor rhrculh hir or rE o*n.i{,loyes.
<br />pn'vrrsl lh.l .kh nqm@rnr m ml irdd.{ rofi.trd ii, sh ,t lt,w. ir llildi.a d lqrecd i nb wiru m }.a
<br />of({r?hria rlE O*ffi aui& *iU hR rtE hrrhn or Foi{ ilq lt d ar di mt hrn n itrFE dr lretdy ,r 0r FrFr ol
<br />l. towForrlF FiFny, rm.rclusiwryoddinB wirt lie.qd.odmcton to $n{rucl llr Fotrr (Sa 7or4. B6iE$
<br />rfll h!{sin (\rL Thc Co r-roir LtcnE L.* &s mr +ply io .. r*F ol FoFnt slF t{i*rr or aiproB rh.r6n.
<br />.d lt, .ndrrr. rq tBh I'DFI snnr Co'nrri6(tr tiaErl toNud 16 E Codrrltr r linr trur
<br />-l
<br />!o.x.6tt ukhr S*ln)n-, B &PC.turhire{n.
<br />Drr. off.
<br />lllSfsSli-cturBsarq!
<br />DE ,^SAISN
<br />I h.rby rrrn lndcr p.ehy or Fiury oM ol rn folhrioS d(ln ioB:
<br />-l
<br />h.E rrd *ill min[h r Ccnifrr. olcord ro S.ltltr@ ti k t6 6n+.rdi,.. ar FoviLd ld by Sdi,. ]tOO ol E
<br />trr C.dc. tn lh. F.fl,lrr.a--.. of llE *rt fn *tih tlE Fhn ir i!{.n
<br />-l
<br />h,v. rnd will mimrb mrt.n' conrpcnulnn insunr.. 6 mquir.d b, Sd i,n 17m of iE l,bor .Id., for llE Frrortrjlrc o,
<br />rh. k t ld *hrh rhlr Ftu h no.d My *drn 6?gsd_:994sltr ffi .d lDlir.unlE &:.* ., Frrerrs\ A)a$'oa^[ -.4,.S . . , , ^*n,n"*", - '76roe1o4fl1 I ',,*. 1! f ta
<br />-l
<br />(s'ry thi in rrE FdrmN ol0r *o* rd *hah rhF Fon r ir$cd I n ln,ctrphy&yFBnirrr,tutr
<br />$ $lob.sr hJd to llE wrtft oq.ne.li,. L*r ol !:.lifomi!, lnd igR lh.l if I rholld tE$r $bFrl ro llE
<br />wrl6 s"{E.srion pmvirhnr ors.diin lTmofrn Ltr C.d.,l nru. fonhwirh mnplr snhllnr pnairbnr
<br />.'r'l rln.r up r) k hutrJrll rh'u{Rl Jollr\ l5lr uolr. in !&liri.n ro rhc.o{ orcon{rnssrhn. drm8.r 8 tmvn.d tu rh.
<br />sNrtrr.r07()or rll l.rhtr(n([. i frrnr lrr(
<br />,,",.,- 4f o/6
<br />llKrt&ulll}
<br />I lktohtiifirmu.,ld trMlry. f FrJUry rh lr li(n{dMJc, Pn i.i"n,n ('hrNcr vr(,mnrNin! }irhS(rirTrlxlroll)ili\ion l
<br />r rtts au!tr$ rrtl Pnrr.sr.nr c,d..Irl m) lrcny ^ n rullnrl uJ.fln1;#,.EcnsNumh.r aioSotg*lf,rlet./,a
<br />rl.)lsrf,ucual.ENlltc-aril:lLrIh.rbyunrnu.rrrMlryolp(,jnryrldilErcnacon{B--riotrlcndirs{s.m,trtrrhcFm,nEdcorrrEworktlrwhi.hrhiFmilt
<br />nlEn rsa ]lr). cn c,
<br />&ETIAdLDTC|JAAII(,A
<br />I hattry !trm undd p.nony or ncrrury orE or llE full,*i.B 'i(U6l6.t
<br />I).nr,lirbnPcn k.ArtErkxNorific.ri(r lJcdcEl Rc3ulori('nr(Tirl.,q), Pd6)
<br />lclnifylhll rnc fe'icrllrr8uhlion\ Esrrdrns lsti{nr rcm'vrl !r( nor.n i L k)rhir pn,F.-i
<br />I .dify rhrr I h'!. ral rhn tmlr{i)n d rrrr. rh:r rlx rh,rt inlohd it. n .in(r I r8r h n!.r{ly r irh tll ( r, rrn (i'!nty
<br />onnnrmr. anl sn . l ,s ! rcbrn8 y tuihr,! EF.rdd'B orihrr gry $d Gmy r. c.rd uF n rtE
<br />Jtrtr. rnroRll noncny itr
<br />,\pDlir$l or ,\lenl SiEmlun
<br />l2t r C.-[4u,n r'.1
<br />4!telr
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountarns
<br />Signs (monument)
<br />Lite Satety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Bonding / Groundinq / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit ,
<br />Walls (Conduit) a'/rl,/l{.,&A)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Soflit Rouqh
<br />Ceilings (T-Bar Rough)
<br />lvleter Release
<br />Rough
<br />Service Meter l
<br />FINAL >n77 / -^Jb 4r)
<br />Notes, Remarks,El6,/' //
<br />Under Slab / Floor
<br />l.rklrr'\ Ad(lrut\
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