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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Lile Salety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding / Groundinq / UFER
<br />Translormers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilinqs (Hard & Soffit Rouoh
<br />Ceilinqs (T-Bar Rouqh)
<br />[\Ieter Release
<br />Rouqh
<br />Service Meter .tA
<br />FINAL t\-lrt-1-v,!tu1r1
<br />Notes, Remarks, Etc.
<br />+
<br />OWNER BUILI'ER DEI,CARATION
<br />I h.,chy atum uhdcr Fnalty.f p.rjury rh,! I m .rcmfr liom rhc Contlcnns Li.en{ lr* nr $. tulnrqmS rc&n (S.u ?0ll 5
<br />Burnr$ .nd Pdtskin CqL): Any C , o. County which tcquircs a pcmir io c.n{ncr. alrcr. inrProvc. dcntrlsh r rcIEn t
<br />dn'.rurc. nrix k' ik Nsuair.. llro..quircs lhc.pdcanl tur suuh ncrnnr r,lllc d nPncd slrcnrnr rhll tEoi slt ( li..nkd l'uBu.nt
<br />t'r thc pmvrnns ol ltE Coniracnr s l-a.n{d Laq lchdPt.t 9. Conrmcn(ing *irh S..LUn TUXI of OtvGiIn :l oi rh. Rtrsi*r( ral
<br />Prntrsi,,n\ C,rrc) orrhl lE orshc N.rcq th.relnnandlhcbasisnrrh.allc8.dcr.m i,'n Anyvi{rlarionols.cionT0ll 5byany
<br />rpahMrrrx dt'.nnn subjc(ts lhc aoplra nr r.'!,1l,l:nrlryolnor moErhn Iivc hun,h.l dour\ (i5ur).
<br />L a\ owmr or rhc pdFdy. or my .mnL'yccs wnh wlscs n rncn !,h comr.ns,lon. will 'lo lhc *.r( drl rhc dturm Ls n.r
<br />rr.nl!'l or ou.r.J ld sllc (Sd 7t}1,r, Busirc$ an,l Pn,tcsx,n1 C,ilcr 'rh. Conlt.cttr s l-i.cnse L* JiE\ nor rpply tr M owncr of
<br />lhc pn,Fny wh) huiur or ir{K,hs rh.Nr, rnti qho J,{s sEh *rt [imscll or hcr{lf .r rh^,u3h his or h.r own cmnloyccs.
<br />proviJcd rharsu.h m,tr.kmna m nor ntcnJcJ oro,lcdl ktrsdc.ll, h'8ttr. rh. t'oillmS or r{'n,kmni ir oll rnhm mFs
<br />ot conl,Lr$n. rh. Owncr Build.r will h.rc rhc tu,lcn of Iln)vinS rnnr lI or shc dkl hr huill or imPnrvc ft. In,tdy tnr $c l!,Iss nt
<br />-l.
<br />r\dwncrol rhcpN|.ny. rmc{clusivcly.onradms wirh l'(.n\L{ cnnh.k)n l,) c nsrru.l rtE Pn,j.ar (S&.7044, Bustrs
<br />lnd Pnrc$rrCo,le:'l hc Conrrarkr's Lic.hs. Ldq docs n.rrttly k' rn.wncr ol r'opcdy wt$ burld. or mprovcs lhcrcon.
<br />rn,l wht, contak ld su.h l,oj(cB wrlh a Ci)nlracbl1\) lilrns.J I,ununr r) ih. Contra.ktr s L[cnsc l-aw)
<br />_! an cx.nrpl unLtcr Ser
<br />l!1,186!889!lrlfE!sar!!Jx
<br />U&CLAAAIIAN
<br />I h.rcby allirm un'.lcr lenahyolFrjtryon. olrhc nnl,*mt dc(hralonl:
<br />I hrvc arn will roinr{io x Ccn,licrrc of c.n€.r to s.lllnsurc fo. wolkcr' dmpencar on. rs FrviJcd lir by Se.rion ]7$ ol rh.
<br />tjtrtr Ci*1., Lr rhc p.rlom.mc ol rtu work lor whrh thc !dn( r Fuc'j
<br />I hrvc rtrJ r,ll nrnrrnr workc$ r nlpcnrll()n rn{ran c, r\ rcqumJ hySc.rrxr:]?Urol rhc l-rhor Ci c. Lrrh. Fdnrnr tc.t
<br />rhr wo.k 1,tr *hrI rl'^ Nnni '1"'"My*orlcn (,mpcn\rt n uNurnxc.lrrcr lil plicy numncr {e
<br />'€+t-^aI
<br />Zl (n'rvihr mih. FrlurmRc n, rhc s,rk lttr *h'rh'hnl.rn r $sucd.l \hrll tor cntloy rny l'.bon i6anyhMrcr
<br />so as lo tE{m sutFl ro rhc worLdi con{xnldn,n lrws olcaLnmE. !,,i a3N rh,r lft shuu tE$ft uh]c.l ro rhe
<br />w.r*er' $mpctrrorion ,n)!i\i.ff .f S&rDh l1r0 oi rhc tjti'! Cdc. I sh,ll. ltnhw h c.rq y wilh tlFc Pn'vi\ions
<br />WARNIN(; Frilurc to rcw workcs conpcn\rnon ('vcra8. s unlxrllI, an! shrU iu$rccr an .nlk'ycr b crinml P.rulras and
<br />c,vil hn.s !p b om hundrc'l lhouvn,i dou$ (!1m.000), in a,lJirnr t, rh. .od of.omFmlrR,n, dmD8.s as Povidcd $t rhc
<br />S.(ri,,n 1076.l lhc Lfix C,rlc. inrcr.{ r rorncy \ na(.
<br />AEqA86ITOts
<br />I herchy airm unJer p.nalry orp.rjury lhal I am liend uoJcr pmvl\ion orchlPrs 9 (u'mmmins *nh S.ctr'n ruo) ot Dt,sion l
<br />ol lhe Busiftss!d Pn,hsn,n! coJc,.,rl mylrcnE ^ in fullfire,nl cl1iu.
<br />oos7o7
<br />/o-zZ- 1?*
<br />gqNslalr:u$l-LEluuc-dclNcr
<br />I h.Fh, rifrm u d lf,ndlry or lcrjury lhll rh.rc is a !1,nsrtucrlrn bnJin! .lcruy ntr lhc !'.rforrwe ol rh. wYk ltr rhah lhs fqnn s
<br />(sucJ (Ss 1017. civ. c.)
<br />AEUEAIfDECI.AMIION
<br />I H,y lnim un r.r I.nalty or ,crlury om of lhc lolhwin3 JccladrnDrl
<br />D.mlirion P.rmik-Asbcsros No{ilic{ion F.dft.l Rc8uhlnns (TnG 40, Pan6)
<br />Rcquircd l,trcrolN nidrix
<br />-t
<br />r.d'lyrhar th.lcdcrrl rcgul.lt)ns EAudin! d\b.dos rcnovrle nor lanlic le r) rhis Pn)Fcr
<br />4h1rdrl,,hd Ih,'c rcr,l rhr snpltr,n,i { n.rcrhlr lhc ihrvc inn,runon N rodc.t. l as@ to ompl, *i'h all C y8ndCounly
<br />nfmin(c" rn,l Srrrc liw\rcbrmi r' hu'u'ns(un{ru b.. .il herchy auhrh rqr.s.nhrivcs of thn Cny u'i Cou.ry ro .nrd uFn ttr
<br />,lx,r. mnrionrJ l,fup.ny br rsp.crinrpnrrxxc!
<br />.'-.',." x
<br />Pole Bases
<br />Communications Cable
<br />"^.., /O-zz-r7
<br />I.nJca! Nrm
<br />-
<br />trnJcr s A,JJE$.
<br />-
<br />,nn,'za-72-/'/
<br />---I
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