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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.OWNER DUII-DER DEI,CARATION
<br />I h.kb, llfirm und.r p.Mlry i,rFrrury rhd I rm crcrpr fmn llt Colntrbn LacaE L!* f.t rrr folh*ins rclq,n (Sc.nlrlt
<br />Businc$ Md ProL(ion C*r.) Any Cily o. Counry $hth rqnts ! Fmil ro connrud. llls imPmrc. (bmlnh or Elirn .nv
<br />{todE. I'irt' irr r{.mc..t{ rcrtuirt rhc illl,lirn! rd ru.h F mil lo filc..i!md {ftmnl thlt h.6' 3hc i.liccnsd pu.sutrt
<br />h rh. Inrvi\irrB Dr rlt Conr,.ktr r l-ircnEd liw ((-tuprs 9. ConmNin8 *irh S.crn,.7fln ol Divtion I orrlr 8u'in'* $a
<br />Pnrcsi,ns Gn ) or rh.r tE or rh. ir .rrtr{'! rh.rcrtod rnd rh. h.rh lor llE .llcs.n cr.,r{,thn. Ant vhbrir. 6r sdsn ?01 I 5 hv inv
<br />ipllkrm r(tr r Frnil rutudrt rlt r$li!i.r k, i .iv'l Pcntll y .l n,t mE rhm lirc hudrcd &Urs (S5m)
<br />-1.
<br />!s o*B olrlE FFnr. n ny.rihyEr *ilh *r8.r ( rrrn $b $ryhrdi,n. *ill do lrE r(n dn tlt rnllE k mi
<br />id.id.l r olI.Ed ld sL (Sa 7()4/l. AuriE$.nd Prsfd.ioN C.dc Tlt Coddolt Li!t- L,w &.! ml {,Plv L d ow6.l
<br />rlt lrrrsi, *,r, hlildr d rqrnF llrGn .nd *h dB trh krr him*lr or ,'d-lr or ilmrgn hie c tE om.nPl'F6.
<br />Ii.viLd rl( sh !rymw'* E d iicd.n ndk rm qb lr, bkE. tr. hoildrls q nqftEnd nrld val'i' m rd
<br />ofMr'Ldrr dr O*ffi au rd silllrE rlt hlddr o,FviB dr lEn{tdil i, t iU or irFN dE FtFry 6r dE F,In- o,
<br />l, ! owE .r ltE lrrErr. d.rcl!\iEly dflrd ina $ilt liusd oddm r. otrrnEl tlE Foi{ Is(. ?Ol'r- 86ffi
<br />.,n ffin Co&: Th. all Noir t,tcn- lr* &E mr rprly ro m o]F or lin'rn, lho htitl! or ingmB rlEron.
<br />.nd *lr o r&1r f uh FoJ.dr pnh. Co'r81{rir,li$Bn pllld h tlE Conrxrdt titd t:*)
<br />I !n .r.nq{ unld S.din
<br />Itll8f,lls:ctElgdsalloN
<br />IEITJSAIIII!
<br />I lrEhr !fimod.. riMlyolFrFryor orrlr n'lb*i.8 {t<Lrrri r
<br />I h.w !n r ill f,inrti. . C.nirE.k or ConE to S.ll.l.!ur. tm s,r6 odP.nt io .s FtviLd for bySari,i l7ll).lrrE
<br />llnn C.dc. ld rlr Frf6m of llf, *.d ,r $tih rh Fnn n krDd
<br />I hrw !.d will nEinrtin wo.tcrr i,qEnqrhn !nrunr.. B EqriEJ by sdhn l7m or rlE t,bor Co&. f.r llt Ffolrrim ol
<br />tlE m* ld *hah ltn Fnir ir ir.En. M, qil6t onFeriln an$llm.Mtr ri F,lty.un6.r e:
<br />-l
<br />r.n ify rhlr i. rh. !.ritrnurc ol rhc * rk ftt *h{h lht F.inir i\ ir\!.r], I rhall mr cmpk'y any f.on in lnv mnkr
<br />{r A r(, tE$.r uhFr h rhc *o*6i (n{E.qlirn h*inr( aliri,nir, lnd !38 rhnr itI {sukl tE om subj.{r ro rrE
<br />*n*r( (dmp.n$rt'n I'n, rhn{ .r s(l trh .17(r) or rhc lrhr ( d.. I tull.
<br />'.nh*irh
<br />on{'ly wirh
<br />'hoc
<br />pmlnion ..
<br />WARNIN(;: Irdlur. ro surc *o*.h coqx.{ri)n .nvcn3c it unhstul ind shslt subFr rn.mphF ro simnrlFMXa: and
<br />ciril finci un !) oft hundrcn rtutorrnd dollfir (il(n.qlr)- in uddirirrn k' rh. cost ofcotr{.neii'n. d'rHgcs !r pilrlit'il for rhr
<br />sftrirr 1076 ol rhc lihn(ixl.. inrcr.{id{lorfty { Lcl
<br />o,t, lo.L'tZ noo*",, Al )l!D&o ct)QJ,illTleN
<br />UIDNT}:LIOIIIACII}BDEIIJIAII!]N
<br />Ihcrcby ofiirn und$ Endhy orFryury rh l um lturndl und.r Pmvnion of Chnp'dr I (.ommmins wirh Serhn ?ux)) oI l)ilhbn :l
<br />or rh. BNift*\ rnn P$fcsi,'ns Codc- drl my li..n{ n in lull lorlui .lrt.r
<br />,.o**.r* clo D
<br />Dr,. lc).L-\9
<br />9q31a5
<br />befi jt!+!1 Ev3R-
<br />collsTtlL-rroN I ,r{nrN(: a(;f-N( Y
<br />I lEEhy frm uid.. ttEx, .a Fiwy lhd rhst ir . d,sfidi,n kinS .8crt rdi tlE F.f{ll':Erc of rlE wrt fd *itn rht IEf,il i
<br />irsEd (sN lll9?, civ c )tr ('r N.m
<br />AITIIITTILDESIASAII!.UI
<br />I hdtlry rtrm ud.. l.oty ol tErJUty oft of rlt folh*in8 d..lrnr bnr
<br />D.frnna. P.rmrr Aib6!o. l&rifr.! i,n FaLnl ic8oL!ionr (T[k.lo, P.n6)
<br />-R.1lu'Ed
<br />l,(a dt f*ria.dm
<br />-l
<br />csrif, rhd rlE r.d.nl ESuLlirB E!.di.s rrt$ror Em{l e (ll +CbrtE h rhi Foi!1
<br />\lcdrrlyrh,Iri,rrc.drhnq,I,li(.rnn,i{.r.rh rh..hoE irfmlrlDi n (rEa1 I+Ehondvtin.llcrv.rnCddv
<br />qdLBE rnd shk t rrELt' in tlildins andnc rn h.t t'y.dLne EFltnrriB oalth Ci.v.d Counlv ro dd r4.. t
<br />rhr. trr rkrmd II',t*nynr m\tE1trr'[urF,(r
<br />Appllc..l or Ardl slgrlur
<br />P.m,,F'mrprrn., All Sl { 1Po "vradiff
<br />\a-^ 4t
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lite Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Groundinq / UFER to-tl-18 4z z')
<br />Transformers
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Sollit Rouqh
<br />Ceilings (T-Bar Rough)
<br />lVleter Belease
<br />Rouqh tA.ttrlh,4ezz
<br />Service Meter tu.tH o
<br />FINAL /01 t -tfr Gc zt
<br />Notes, Remarks, Etc.
<br />COMMENTS
<br />l-d..i Addt ri --
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