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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE tD/slG.COMMENTS OWN}:R BTJILI}L't DEL('ARATION
<br />Lmtry .lirm uftr.r FMlly ol rE,jury rhd I m .r.q,t fmn rlE (-odrrclon l.ic.n{ lj, rrn rh. rollowin8 rcdern (Se.ro:lr 5
<br />Br\ifts cnj Pn,fc(i,n Cin ) An, cirt or (6uv shrh nnuinl ! Frml r. .\NM, rlrd. iqmE. &rml'{h or qxn ry
<br />rrflf,tur.. tnr h nr Nunmc..ko Equirr th. lll)Fli(r.r rrtr {rh F.mi n, fiLr risrcd {lurcmnr rh,r h.o. rlt i.,itNJ ptrsd
<br />!o rlE F.viri,n. or rlr Contrtr\ t-rin{n l,* (('lDfr.r 9, GmnFmm8 f,nh Sdnn 7(Ix) ol Divnion .l ol rlE Blrit$ lnd
<br />Pnnar{ioNCod.)r lh{t lEorrtE is .rc.qrl th.r.r..nr Md rh tlris n, rlt rlLr.d .r.m{ri.,h A,t lirLr$norSdlbr r0.!1.5 t'y.ny
<br />dlt 'rrnIFtuuh,c!rrrFq'rlr,^rr'!,*'lnnrl,'rrnurm{.rhrnr'1.hundFdJollmrllur'
<br />{[lyh $F.lrhcF,F y.n,m)cn'j)li)(\w htrlscc0rllEtskorrrEnsri,n,willd.,rLtorl,r,rh.rlralEkBqr(nd or oncr. n, eh rSF 71n4, llulm$ mJ Pr.fsrbN (ird.: l1r (irtrdd'r L.acn* lrs dB ml +plt ro u o{ ftr of
<br />rh.nmFny *h h!rld! or rn{ross r}mn- ud *t[ dEr u*h roA him{l( or lErclr r llm'u3h his rr hcr o*o.rl0l,tt.!,
<br />,)nn ild rhd skh iir{nnr:ldt e nn i ftLd or ofidtrl f(, sh ll lre\q. rll tIiBilE nr itrirftEir h sE enhin rm ,err
<br />otdJtr{ldirtr rhc ()wN aui!. *ill h.K rrr hldr orlFllE ln.r tE r{ {r di, nn toih r inFrE rh Frldy fm
<br />'lE IrrFE llf
<br />l. r\ ntr kr of rh. Foncn y, snl c(lu!\.ly cont!.r ii3 * h li.cncd .oitirt..\ r, .do{ru.r rlI F+.r (Sc. 7r ll1. Bhir(
<br />Url Pn'rLsrrC{rL llEContrrrtr'\IirnaIif,d,r\ftnallPlt()!notrkrrl|,,ildv*h,huitlr.rrmprtre\rh.rntn,
<br />lnd rho .onrnf,lsIr ruchrn,Echwnh!(.,orrocn'lls tr\al I[' \urnr n, rlf, conkrr
<br />x|"oiuffi"
<br />UICIJIAIIIIB
<br />I h...I'r rlfirnundd Fnrlryol Friury om oI thc nntrtrnl3 d..h.driont
<br />Ihr\.inqillrsinrlnd(cnirrat.!f(-.u{nrt.S.tf.ltrur.r(trrork.6 corranurion- !r noidsl I'tr hy SNrir lTur of rh.
<br />tlhtr (irh, ntr rh. FfrdRr of rlE f, dt n, r hih rlt Fmi r iriu.il
<br />-l
<br />h.\r !*t r rll mintiin s.rtdl' con{Enrrhn rnrurlN.. !. knut.d hy SNrrr .17ur ol rh. I atr( (ixl.. for rh. FrfotrluR'. of
<br />rh. work for rhi.h rhn F,nril i! isrEn M y workss' (n{E.sr irr inrur!tuc.rir &n Fraymmbcr ml
<br />@ .cnifyrhrrinr&Irnrnrrcofih.eodfm*hthrhFFtrn t,!\udl.I \h.ll n cnllLy .ny lcmn itr !try mtrrcr
<br />b t*t*.nr suhJ.rr t, rhc qo*crs ronvEnsli('n lrx of Cuhnnni!. u! .3e rld iIl rl$old t(od $hFr k, rlE
<br />6c mrFrc! nn fmviriN ol Scdnn .r 7u) nr rhc l,hr Ckr.- I iull, ,',nt{ irh dniply *irh rtbr Frvsio.<
<br />WARNINC lorlurc ro surc *orkc6'rcnrEnnrri,in srcruc i\ unh*rul. rnal dqll \uhj.ar r cmplorr nr ainiul Fmbi\ rnd
<br />.iuil li*r up ro nE hundGl rhoue'n doll.n (tl(l).ux nptr rlir'r.\ r\ n,L^trnal ntr rhc -
<br />;::i[////
<br />XITL,\BIIIII!
<br />I hcrhy rllnn u*ld Fnrlry ul Frrury rhd I trr k.tr<l und.r prrristu.{( hut'rcr 9((m'Bh-'in8 tirh S&ii,n 7(XXr.IDnili'.ll
<br />ot rh.tlu\irsr Pn,r.*knl(',ri. r l m!li.nr a in lull lmr xfll.lldr
<br />SIIEIBXIf:ITI8j.IBIII G.AGEM]T
<br />I lEnty.fiLm un&r FMhyni Fiur) lhd rlrE k r odMir kndiq ls6ry ror E Ffrlllrm or rrF frrk tu *h.hlh! Ftni ir
<br />t.kJ (sft 1097, civ c.).
<br />APPI ICANT NFCI ANATI(JII
<br />I Hry irmun&. Frt, orFr,lly oE olrlE folhwinS &ihEri,.r
<br />lxn'lhi,n Pmirs A!t!{d M irr$bn tu hlR.3nldi,nlrTnk tlt). Pd6r
<br />-R.rl!iErl
<br />l!ii., oll{difdi,n
<br />ffi*i
<br />'di,t rhrr rh. lsL6l r.BuLkn. E3adrry a{Eior rcmrrl i c mr lrnliat L ro rhn pnFl
<br />li'n\r! 1r{rr rher rh. 'kn. inli trm i\rotrNr lr!,& rr.nInN s h oll( iiya.d (i,utrr!
<br />( irymdC.unrYro.nh uFr rlrfu hutr'nC!im{u,hn. r hnft r.Fra.rdr.sofuht
<br />.hr. nrnri,ftd ljn1Edt
<br />i,,r'*, - ^*"r.'*,(r.-rr*no." rpanl
<br />o/rlr
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Salety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding / Groundinq / UFER
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Boof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Bough)
<br />Ceilings (Hard & Soffit Rouoh
<br />Ceilinqs (T-Bar Rouoh)
<br />Meter Release
<br />Rouqh
<br />Service Meter Il ltzlzD Oet-lf t"
<br />Noles, Remarks, Etc.---r-T I
<br />t
<br />Transformers
<br />FINAL
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