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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Facto ry Wired Unil
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rouqh)
<br />Meter Release
<br />Rough
<br />Service Meter
<br />FINAL 6t/-Zn t(c ,9,P€r(Ag Ul)
<br />Notes-, Remarks, Etc.
<br />L
<br />OWNfI 6UILDER DEt,(ARATION
<br />I h6.ty Im u,xLr Frtyof Fiury thr I s 6cn$ t m d'. cffi.6 Lie I.w 6r
<br />'lE
<br />follo$t 'En tsd tol|J
<br />8G!trd ard ProfBirn Cd.): Any Cny or Couiy $fiifi Equn6 ! FEi ro oddd. rrs. trl$.lE .hFlir' or lq., uy
<br />ntud@ Eir ro hs iM.. rlh r.quiG rlE Fplxer for $ch Fhn h fik ! rtrrEd nrtur $i h. or dE a lic€Ed Frun
<br />lo lh. Fori3ioE ol 'lr ( of,l.erm t Lk.G.d b* ((tuFd 9. (-oonftinB wnh Sdio. ?0m ol DirtioD ! ot lh. UuiE ad
<br />Pr.t*bB Cod.) orrh.r lt d rhc L d6lpr lhdcfrom&d rt tEn [or rh.dLs.n.roFiro Any rbhior of Sd-n 701I tbley
<br />lr,plicmr aor r p<mil luhldr. rhc !p?li.d to a civil p...hy of not nor. thr. fiy. hu.dral &Jlld ($500)
<br />l. a ow.d oflhc FoFny, or m, dpl6,6 sth w.sd d lh.n ek sorqsa'on. {ill do lh. $qt di tlE inErR ir Nr
<br />i'rd,:lol orofi6.d aor sh (S( 7ol.l, Bciru Md Ptnft.qrN Cod.: T6.Co dor!l-k*l*rlBml+plylob0$16of
<br />rh.FsFtr- *lb t!il&., lnFord ttEo( id *tD dE sh *rrt hi@lro' [<*lt or rtmugh h! d h.r om nphtq
<br />Folilcd rlE sh 6F.ffi mDr dsrbl uolH i, rl. l[ hoq-s, tlI hl loa M !r!.sdEr i$U *ito w yt
<br />ol @rpbir dE ()*c &rill6 *'i[ hot UE hdln of ForB rL l! q iE dd Dt h,ild d i!!ro* tlE FoFty b. 0E F Dor. of
<br />L ar o*nd ol !h. For,ctr. m d.l*ir.lv olnrer
<br />'na
<br />r ih l(ord co r&ror ro codrud llr !ml..r {sd 70,t4,I!6,6
<br />od Pfufssin ( od.: I h. (-o.l.r'or'r l,ic6i. Liw do6 not .nply !o M oq n6 of ,ropdr $ho build! or improvB lh6on,
<br />and \fio.nirdcuhr$'chFoj.(ri$nh.CodEcto,lr)lico€dpun@trorh.(nnrri.lo.3li.eLNl
<br />I d.r.mpr uods S(lrn
<br />uof,f,ff,i(aurEdsallo!otoaaauqt
<br />I hd.S' rmm uidd Fun, of Fjury om olttE folh*ins &rLr io6l
<br />I h^. r.d $ill tuinrrin i ( di'akr!. oaco'er ro S.lf ldurc ror qort6-(nFMm. a tnn irH lor b_! Serm l7m of rh.
<br />lrb.,r Cod.. aor rhc pqfomu(c o f rh. so& for rtrch rh. Fur 6 s.d
<br />I har. and will mainrain *ort.R comp.Ertion i.sur.n.., d! r.qut.db!sRrio.1700otrh.l,b.rCod..forth.panrm.n..of
<br />i.htlirl6nir t isu.d Mv tror!fl'g&rd$J ]!q
<br />conpadkr insurdN.cani6 nd Fnq numb6 E.
<br />141,J(igqqqc ePL,J I O/lc 0?.{c
<br />I csrit rh!' inilE FfortlllBorthc so fm r'hkh thir Fsn is i$.d.I aullfr 6doy.n! Fr$n in sy heEs a ro baor $ti..l lo rh.ldld onFsdiotr tlq of (-rliirmia 6d er rh,n rtl tuuld tr.dE $tixr ro rlE
<br />$!ltd'66FnsrirnFvt6Nolsdion.lT0Oofrh.llEr('.<jc.lCull.lonhvnh..mplysirhrlhrF.ririoB
<br />w RNINC: Irailur. ro Kur. wo,lsJ
<br />cnrl fi.B up to onc hondr.d thosd
<br />sEri.n 1076.f rh. Ilhrr (ir+ nr6d
<br />**,*larTlAn
<br />ompa$rion .o\d*. is unbwtul. Md shnll rubj6! M mplors h onnin.l Ftrhi.s Md
<br />dollm (tloo.ffiJ), in .ddition lo llE.on olconp.ulion, dm!36 $ r'rorid.d I$ rh.
<br />I h.cty lnm u.d.t FMnyoaFJUrylh,I u lirrEl u.&. Ftrlihn otcn4is c((omIltrln8 tr t Srrion',000) ot lrr B[r r
<br />ol th€ BBilB dd Prul6Fn3 (tdc, &d my li.e a
<br />'nc-\ c70 A--i C1il c lc
<br />6 aobq6
<br />"'iru,,5Wl1/\i
<br />ca!$f,ll(Ila!-LElllucrcflcr
<br />I ffiy .rm un& FMlly oa Fjur.v lhd rlE. ir r odndnn ldldo* .edy aor rlE Ftrrlla. ol lh. qvt tur \tth rhi. Fni il
<br />s!!.d (sa 1097.ci! c)
<br />AIIIITAILDECI.ASAIIO!
<br />I Hy .trEn urid Frhy of pcju.y oE of rlE foll,wirg d.cla.lid.
<br />DaDhion P@n$A!t ror tldilicdi,n riid.l Rnuhraon. (Tnk a0. Pat6)
<br />. R.qdrd t r. ol t{ori[..n
<br />I diry rhd dE tuad Eaulrio6 ,!rdi,E 66dor lftr.l G mr .ppla.blc lo rhb FoF.
<br />a),.
<br />!r! I c-rnit rhd I lrvc Ed rh! l,rlk.t ion Jd rdc rhd rhc .toE inromrion b c@ct I .sG lo ond, win Ciryrdcou,S'rdr6 md Srar. L!*r EldrE ro bo,ld'ns .oMucrEi- .d lFcty &rtbrj2c rF6drriva of rhi! Cir, lod co6tr ro 6la upon 0E
<br />rlrv.'norion.d pnplnv ln n\F.lk)n
<br />C,Fg''o
<br />rpprttrnr or.rlor stsnrrur<(
<br />P.-1,*-..rcar,, !(
<br />LeN/fr
<br />Under Slab / Floor
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