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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spqs, Pool, Fountains
<br />Signs (monument)
<br />Lile Salety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding / Groundinq / UFER
<br />Transformers
<br />Lorqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unil
<br />Walls Conduit)
<br />[Valls (Rough)
<br />Ceilin gs (Hard & Solfit Rouqh
<br />Ceilings (T-Bar Rouqh)
<br />Ivleter Release
<br />Rough
<br />Service Meter A
<br />FINAL 'o'1'A h&Util)
<br />Notes Remarks
<br />OWNER BUILDER DELCAT TION
<br />I h.rt, rffrm undcr Frh, of Finrr, rh.r I e.x.q, n$n 'lx Coddm l-ile l,* for rlE folhriry Bqrn rs.c.?oll.t
<br />Burin.s and Phfcsion Codc): Any Ciry nr Cour, which .cquirc\ ! Fdir t, .on(dd. ,116, inrpn,vc, il.m,lkh , 'qrtr ey'
<br />sEElm. Fir k' i,t i$u.N, .tQ Equnn rlE rpplfinr ror ruh p.mi r' nL. n8Brl {d.mnr rhlr lE o. rrE i li(n<i tltlJe
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<br />rlE Fova\nnt ofrlr Conrrtlorr l.ienrrt t * icn lad 9. ComnENm! r'ilh sarir ?(tn o( Diisbo I of ill ltlriK &d.
<br />Pmfc$ nsCodc,orlhd tEor sh. ncrcn/ th.r.fnnn ind rh.thsis ror rh.illcg.dcrcr4,rhn Anryir)ldrionolSdhnTl)ll.5hyi.,
<br />+pltrfl for . Fmit rohF.k llr +plaldr ro !cirilpcElryoln,r DE rh.n fik hldr.n dl,ll,[\ I lt(x)).
<br />-1.
<br />!{ o*mroflhc pmFrlr. or my .nploye! wnhwrS.r. h.r vr. d,mpcnitrioo, willdo ltrs* !dlh. \lulE n n
<br />idcrnn or olt.ad fr eL (S<'7(X4, BuriBsind lh'fcssbnr C.dc: a& Gr ncn, t l-kcM tit dtt mi rntly h m owE of
<br />it FoFny sh lxittror iqmB rlEEh..ri *tn d(Bqrt Hrt hid*llor tErllor ilYoulh hr r lF o*n.f,PhF.t,
<br />prov!d.{ fi.r r!.h rqhRft.R e mt hr.rd.n or olI.di ,(tr sk If, ,F$.rE, rh. h{ilirin8 or iryroliEnr k v,d rihn or F&
<br />. t corq,L,rion. I h. Owmr Builds will lErc lh tud.n of,rolin8 rhd lror {E dn d hild.r nr{'mE lh. tmFny fo.llr N4re ol
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<br />I. rr owft. of rh. F)fcd y, an crclurirclr .ofiacrirt8 *irh li.cn$d cuittr ktr\ b .onntur tlr ptr'r..r ( Sc. 7(}l,1. Buti**
<br />Ud hsa<h (iiL TtcCo ftrr'r Ltcna Llw &Er mr amly ki .. .*ra ol pmtEdy $tr| huilr or nqrn'rc! ih.rdr.
<br />.nd {lb Nnrtui f(, fth 1reF13 wirh r (bdh-trli) lirned pu^d k, rL (i'irdor'r Lirn( trs,
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<br />lrncr.mfr und.. S.dn,n-. A &l( Ir rh^ r.!q{
<br />D.r. (hn.r
<br />wonxrrs' crlttrpprilrrrtn
<br />DECI.AaAIIO!
<br />I hc,$r !m u d,(nrhyotroruryomoarh.folkrrirF d&hrrrions
<br />-l
<br />h.r! {n s'llminr.in. C.n rrE.r. of Concd r,S.lr.lnrur. ror *rl(r on{rtrsrinr. rr rFrilni for h, sdri,n lTul olrh.
<br />t hr Cod.. ftr rh. FftrmN orrh. hrl iir rnih rh. Fmd is i(.kd
<br />-l..n,fyrhd
<br />in rlE Frrolmh olilE *ort fr rhih rhit Frmii n 'r.kn. I ihtrll mr rn!*,y iny Fr$. tn..y mnrr
<br />b ri ro lE$m rubFr lo rhc vrrq. or{Enerhn Lqa ol (-tlitunr. md l8R lni if I fi{E lE or uo,!1\r k! I h
<br />trorl.'\ .onrthrnni, f "\ni{,n\ o, socrtrf , lTlr) or rhr l rh r',{1.. I nill. k
<br />lur. k, rurc sorkcr co rF. r unbrrul, q0 \h.l
<br />i" lJdiri.tr n' rhc\
<br />ll .uhF rn 6i{'hF h niminal Frii6 !n
<br />0fcdtr'p.trolnr. dlNrcs r\ rovidcd tor th.otrc hutr(lrd rlhu\rtrd d(
<br />lE tlhr (od.. irlcr.{ rR
<br />t hcEhy slli n u.,lcr p.uxy ol Frluiy rhd l 0m lNn uBLr Eov(io.olChrprd e(snmrfrin8 rnhSdilnTuxJr or l)ivnhtr l
<br />of ilx,Bu\inc$ J'd liolc*r,n{ (i c- !ftj tr,y lictr{. i\ ir iull l'tr{ a'rlrrlrrr
<br />o frsb
<br />I h.rht,rlirtrr un q rcmlryol ncrury lhlr
<br />i\\u&lrs.c lor)7 ( ir ( l
<br />r. ir . di.nM irtr bndin8 .Icm, aor rhc IEinnnDmc nf rllc work lin r hin rhii Fnir it
<br />AfII.lr;ANflIEl,.AIAIlg!
<br />I hdrtry rfm und( Fnrlry .l p.rruy 6* oa rlr Iollo*ins dd&,rr ioni
<br />D.nrl Dn Psnnri A<tE{or Ndifrdirn Ftncd R.auLrion( (1!L10.1'rn6r
<br />-R.quncd
<br />lrtrcr o, Norifrdirnr
<br />trE rdLr.l rc8uhr[n( EBlrJins rrtrd'{ r.nIrrlm mi rfl'larhlc t. rhir FmFd
<br />ii,omui., nconfl I r8c room
<br />.by o,horiE EF.dliE rr rhi C
<br />lr I hlre rcnd rhtsntlinri,nn rrlrcrhnr Ih.rhtrr dy $irh rll ciryrd (lrunry
<br />ny rnd G,unry ro .nr6 +on thcSr!r. tj*r FbrinBn, t 'ld'n8 rnnnd.ri.n. ml h.,
<br />(n4
<br />s[=1r o
<br />Communications Cable
<br />EtC.
<br />_l tuk .In sill minliin *orkcn cotrrFNnion inrur.r.. $ r.quit{ hy Sd hn .]700 of r,E L:h.r Cod.. lU rh. rErro@rc or
<br />rlE krt fu whi.h rhir Fmn ir iaard My w(ts ..nIEdhn inrum ffi. !n Inliy dnlE rc:
<br />Lxnd.r. Addrc(
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