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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS OATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Li ght 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
<br />Bonding / Grounding / UFER
<br />Transformers
<br />!orqueing
<br />Sub-Panels
<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 />lvleter Release
<br />Rough
<br />Service Meter /IF|NAL q,/////4
<br />Notes Rema4/s E6 - -EZ
<br />OWNER BUILDET DEL(ARAT'ION
<br />I ha*y .lTm un& F[ny of Fiu.y rh. I m dsrf, tDn rlE Conrxlo6 Lta& Lrr for rt* 6lb{i'8 E$o. (Sc 70] L
<br />BBin* .td Protgion Cod.): Ary Ciry or Cou y f,hich rcqun6 a p6nn lo .onsruc1. .1t6, inprove &mli!I' or rP.r dy
<br />ntu(GFbrbi. 6u,E. llo aqui6 rh. @li.dl lorshFtn 16 frl.. i!8,Ed srnE{ thi h.or tr i! lto!.<l IIrlEr
<br />ro lh. FlvilioN of llE ConrElor'! Lkor.d l,w (Ch'dd 9. Com*iIs wi$ SRlior ?m0 ot lrivnioD I of rh. aGims 6d
<br />Prof66B Co&) or rhtr lE o..h. ,t aarpr rhddiDd rdd rh. hcir ror lh. itle.d ddFbi Any rirhio. of S<tbn 701I 5 by er
<br />rppli.Ml for . Fmn .ubjel3 lh. +?li.d lo r .i!il p.Bhy of mI mE lho liv. h!.&d d,[6 (t5m)
<br />L ! 6E ofrh. Fspany, o. mt opb)6 *nh *.36 a rh.n bl..onipd!6n. Nin & rlr "dt d rE tuE i! br
<br />i axt d or oFftd for iL (Sa.70,1.1. ENh6 ud PiDfahs Cod.: Ttc Cod,Eld.! LaG lry &6 d .pply !. u o$G oa
<br />llE F,Fry *l[ tlili m if,p.os O.ua rd plD dE rrn srrt ti,rlr d lE*lr d rthush hi. or hd osn aryL)6.
<br />rrovi.l€d rhd 3*h iml'o\ffi ft d i si.d oiftrd &r..l.. ll lb$rs.
<br />'&
<br />builltrB o. ulFuErd i! nld wilhir oE 16ofcorphin 0E ()$€ B!il& *ill h.E tlE hr{b ofForil{ r lE or Jr dd tur hnB o. irtr(lr ttr FlFry &r rlr F,F-oa
<br />I, r o*n6 ol rlE Fopqrr, m 4clurr.ly cotui.rins u'nh h..G.{ cortdon io mnind rtE Fj.d (Sa. ?04,1. &!'nc
<br />dd Pr!to in Co&: Th. Conrrrroir Li(.@ L.q,&€ mt .!oly ro e o*E otpropdry u ho huild! or iiDor6 rhn@o
<br />lnd who 6dd! fDr 3u.h FDjeli $nh . coddo,lr) lt6.d psGurr ro rt Codmorr Lkae ll*)
<br />lon c\.mfl und6 S6'i(!n
<br />D.lc onrF
<br />woR(FRsi ( ontPENsailoti
<br />DESASAITq!
<br />I h6.t', amm unda Fn6lrt of Fjury- onc ofrh. folLsinI rtil-rioN
<br />I h.v. rn u'ill minl.i! . Ccliasr. ot CoM b S.ll.lEur. fd n'orl6 smpGldi,n. ! Eo\iLd ro! by Sdrhn l?00 ot th.
<br />llbor Codc for th. FfolIE. of lh. *ort for *hkh fi. Fnn ii i!.u.d.
<br />I lli\ . 5nd n r lt mainllr r ort6 comrcNll,on mrur!ftc. d rcquu.d h, sd
<br />'on
<br />17oO or rhc l.ihor (-od., lor ih. FfomR. of
<br />rh. rslforuhahrh!rrn i! isel Myuorkd comrFldhn i@rd..nir rn pon.y.unb.r R:
<br />,..,., Q*ctF,<-
<br />,,.,,,, ",,,,,,..
<br />wAooo \, cr1 (-, +,,.",- alazl.l
<br />! rdift thd in rlE Frfolffi otth. worl for {hkh rhis Fnt i! ie.d. I.hrll m! .rnploy uy F$n in &y i&nd
<br />e 6 ro b..oft rub..i ro rh. wond snFinion h$! orcd,tomu, dd ,sc lhd 'f I rrblB lEom rlqqi ro tlE
<br />hrt6 orF6dion Flvtio6 ofs.dio. l7(I) ot rh. I "bor
<br />( o&. I lrElL aodh*nh o.Dly $nh rlbr Fo\irioa
<br />wARlrlNC Flilur. t. su. qul6' comFElirn cor6.s. ir unLstul. !n rh,ll lhql e on?hls lo omld Fsria t d
<br />civil lio.s up ro oE hundr.d tholMd dollm (rl@,000). in lddrrn'n ro rhc clit .aco'nFerion. d,osd a pmlid.d l th.
<br />C,ik- 'iqd dd .rorE)'r t6
<br />iv"
<br />[ECusAnA!IhmhyirtrmundopalhyoaFjury'h.lIdtrlicc.dundarmvilio.ofch,ptd9(.omr*inBwilhSali.n700rJ)ofDivnionl
<br />of rh. 86n6 od P,oisita Cod.. rn ry t.G n in tull foE ard {f*t
<br />u.r. lO
<br />C1/){"i[u
<br />ATILISAdI.IISJA{IION
<br />I hdq rfrm u.&r Filhy ol Frury .n. of rh. following <k(l@rioN:
<br />l>nnlirio. Pdir'A.t d6 NoriarrlF. FcI6.l Rcguhriod ('Inb {O, Pd6}
<br />R.q!nai r!rd of Ndifrri{
<br />I cdlii rhrr I lsc od rhir 4pl
<br />or'li.anc6.nd srdc Lrw! Ehrin! ro
<br />.h.!c '6lnn d FlFry for iq.<r
<br />nrr. rh, ttE .tor. dorrnran n cdrcr I .gre ro Nmplv
<br />c.<ru\r'.n. Md ha.b) aurhn",. '.Ii6at0r{6 frhsair!
<br />,\ppli.rnl or l*sr shr.lur.
<br />(.;,-
<br />md( ounr) lo ard qnn lh.
<br />,eJ+-lu
<br />''". ,"" n. 11cl ('lo
<br />.""-"- $rua tr*-Cho<"-f.or:s
<br />CqIiIAl{f,lOUllDllG.AGEdIf,
<br />I hRby .mm u.dr Flny of pdjury lhd thac ir ! onnru.:lion kndins .s6cy fo, lh. paIolrmc. otlnc uotl aor *li.h rhi! Fnir i
<br />!$.rl (Sft !o97, Ci! C.)
<br />l.ddd i NM.
<br />I cd'6 rhr rh. f.d6d rcsuLrDE Esrdins stEror rmrll u. mr {pli.b!. ro rh! Fojdl
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