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ELECTRICAL-INSPECTOR BECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light 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
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soff it Rouoh
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough
<br />Service lileter t,
<br />FINAL 3/c/*", .1rffi '-'zt )
<br />Notes, Remarks, Etc. - /I
<br />owNt:ta 8ux,DI.:ta DlLcAt{A'IIoN
<br />I h.Ehy.finn u ., D.nrlry of I'.lury rhar I mr.r.nfl 6!nr rh. Or mcr6'l-ic.nr. tiw ld ih. fullowhg Erstr 1Sa.7031.5
<br />Busincsr and Proltsion C.dc): Any Cny.r Countv which rcquncr a lsmil lo con{Mr, lltcr, iq,ovc. dcfrrish or Er.rn ry
<br />ifldE, prid ro irr ksuanr., alsD rcqums rh. appli.arr io. iun Fmui ro 6k r sig,Ed srar.Eni d, lt or !5. h li!.rEJ pusoi
<br />ro $c 0mvNon\ or E Co.rr{rnrs l-Ecn{d I.s (Chrpr.. 9, Co,nmEmg wlh S(ri.n 70rD oa rJivhrn 3 or $. Busir$ rnd
<br />Pnf.sions Codc) orrhar tr or \lr i r(n{i th{.6on all,. h&!is lbr r allrcJ.i.nprbn ,^ny eiol,rion of Sdrion 7011.5 b, T,
<br />.ppli.dmlorrp.annsubJcrsrh..ppli.mrrod.'vilp.nrlrtolturtur.rhannv.hundr.ddolhs($5m)
<br />-1.
<br />I o*ncr ol rh. [orny, or my cmpl.yccs w h wagcs ,x thcn ek mmpcndioi. *,ll d. ttr *trk ,ii rlr {dm is nn
<br />itrt d.d or orlrcd ror $k (56 70.1.1- BunEi( a.d PDr.$ioB Cod.: m. C.dradq! La.n\. kr dG1 lor apply ro m ower or
<br />tE lh)rHy wln h{ildr or inrhkr rlxr$( a l ,ln ddr $ch *r,t t im.lf or lHslt or rhrclrn hk or ls orn .tuploya!,
<br />plolid.d (hd soch ihlrlv.m.k dr n inkdl.{ or ,rfcnd tu sL ll hoM, Ge hril.linl oi iqrMftd i. $ld ranin oft ,tt
<br />ofconpL(ioo (tE O*Er Builld *iI hlc E burd.n of tsovirt8 th, h. or xlE dil mt build or rptur. rh. pmpdry {d rtE purpo* of
<br />I. isorn.rorih. p$rEd). unr.xcluriy.ly.onr'.rint *irh hu.r*d dnu*rohh lonitu( rh. pmF.r (S...7044. Blsin.s
<br />a8l PnlrsDtr Co'le'Th. Cir rucror'rLic.neL.wdG3e{applyro0nowftroiprop.dy$hoburldsorinrpnv. hscorl
<br />and who co.tr ch ntr su.h pn'rccls wiih a Cunka.ttrG) lE.tr{d putrumr ro rtE Cbntdor's Liccm. kw)
<br />I ln.xemtr u*ld S{rtr
<br />t!!JB[!&i:lo![u$ 1I9!
<br />DESATA.IIIIN
<br />,U trlinr.h r ctnnlcdcofc.trsnr ro s.lf-InsuE ntr {Drt.s cotr:,Ensrrion,.s rovid.d for by S.clon 1?00.lrtE
<br />n,rhcltrl!trnrmcrolr[. "! ntr\hichrlr It,tr'iL is Lskn
<br />udwrll n$ntur v.rk.N' .onEnsuxon iNur!trc., r. r.{uiEd hySccfur3700oirh. tjbor Cod., ior ll'. FrIunBr. of
<br />rh. uork for wlEh rh,s l{rn r i$ur\t My *.rkda con Endion mlrdce Mrr drl Ibl€y n!n$$ N
<br />t,-)(o
<br />(qt I /^*\n
<br />I..ndyrlur n rlE tf,rlninrec ,'l rhc pork Ior whi.I rlN |Ermir r. RsDcd,I slull nor.nrtroy rny,E^on n {ny nunner
<br />s &s b hcNr {l,jcd '. thc wodc('ornpctreron r0!\ ol C!l,ron'a. .nd 4r. hd it t should r.cor subrlc' h rlr
<br />$u \dJ .onD.fl$rDn ptuli\o r of S.dD, 17(l) of $. Ijbn Ood., I slDll, fodhwnh NnEly *nh lho* DmvirioN..
<br />WARNING: rdi[r. ro *.ur. ]orl.h !.,np.nsinon cov.rr3.vf!1, ind ih.ll :ubicr in .!r'ploy.r ro ririndl p.Blis dnd
<br />ion. &nss.s a ,rorxl.d for rlrrivil tuEs ut nr oE I'mdr.d rlk,uytrd dolhm nr b rla cor ol cotr[ENr
<br />n.,. J /5 /)oio "
<br />I lEEby dftu urLrp.nrhyofp.rjuryihirIr r LcdrJ und.r pov;ion ofchdprd 9 (.otruEDcint virh S..1Dn7000) ofD,visDn l
<br />oI rh. Busn.s\ rnd PD|ssbnsCod.. a mylt.ns. i\D full lore rnd .ll.cr.
<br />Cro 15((t'r(Jr. El r(,tr\r
<br />r.arnlx!r:!&Nrr!u!!!,!!E!(r
<br />I hcEby afllrm und{ p.n.ky.I!.rjuryrhd rlE is..o^(tucthn lcnding .3.my forft.Frmtrm. orrh. }6k fm rhEh.hkp€m b
<br />issu.d lS{. 3097, Civ. C.).
<br />i!.E!!L!-!L.!l!.CL!!!
<br />I lftl,r ntr'u 1., r(rLh\ oltrLru', !trtr.o1rh.l"lh,qn,srl(l rltrtrr
<br />Dcnxnitrln P.rn,irs Arcinos NonlicI s,l R.BUhn.s ('titlc 40. Pd6)
<br />I rh. Ldcralr8ul.ri,,i. r.8ddii8 6b.s!xRmrrld. nor appltibb ro thk poj.r(.
<br />..n'rrrl l luvd '.rlrltr\ it)t)l'.r!r'rl'xr rlEah,u rnntrnulotr tr.or..r I r8rebcon{|, *nh, CnyrndG,unty
<br />ev'^ Tct\o
<br />ruhr c rcFc$nrative. ol lnir Ciry arl Counr, ro cnrcr upon UE
<br />^,.,j41)11e
<br />Rev.08-07'2015
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