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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCAR TION
<br />I h6cb, .flm u q podly of pijnry tht I m dcmpi ftom lh. ConlEh6' I-ic@ h* aor lh. followi4 r.en (s(,10.11 5
<br />Busrn6r ..d Proasion Cod.) An, Cily or Coutny shich rcqln6 . ,Emi to conirucl, !h6. ihrrov. dmolih .t rq.i d,
<br />srruc1uc, rior kr t! isuMc.. dLo rcqut6 lh. rr?lEMl tor such Fnr ro lik r si8n.d 3ldtul lhd h< or JE i! lic.B.d puBultr
<br />ro rh. p.DvisioN of ttE Conrd.roas Ltos.d bw {(_h,Fd 9, Comm.ming wirh sdrhn 7fixr of Division I olth. Botind od
<br />Prcfsioro CodG) or rh.r tl. or lhc it .rdfl ths.Irom ed th. b{sis for ln all.r.{.rmFion Ary riohrhi ofsc<lio.70:rl rtv!n,
<br />appli.a lor r pdmii subj.cl! lhc applica.t lo 6.ivilp..txtofnor mr.lh.n fiv. hun&.d doud I l5tr0 )
<br />l. u o\M olrhc FoF.ny. or Dy .6phr6 wilh w.B6 s tLir sL conFsdion, eill &, tL worl .d ft tnar@ i! ml
<br />nidx,.d ot olt6.d for d. (Sc.7041, BsitB ed Prof6lioB Cod.: Th. Cotuoar Lk.E b* dod Nr +ply lo M o"E ot
<br />ih. F.Fry *tbt l.k or 8qo6 dEE! &d who.t6*h srt nirelf .r h*lf or llFulh ha or hd o!, @pht6,
<br />provird rh.r ut !ipr.\6rEs c d h.i.d dotu &'r 5E lr. b*66, tlE toitli'B d nqsqEr n sB*nh6*
<br />'dofotrplrioc rlE O*G &rl& *i[ hlE rlE hrda ofFlvils tti lE or 3h. dn mt t{ild or inFlE lh. FnFry 6r tlE F,!... ot
<br />t. sowofth.F.Fly. &.rchlnrly cofirlins wnh licoE n.odrr6lomlnnEl lrt F.id lS( 7O'l'1. hlilr
<br />.,rj hlknn Co&: Tnc Coflrsioat Li.@ kw d.a nol arply lo e oMd ol proDdly rho boild! or idphv6 rh66n
<br />sd *ho .odr*B for sh p.oj.!li $nh r Coltlrdo(3) lad!.d lxmur lo rlE Co,nEds t t.i.e ks )
<br />I 6.rfrF u.d.r S.dio.
<br />}oaSEELCAUfEd$IrA!
<br />OECIJf,AIIO!
<br />I ,--!* lrtrn undd FrIy ot pqjwy oa of tlE followi.s d6lrd6B
<br />-l
<br />h!v. rd vill di:n.n r Cdifta. of Cote:l ro Sdf-ltE@ ts *srd €4aErbn. B Fvij.d br b, S<ibn 1700 ordt
<br />t td C.de 6r llE Ffulre. of lb *sl ld [tih dE Fnn i isucd
<br />I hrv. rnd qnl roi.rih uort6' cohFBnion ilullfui . rcquit d tt! S..lior !?0l) of lhc I
<br />rlE *nr f, {hrh rhE Ddnn ! Eld My uort6' Ntrsaso. rNft..aiE rdIDli\ N,* W:l,*z.rl (*sh JlrS.
<br />rorioN,.*,, @u.c;-,
<br />dBr Cod.. for llE Ff(yrlE. of
<br />t r.l<
<br />t c6r'ry rh.r i. rrE F6lrW. oadE wort ad shth tfiit Fhn it is.{ I !h!ll mr .4hy oy F$n i. rt IlM
<br />h 6 ro b.<.m $ti{ b tlE xut6'@npqstrnn hs. ofctrilmia od *r lhr il I ttFuld haom stic! lo llE
<br />srll6 omFMi,n Flriri'B ol SErio! 17@ of th. l,tsr c.dq I fill, tonh* irh ondy *nh 'hE FDrirnE
<br />\taRNlNC Fol@ ro G@ $0*6 mnpGihn clrqrs. i! u.l,*tu|. xd ndl $t.d e oilhts ro miEl F.n6 rnd
<br />r^il fd6 up ro orc n&&.d lhousd dolld (tlOO.oOO), i. .dd(ion b llE (or ot conqtuion. d!u86 6 Foricd for rlr
<br />Co&. nrdd ed dlonEy'3
<br />DECIIiAI(}!
<br />I lE*, .fm on& Fuhy o t Fju r.- thd I @ licqlr.d ordd Fo\ tioo of Clqtd 9 (s.jl'ming *irh S€lbn 70m) 6r Dniri'n r
<br />of rhc aun6 dd [,rof6io6 Co<!. rd iy lade a in toll ao@ di cfrrl.
<br />olia.
<br />TaSt=-
<br />COISIBII(fIANIIIDIIG.ACEM:I
<br />I hrby lrm udd po,Iy of FluD_ rhcl thq. n t aldru.1Fn hndhB aadv f.i tn psfomdc. ofrh.{otl lor *t'.h ihr Fmi a
<br />is.d {S(.1097, Civ C.J.
<br />Landd ! Nm.
<br />-
<br />AITI.ICAXLDECIdf,AIIO!
<br />I ho&atrm und6 D.naXy ofp..jury on.oflt lollowir8 d(lmlioos
<br />Ilmolnion Psmilr-kb6lor Nolifi c.iion Fcd@l Rcgul.lion! (Tnt 40, Pan6)
<br />R.qui(d Ii'6 oaNolifi calion
<br />I cdiry th.l th. Ld6d r.gulario.s EBedi.s sb€ros rdno!.I dc nor .lpn..hl. to lhir rojc.l
<br />t-fidiiy rld I h,rc rad lhk spplielion dd srtr. that rlEabov. inlonnilion L\toconrplysirh!ll( irl nnd aounle
<br />n.d anJ Srolc t \rs Elatins to building.
<br />nknrlon.d flopdt for insp..lion
<br />1,,-,
<br />.':::,:'{c;""""'-
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Founlains
<br />Signs (monument)
<br />Life Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough
<br />Service Meter
<br />ttl{/'i6 >lt<4
<br />Notes, Remarks, Etc
<br />-f
<br />'lilrolF
<br />'1pplicinr or 'r8or Silnrltrre:
<br />FINAL
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