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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNEf, BUILDAT DEI' RATION
<br />I hftby !,Im !nd6 !6tlly ol p€Jury iha I n ddpl nos lh. Co, r..ldt l-ic.nr. Lrq fot rhc aollowins .d)n (Se ?oll.J
<br />lruin< e'd P,ofs6n Co.L) Any Cny or Cour{, whth ,!q!i6 ! F ril lo @tr( .! dla inptov.' damlith or lF.n dv
<br />nn(r4Fi,toilr !!lll&.ho,.$n6 0E @lisr forutFnilo 6Lt ri8Ed oE! $r l'.or dE ir lic6.d trtn r
<br />lo rtE FDrind ol $G Cofi-ru! Lci-d L.f, (clrFa 9. Co'ffiiig snh S<rbo 7000 of rrtib. I ol lh. &Bil6 dd
<br />Prcllnhd Cod.) o, rhlr t d tE ! ddlel thcttoh Dd ln. b.i! fot llE rlLs.d crorsiotr tu, vioLli,. of scrnn r0-r I 5 bv &v
<br />lrplicet for ! Fnnn ubj6r' llt .,91'cml ro ! ovil p. [yof ml tur.|nM fiv. hudr.d doll@ (1500)
<br />-1.
<br />s o\rG ol0E FnFly, or dy dpbt6 wilh w.86 ! En 3E otr'Flrb.. *iI .b tlE wi rd dE rirlw i. ml
<br />iiad or o,E rd l- rL (Sc.7O4a. BuiB -d Aof6iB Co&: Tlt (drrr.id . lio* lr* &6 ml +lv to , 6$E of
<br />rt FoFty *ho biLl n itrqlE rE@ nd *lD dG rdr q,l hirelror h*llor tlrculll! tir d lE om d4lo,€
<br />pr.vid.d drd 3u.h imF\ctlt E [n nai.d d o,LEd 6r rl. If. ho6q. lrE hiiuit{ irylltd i -ld sithit d }d
<br />of@mpkrhtr E OwF &ild. *ill hlv. ttE hrdn ofFonrg d!, h. or JE .tid ml hild 4 inFoE tlE FlFtv fd tlE FrF* of
<br />-1.
<br />Bo$E of rl- F$tEtr, E a.h!iwl, odidi'E *nh ln.rE d.odrIi6lo @,r!l,trt rlt FoidI (Sd 70r.. Eli'E
<br />!d arotsin Co& Tfi. Conm.ror. Licce Lr$'d.td Dl .p?ly lo & o\E of FoFlv who t{ildt or isP66 lna@(
<br />Dd who coidrdr aor ech Frj6l! wnh a Coif*lo(3) licq!.d punu,n lo lhc coniEcttr t Lk* Ltw).
<br />I m.rdd trd, sdhtr .8.&PC fur thi la$t
<br />t.r. orE
<br />.uaSfEEs:caulllsarlq!D'CI Aq TION
<br />t hq.by .fm sids Frny of Frlty oG ofilE tolbwry dEl,abdl
<br />-l
<br />hnc ad wiu did.i.. Csrifttc otcoE[ ro Sdf-lM 6r Era' mPaElis\ B FlviLd tu b, S<liti ]7@ of tlE
<br />L.tq C.dq 6r tlt Ffnlrc of rlE wt 6t qtki t& Fen i! ie.d.
<br />-l hrlc ud will m.inr.i. work{ comp.Mrbn iB(lltre s rcqln.d by sqlitn :l?00 of th. lrbor Cod., aor llE Fao4lm.. o I
<br />rh. srl for whth thi! Fnn i isel My Enl6r' mmpddion iBlrc .ei6 nl ,olty ruoho a
<br />t-.\
<br />-Exrn6:
<br />'
<br />l.dil dd in rlE Dcfotu. of lh. *orl nr whah thir Firr ! isu.d. I ttdlNlorploy at Fen in &, ME
<br />r B ro balr ,ubdr b lh. *irrd' Ntrpqlrb. lr*. of C.lilomia .d .sB rhr if I slbuld b.c(ft Fl*{ ro llE
<br />r! 6 onFldhnF$itbNorsaion l7mor E L!b.( ( o& LrdL fonheth omgt wnh rho. Fltiti6
<br />WARNTNC: rnilue lo w. workd' coiFir.tn'. cova.8. ir unLwtut. ed rhtll lubjd e dploF lo dinind FarE Md
<br />.Nil fB up 16 oE hB&.d rlnust dolltr {11m.000), in tdlnaon lo ilE.o, conp.6rion. dtr.86 ! ,eviH for rh.
<br />I ha*y .rm !n& Fuly ol pdFry thr I m li.qE.d E& Flvirbtr oaclt Fs 9 {@.lll4uE wnh Sdii,! 7000) or Divnin t
<br />of rlr. BqiB !d PrefdbE Cod.. .d m, lt6g i! itt tull foB .d crer
<br />'clo Ll
<br />,tft641
<br />( oNs'rRucrrrrN I ftll)lNc ,t(:rN(-\'
<br />I h@by .rm und.r F6liy oa Fjutr lhar lhs. is ! connru<ri\. h irs astry litr rlE psforu--.-. o f lh. mrt for whrh thk Fmi ir
<br />afllJcAulllEllsArlo!
<br />I ho*yrfittru ia Flhy aaFr[y oE of dE follo*ing &.bniE
<br />Ddmhion Pmnr-Arb6r6 tlotifrdion F.d.El RcsuLlioa (Th1. 40. Pal6)
<br />-R.qun.d
<br />lrlq olNodidio.
<br />-l
<br />cdiry rha rlE tu6J EsrlrbB GlEtli.S shd6 lEmr.l s. iol 4pli.U. lo lhit FDj{ti
<br />k/"orityrt^tt "",,narnllrplk.rion!'d!l.tcll lh..tb( infondion it.or.<r I .€B lo smrl) *nh .ll cirv rnd Courv
<br />oijih.rc6 ed srarc Ii$ rchrn* k' buildirS &d hd.hy uthornc rqrtrrarir6 . i rnis ( ity Dd Counlylo fllE ulDnr
<br />atFr. 6'ion.d F.pdr for iNp.1ikr.
<br />Aprli..nl o. A*dl shn(ur X
<br />,..,',...-"",U,rrr, F re CE\Ze
<br />-EliL/tc
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Founlains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Building
<br />Under Slab / Floor I
<br />Bonding / Grounding / UFER \>4 '11 /41.11q(!)
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipmenl
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Soffit Rouoh
<br />Ceilings (T-Bar Rough)
<br />Meter Release k ?.4ttq //tql-a&'tt 4 ILL+(1 .Uttc(D
<br />Rough *7,41t1
<br />Service lvleter
<br />FINAL Lt\,)4fl &t@)
<br />Notes, Remarks, Etc.
<br />Site-Work
<br />Communications Cable
<br />Transformers
<br />SdFn 1076 or rl. l.bor Coda da.n ud.rdr.r'r fG
<br />,.,,, . 4lrcf h
<br />c*"*.".K
<br />Biad (sd 109r. civ. c ).
<br />L.d.r't N.m
<br />-
<br />ry
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