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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS ID/SIG.COMMENTS OWNER BU!LDFX DELCAIATION
<br />I rErchy .rrm unld FBhy ,n rErrrry rhr I d .i6nr 6I'n ih. Codklfi lilnt L.* fo. rl. nnll)*in! E&,n (S.t tu]| 5
<br />B$hc( d,n Pnrf.rnon clri.): Any cry M cdrry sh.h mquB r Ftn t, rol{tur. 1116, in{iow, &B irh or qrn s,
<br />{tu.rnto, Irx,(' r! (!ufr.. rl$ Rlurc! rh. rpFl..nl lornrchFmn h iil. r {8ncd nll.mnl lh.rlroriltnl.lned pB!.,rt
<br />r,, rlr Imiqhi of rlE Conrur*'i Lknr.J lrr (Ch.dd 9. ConftEhs wlh Sc.rin 7cl0 or Divrbn J ol tlE Burir$ rd
<br />Pnnasnons C*lc ) or rn.r lr or 1lE is .r.q th.rclnmad lh. h.si! hnlrE rlLs.d.r.qr6. Any viohri'n ofS-rbh 701I tbr y
<br />+llunr t(r r Fmn .!bi\r trE .t?lL:nt ro . .,vrl F..lr, ol rtn mr.
<br />'h..
<br />I rv. hu.Jrd dollM I t500)
<br />-1.
<br />.r owrr ol rtr lf,Itny, t" m, cmphyrs w,lh was.r A lh.r $L .otr{f,nqr(,n, P do [rw,*{n$.irurmn mr
<br />dorLJ d ofi.ft1 td sl. lS<. 71X,1. iotFs! r Pnna\rn! Qrlt: Ttr Conuald ! L.mr t:q &- ni .{lJ'ly t. , owr of
<br />rrE pn'Fny wtr, ltuill! or olptuws rh.6n, .il wr$ d,f,! luh u h'm*ll or lEr$ll o. rtmulh h! tr h.r own cmlLx.r.
<br />F.vrLil rh.r 3Eh qnr\mdl e ni nr.ihl d ofldd tu {b ll. horw. rrE ln u{ or oFNffi ir $l] *rho rft lt{
<br />ol coi{'ktbh. rh. owmr Bu .ld * l h.E lh. hun}n oI lisvEs rhd lr u {r dn nn t[d,l ot uqmE UE FIEI, n{ 'h ,l[Fr ,rr
<br />l. 11.*mrol rlE In'p.ny, !m.r.lulv.ly conra(rm8 *(h licncd.onrr. r n' .onddcr rlE th,Fl (S.c ?04-1, BuiGn
<br />$l Pnn6{s clrk: Ih. Codr&ror.l.r.nc b* tlrs dn.ml, !, n o*kr dl rhrFny *lt, hltLlr or nl'n,k! rhddr.
<br />rnd *ho conrr..k l,n \u.h I'l!..k w h r G,nhcr,(, l.ctr{d l,luud b rh. o)nrr.b ! l-k.n€ l:* |
<br />I mcrchnl und.r Sccu,r-, a a PC ntr rhii E sr
<br />lryoLKr.LS', COf, tPE!{SATI(rNpEcIaBAIlo!
<br />I h.rchy.frtrm!nd., p.Dlry rf pdjlry nft nl rh.lolh,wnt c{lalandn{:
<br />I h:v. n *r ll msm[m r C.d 'lirr. of Contcnr lo Scll-lnsurc lor wortcF' (o'qcnql.n. * FlvrLd li)r ty Ssrrn .11]O ol rlt
<br />bhtr (i!.. lrtr th. Frftffir ol rh. k t nr *hrh rh. Fmr . r*u.J.
<br />-l
<br />h.E nJ *rl! tudrr k'*cn' o,{Enftk nur.ft.. 8 r.qurri hy Sdr,n .l7m ol
<br />'h.
<br />blrtr Old., lor rhc !.rio''l!e-*c or
<br />rhc knl tu*hrt rtn Frmr r rrBd My wuk(r cohp.n3.lrr irru.u.-.c dir an F ry.umlEe:
<br />.-*, Atngn cor'. Z.,-l c\
<br />io, ltq_n,u.rn,.". hl c 5t"1 batS l1
<br />_l rn'lyrh2r'nth. Frrormrcd tlf, r.tk (n *h.hlhFFrmlr tr Fiu.J,I \hrll ncmnl,ytnyn rv'nrrnyhmrr
<br />q' N t,,lBDnE s!l'F!l b rlE *rdcr' ronqxtrqr.,. hwi ol Crliloms, .nl .3r rh.r ,l I th,o[ ltod ruhAr l" rlE
<br />unt6 conyrnql hn poyFi,nr ol S&1Dn 17u) trl rh. trh{ C(r1.. I \l[ll. liflh* i ! ofrfly wrrh rlNE PnrvF!,ns
<br />WAININCT rrnuE k, EUE B cn omrEnsiion cov.r.sc n unE*tuI. {n rhrll ruhFl s cmOk F to ffil FmlF .,n
<br />( 'l fEi u,r ro om hu,rlt ii thu{ Llolls (tt00,ll0o). n dJ rD b rh. dN or comPcnttln{, ,ilmg.! rs Frvri.d for rh.
<br />Lrhtr (i{c. i,r.rcn .n i rotmy'! rc
<br />?.A.'trrc"*,,C<,aagetz
<br />u(]ililLrcluxl!(]llBLrr!ljt&uta!
<br />I lBGb,,tun x.d.r p. lty or pcrjury lhll I rn liccnsrl lRLr pn)vlti,n of Chsprd I (onmE irs t h S(tDn i!oo) dr Orvsrin l
<br />.f rlE Bu.E( tDl PmldiFnr C*k, arl my lr.nr 6 r tu[ roM xi cltdr.
<br />(,
<br />-|.f,.n<
<br />Nuhh.i 17 s1 5L
<br />1 -21 - lq Vrri,"f So Iar
<br />IPISI$J!:IIAIILEdDIX1i}AEIiCI
<br />I tIrny rllim ulLr FMlry.f Frury rh.r rrxr. ! r Lrr{urln !ftrrS lEfty ftn rtr Frl,'lm colrhckr ({*hrhrhsIEn,t E
<br />rslqi tsd .1097, crv. c.)
<br />l,nrs l Nam:
<br />-
<br />AIILEAAI.OECIJ8AITQ!
<br />I nd$y .nrn !si.. Fhrlr, o, Frllry om ol lrE lollowrry dekr.l onr
<br />I).Brlrir P.mtrl^rtE.b. Nti'If,.rnn Fa{d.l R.3uLrb.. (TnL40. Pd6)
<br />-Rt
<br />luEJ l-Iq ot |*rfud
<br />I (cnrry lhalI hN. rclnrhN rml'c (k,n dri d{crh{ rh.rf'v. r Irrrrt'.,,r{ yuihtllCi'y.nl(tdnry
<br />.{rrur.!rilSr,r.tl$\Rhrryrol{'l(!.niu'o{urhi!rarEr.n!rurh u.r.Frrdrrr.. Ithrc }$rlC unt x'.nrn uF,nrrr
<br />rr.v. mn,!,trcr n.n n) i,, tr"r..,-./-r.,rrt l// /l
<br />Appri.rnr or
<br />^r.r,
<br />srr*,u(. z@ {l/-- n* 1-?'7 tq
<br />Site-Work
<br />Underground
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Life Satety /Low Voltage
<br />Fire Alarm / Dampers
<br />Building
<br />Under Slab i Floor I .L,
<br />Bondinq / Groundinq / UFER I 0 q u .Dft{6 7
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners ^l-t
<br />Roof Top Equipment tu t,.,U Dqw'k
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinos (Hard & Soffit Rouoh
<br />Ceilinos (T-Bar Rouqh)lt I
<br />Itrleter Release u -ru tYWD 7
<br />lr
<br />Rouqh
<br />Service Meter tl ,t2 a
<br />FINAL 1 '),,()DtrtrZ f/
<br />Notes, Remarks, Etc I
<br />DATE
<br />lJtrd.rr !dF$
<br />-
<br />Irnrlyrhd rh.lcddrlrc3uLrrr.\ r8{Jtr'ga\h.io\ rcR,vrl .B aff'lk ihl. ro lhr pftFll
<br />Pole Bases
<br />Communications Cable
<br />ll]
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