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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE tD/stG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Liqht Standards
<br />Spas, Pool, Founlains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor I
<br />Bonding / Grounding / UFER 817? l1i 7 D/t^raa
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment Ylztlzz , bt*,{7
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouoh)
<br />Ceilings (Hard & Soffit Rouoh
<br />Ceilinos (T-Bar Rouqh)
<br />1?'7lzo D*t+6 7
<br />Rouqh
<br />Service lvleter
<br />>7
<br />Notes, Remarks, Etc.
<br />{
<br />OITNKT AULD}:R DE.I,CAXATION
<br />I H, rtlm lntr Fuly of p..tr! tlu I 6 .En$ nlm rlr cdrara!' Lrtc !.r iq Ut io[o*i! E& (s.(.70]lj
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<br />inEruE. plrr ro hr @4., dlo E{uiB rh. {rt a!, lor Mh |Enn io 6t r lisEd icdg ihr h or IE i, lEd.d Frud
<br />ro th. F.rilioB ol rh. Conlr-Lrt l.tcnEJ Lr* (o'rrrcr 9. C.htrEin8 with S.crhn 7()()O of Divni,.I .ftu Buids ud
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<br />rlh.{ .rn rin Ary vELrie ol S..rio! 7011 5 h, Dy
<br />.pplid Lr. Fmi NbF[ ltE .pglr.n ro r.ivil p.Ely of mt mE rhr nE lltntld &,lln (tJd))
<br />-1..!oqmnfrh.rr.rEny,tr6y.npkltEswnhwrttBrh.n,k$trp.Mrhi.will&dEk*tnrlE'&68ndidarlal or olT.EJ for rb (Sa.704,1, BoriEs .rd P!.L.ions CqL, TIE Cotukol' Li.M Lr* &Er Nr rpPl, b u oE oI
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<br />Forid.d fi.r st irFDt@n, ft ni n.d.d€drq.d l .L u. br.w, lE hrlia(EFEcd i.r'id rtlbc Fr
<br />of.qlptlia 0r O*E Blitk sil h.* tlr trl.J.n olFyru rt h. * {E tlil d hil, ( dI.sE dr Flrci, ft, rlE Frpor o{
<br />-1.
<br />6 o*Er oiilE F,pdr, m.rch$v.I, .otdr(I rrh li.Bd .otur6 ro .!E{M llE FDFi isd. 1).4, aurirs
<br />rd tus!. Cod. Th. Conidr! Lr.nr tr* ddr Li Aply t, u ouE oa F.Fd, *ho h.lut d i4bE, rh.ftn
<br />rnd vtF arift:,r rh thFrr *ih. coM,(r ltcor.d F{lM 'ot,Ec.,r -l6 ' t.itn Lv)
<br />_l an'.ktrfl und.r S.(ir! ,ll &PC hrilnrK,,
<br />]IqEA!8S:CQM!!I6AII!N
<br />DECLAXAT'ON
<br />I trrcbr.lli.nr utul.r O.rrhy oI r4u.y oc ol llE lolh*r3 dcclarrioN
<br />-th.ruls
<br />l rorin tcditrd..tcl,lld ro S.r-!|re fd qrl6 !!trFUrra a FuviLd td br SG:b rT@ or E
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<br />I h:v.utrd*illnnnrrnso.*rotr,p.Artxftrtrursrr..i!Eqtrtr.JbyS.r(nr37mofrh.L'h*Cod.,for,h.p.rfoaikrtoI
<br />suk nr rlrhrlns rHnnr My *rxt6 NnFMDn iNur$. Ms .n Ir ky nun*Er r.:
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<br />_l..dify !h:r u tll F orn*. olrL *dt ft, *h.h rh! Fhi, ! !o.d, I irll dr dpb, uy tE$D o [, lll,m
<br />$ sro trr.m sut c.r ro ri. wrr6 6qxds L5.(CdiI@. r,!d r,c Dr if I dFrL t ..r oliu ro rlE
<br />sort6r' .!r'p."qi,n proB-N o, Sai.n l7m ot ih. Ltr, CcL, I tru fdh*iih Ntrpl, rh rrEr P,DvuDB..
<br />WA|NI G l_rilur. ro *(uc rnl.^ or{ldNn ..8l3. n unL*rul, ri stull rrbFr rn .rPbyd ro o'frl FEti6 rnl
<br />.ftd fEr lri ro oE lurn.d buod &,U..s Itlm,UD). i! tdild rlE mr ol conlcEri@ a,F*., ! I'ovnal as 'ln
<br />lEltlf,arlotr
<br />I lErby lrlm un d FBty ol parury $. I u linl ods Fotun of Ol+G 9 (ffiq r.h SdiE ?O@) ot Divlp. I
<br />or rh.BNmriand l'mr.$'on\ Cod.,.nd my lir.tr< N
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<br />illlror( fi1crlar
<br />L-o lo0YLe'l.
<br />cglsrlulaaMJBDlrcriacr
<br />I tftby rlfrm !n&r p.dlty .I Filn thr trs. ir . (N6is Ld6, .,try Id dr F.fM. or lh. rdt t, rAih tt'i! Fs. ir
<br />ii$.,j(sd. 10e?, Crv ( )
<br />APPLICANT DECI ARATION
<br />I hdrlry rfim und.i D..r[ y ol p.4ury unc of thc folLviry &.brtmr
<br />D.mlirin P.rdil}Arb.nor Ndrfdu !.&rn R.tulditu (r.l. 4,0, Pd6)
<br />_R.quGd rAa ol NdrtodM
<br />_I cd,ly rhd rlr lcdc.rl rcgularin r8sding abcaos rc'n,vcl c mr .Ipli.6bk ro lhn pnjcr
<br />{r nr. $rr E rtr^. innnturr ncmr I {r ro d,n+ly vit rU c. t rn cMry
<br />rFrt{dE oI $! Ci y .tn Cou.ly r. .d6 urn! 0r
<br />Radl@a[l6dtt
<br />Rev.08 07-2015
<br />Ivleter Release
<br />FINAL
<br />- 6-Ll.
<br />c.loct h\
<br />ilu/w
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