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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE tD/srG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor EYDIE!EI\
<br />Bonding / Grounding / UFER
<br />Transformers Altc t n ?nt7
<br />Torquing
<br />Sub-Panels SAMC 8-43, 290, 556, 667
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory 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
<br />Notes, Remarks, Etc.
<br />O*nd-Build.r Dcclhtid
<br />I no$r rfm unds Frlty orFjEy dtr I m daE fm dE CdE cdr'Lj.ac t8 fa thc foll@itr tu (8.70! I 5 B6iid
<br />ed PEf6i6 Cod.) Ary City a Cot, riici t!q!i6 . Fnt to o.tu1 .lla, imFrc .bEliti a EFir &y !tdE. F,d b itrise.q rlo E9ui6 rh..pdi6r lc Nd Fhn l. 61. r n8r.d n E6r lhr h. c th. t li@lcd putter ro rhc Eoviao3 oroE
<br />C6mc6t Licard rry (CtlPr6 e. Cdfficint rirh sdrio 7000 of Dvin6 I of lh. BlaiEr od ProIdi@ C{r&) d lha h. a
<br />dE n aanB rh@6w .d dE t.n ra lh. .11!8cd adFid Aiy viollio of Sed6 70! L l, a, rylidr fr r FDi Eti..n 6.
<br />.rplior
<br />'o
<br />. cavil padry of.ot nE the 6E hurb.d d.lld (t500)
<br />_1. E @ o,$. Ft?sty, r ny 6pl.rs ann raB ! dEtr $1. dlpa!.'6. rill & thc rdt rn d. rt,Et!. u d inrad.d
<br />n ofidld fd td. ( 56 7o,L, Buin6 6d Pof6i@ Co& rt. Cema* ! Li..@ tr dG d .p9ly b x ffi of rk Fq6ry
<br />who blildt d ioFori t'.F., &d who d6 r@h wdt hitulf s ho*lf tr thrcuah hit or hd om mployd. Foeid.d drrl trh
<br />itrFrovaMlr d rcr ii|ax!.d d ofiad fa d. l(t@.q.drb ldiD8 d ir4.ovgEr i. &ld *iUin @ ra ol carDldc!, dlc
<br />OMa-Buil& rill b!. lhc hda of Fleina 0!r h. d rhc ao( b{ild d inprov. fr $. F,pa. of rd.)
<br />_1, r ovtrdof rhc F!?.riy, m aclqiv.l,6E lirr *idr li.d.d 6t-1d to drl'ucl tt Flrd(Sc 7041, BqitB ud
<br />Prcfdid Cod. nt C6!-dt U@ L.r.ba n. t,ply lo m orc o(F.rcry 116 h{il<tr r irFoE rtoa, -d yho
<br />6c-1! fd tuch prol.ar nth . C6r'&1d(, IiEu.d pu ur b rh. C6tu't li6r L., )
<br />_l n q@'t u&, Ser6
<br />WORI(ERS COMIENSATION Df, CLAXATIOII
<br />I hftby tlflm u d parlry of p.rjury dc of rhc foll*in8 deldi@t
<br />_l h.E !d rill,Dnr.i. . Cdtific.l. of Cdet to S.lf-lnt4 fa Era' mFldo, . Flvid.d f( by S.cri6lroo oa6c
<br />kbd Cod., fd$. Frftuc of rh.rcrt fq*hicn dE FDil n in d
<br />_l fi.E ed eill mi.ui. ra*6' .mF!.i@ iNulrd. a Equ,ld ty Se{d }70O of rlE t-6o. Cod., f- fi. Ffofue of ln.
<br />ral fr shidr lnir Fnn ir iBud My wdtd 6Fa!..d6 'tuu6@ €i6 &d poli.y numb6 e
<br />Policy Nmb.r ErpiE
<br />ohn !.did n ..l no. b. dlpla.d ilrn Fnn ii fd on. hutild &lla l!t00) dla)
<br />ar,ruc^trT,s pEct lrL{TtoN
<br />Dadino Pmil}Artdd tldifi.dd F.dad R.rllIiG (Iid. ao. Prr 6)
<br />_ R.quird L.na ofNdifidiq
<br />I 6ti8 ih.l dE fc&rl Eguhliffi Eardjng stEr6 rafuv.l e .ot plic.blc to lnir Fojcl
<br />_ I ccnify rhd I hlvc ard thir .r?lic,1ion ud tt r. rh.l rh. .bovc infdrlIio it c@cr I {re ro c6ply *ilh .ll Ciry ud Ctuty
<br />ddinr6 .ld srr. lls Elnins !o hlldi.r casrEiid. sd halUy idcia rq.E6i€ of $ir Cn, Ed Ctury b at' upoo rh.ltry. l6li6.d F!9qiy fd irqerid F,F.€Vz=.t-to /
<br />r
<br />_l cqlify lt.t in fi. F mc. of d. w t fa rlich 0i! lmn iit uc4 I !h.ll .or dDlo, ny FE inDynrenrcBb
<br />b.cs. lubjEr 6 tn. *qtd qdF..l!6l.s of cdifmil Dd.xE thtr if I rh@ld beoe sbjer io,rG *dr6'
<br />c6F ..,i@ Fwitid of S.aio ,r0O oa dE L$.. C..lc. I th.il. fdthrid cfi9ly raln tne Fwind
<br />or, tl -to ./o Z? tnt*r, { Z-,
<br />wARNINC tnlw b lE@ edtd' drpauaio 6€.a. n Ebrft4 od rlill nbj4t o orplorE ro cimii.l Fdda ri canl
<br />find up ro 6. hun&ld rhoqq.t &ll5 (l loo,Ooo).ii .ddnim to th. .dt of drpqEljo, dn46 . !rcvid.d fd $. Sdi6 to?6 of
<br />$c Lr!6 Cod., i cr6r lld.r1o.rrr'r f6
<br />ucr{sED coNax cmRs DfclrttraTrox
<br />I h@by afim undd p6dty of pdtury rhrr I m lica.Gd udcr ptot3i6 of Ch.p(cr 9 (cMh6.in8 witfi Seiio TOOO) of Divbis ] of
<br />th€ Buhd Dd ProfdiN C.da &d n, la6c n in full fau d cfrd
<br />Li6e c1& _ Licd. Nuhhd _-- -' .. - ---x,, .f-zo rzbZ c^*- 44-. ,
<br />coNsTtuctroN r ,{pr{c acENcY
<br />I 6, tfim 6& F.lry o{Fjdt rnr dE! ir. qlEdio ladla {gry td tr Fforrc of ln. rEt lo,ticn lnt Fdr i.
<br />is!.d (Se l@7, Civ. C )
<br />Ldda'r Nm. _
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