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APPROVALS DATE ID/SIG.COMMENTS Ofi{IT BUIII)B8 DELCAR TION
<br />I rEEry rmrm ud6 Fuhr 0l lErjury rh.r I m .rcrpr tnm rlE C..ir-r6 Live Lrs ro. rli tolhehB Esn t'a..- 7l)I 5
<br />Buiin.lr id Prnr.shn CflLr Any Ci't or Cdnry *hih rquiEr ! femir ro .on{Mt. dh.r. irilllbr.. &mlih or EFt o,
<br />sldcrurc. Ei,, to il3 irs!iR., alro Equmr rh. q,nlrml an ru(h Fmi lo llkr nSEd rl.l.mnl lhrr lr or rh. is lt.tr<n ,Iurqlnr
<br />lo rh. Firi.irlr of rh. Conrmrd r Li..n€n tls (Ch'I'r.r 9. ('trmturint wi,h Serbn 70fi) or Divirir. I of rh. 8lrift$ .nd
<br />Pmf..$nt C{rd.) tr rh, lE d rh. n.r.q, rh.knom d rh. hrn for rlE rlLf.d .rdlxion Any vi,lri,. ol S.rli.n 7O-11! hyr.t
<br />rptlk.nr tor r Frnir uiF h llE .r'!lt, ro . .ivil FMhy .l $r m,. inr firc hu'dcd dolLr ( Slrr
<br />-1.
<br />.( owmr of lh. pnrFd y. rtr ny .niploy(i wnh w.!.r .s 'h.t $L Nn{Entrxm. s ill do ilr wnl rd rlE ndr ir dn
<br />inlc.nor.ficrcdlor$1.(Ss,O1,4.Busir.slndPmL$n'niarrLTlEO,trrcl.i\l-icr{LIw&BnollnFlyro,iowmrol
<br />rh.F,tdy *h6 triI. or iqhh rrBsn. .d eb .k6 s_h snl hnnkr o, hselr or r hDlrh hn d l.r o*n .'rrh!..\.
<br />pflriLd rtri uh rymmds E r{ hi.nLd ddEEd nr sl lr- h6s- rlE h(turu r idllrmB n $U rirhin,ft )IdolnfriLrm dE owF Buill. *ill lrE rrE l!n.L.rFuts rld lE f tlr dil ar rliB m irlmE tu llrrdy ary r F,Ir.ot
<br />l, rr owrcr ot rlE Fi,pd y, !m cxclosivc ly conr&1in3 *irh li..nrd .ofi!.n'n n' oNrrud rlE pFFi ( SN ?(}1,4, Burim(
<br />url ftna$in Cod. 1 hc (',n ,octor'r Liccnr lrw do.s tr, slnly I', .n or.d or IrlF y who burld. .r imnorcs ln.r.o..
<br />..d *h codmk f(r \kh |'n,j.ik wirh ' (inkrron n licMd I'Ursd rorh.(i)nk'dor's Lk.n\c li*)
<br />lrmc(nq{ urifl SA1r,..B & P( litrrhkRav0
<br />lr.r. ()$n.r
<br />rlla[E8LrlJAlElitauo!
<br />I)I:S.A.EAIIQN
<br />I furcht rltu ui&r tr'!' h! ol If, r.,ury ofr- ol rlr folk)s in! dNhri nn\
<br />I h.r. ,n *rll mdin r C.dif.rr. .f (',,enr ro S.lt ltrsrc lor hll6 n,tqrnsrnn. r F,rd.n ror h, Sdrir .17(l) ol rh.
<br />tlhn ('iik, rr i,! F.frymE ot UE $,t lor *tt,r llE Fn'r i( !r.Ed
<br />I harr sBlwillnnnhrn *ork.rC ..nlxnertr'n irxururk.. rr r.quirdbyS&rn lrrx)oIrh.lrtrtr(ixL.l rhc l!.nmEncc rl
<br />rhc qork for whi.h rhirFnnir N sshd. My rurkd\' ..mp.n$r i( rn\ura*. .dri.r ,nd F'li.y nrrhcr irc.
<br />{qv l&"/ c^rl*]]u rw:
<br />,,",'"'' ht:b Zf4jHt I \oo
<br />lrr ifyrturinih.IirktrRmr,,frh.*orklil$hthrhnplmrr N i$u.d. I \htr ll trol cmpk,y !f,y p(^on in 3n, mnrr
<br />v, !\ h' ti\nrc rubF(r t) rh $1)*.r' .onlll.i$t [n hss of ( rlr hnnk. r d 4r. rh.t i( I \h,uti tE(uE nrhr.1 ro r&
<br />ro*s\ Luv*nsr$n |}''rr!tr'n( olSNrrr l7U)ofrhc trh{ ( uk. I \tu|l. lonh}nh ennlnl! snh rn,{ n ornhn\
<br />WAllIlNG. F.ilur ro rM *orL( .onFndi'n o6F s onbrrul ad ilull obFt u .irlll'F ro diniMl Frh-.,n
<br />civn nn.r !p 16 oft huidrn rhouqd dolle (llll),o(I)r, in.ildirhn.o rlE o( ofoqrnqri6n, &Da.t r pmrid.d rnr rlr
<br />1.",''j''"'i'l' ii':'T;;,tppri,",, f
<br />DEIIJXAIf,'A
<br />I nd6, .rm o'd.r Fn lrt o, F.nrry rh.r I u lhr€l u!l(lc. Im$io. o, CluFa e lolfrrina *ih Scri,n 7om, 6t lrirnir l
<br />nr llE Au.iffir rd P,llis.nnr C.d.. !n my la.nc is ir tull fohr ]n .rd
<br />l-i.rnECL(: '*"' \ \2 6_\ol?
<br />-l-i...*
<br />NunlEr -Lt-.*,*,E \2€-
<br />\001'1 6r
<br />qNAIBJCI]I]!.I.8IDING.ACEBCI
<br />I lEEt'y rmrm und.r Fnrlry ol Frrury lhr llEE ir . .ofirrudifl hidinS .3.my for ln lf,rronDft. orlh. Mtrt for *nich rnt tsmir i\
<br />irtr.d lS( .1097, Civ C I
<br />AITUSAELIII;II.ABAIIIIB
<br />I h.Et'v drm und.r p.n.lry nr F iury ok or rh. (rlkr*in8 {ka.l,rltirnr
<br />txfrrlirrh Pcmis AsLrtx Norifrrrhn tsLrlRclllrrir rlih 40. Pd6r
<br />-R.quid
<br />lAd ot l*rifsiir
<br />-l
<br />..nify ihll llE f.d.nl Eguhiiom E8.rdiry .+r o. Gn,v.l rE ml appltlhL k' rhh p6l{l
<br />_l Gr ify rh, I h.r E d rtir rpr'liarih !n n.l. th.r lh. tlnr int ridion n co,r..l I +r b ord, *irh dl Cnt rid Counry
<br />rrdioN.r rn SlIl. uri ELr!E ro hildins.on{n cri)tr &l h.r n.r orrtn ( iiy.nd Cdnrynr.nr( uF)n rh.
<br />,lnrr mdnEd FmIdt rln mlFdnn F{rF4.
<br /> Dplh.nlo. Armt skMluF
<br />PrmftN Mmerprid): t(s
<br />ll2.l'-
<br />A.L/( A,^.,
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Si gns (monument)
<br />Lite Safet y /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceili ngs (Hard & Soff it Rouqh
<br />Ceilin gs (T-Bar Rough)
<br />Meter Release
<br />Rough m r/t(5 W.21211+ ?{
<br />Service Meter a_
<br />FINAL -.h b/tc )Nr llEA+4,
<br />Notes Remarks, Etc
<br />-+
<br />ELECTRICAL-INSPECTOR RECORD
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