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ELECTRICALNNSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS Osd'auild.r DG.ln!6
<br />I hq!!y.mm uida pot.lry of Fj'ry 6r l 6 q.nF fm $. Cdt&.. LicaE 1., fd d!.loll*i.8 t!&r (c.70!r.J lBiIa
<br />rd P6f6i6 Cod.): Ai, City d C&aty Dhid Eq!i6 . Fnil ro .dr.!.! .116. im,.oq d.molith * r.rrjr Dy rEst@. Fid to itr
<br />ia!6cc, .lso EqliE th..!pli6r fd tud Fhit lo filc r rig.., i.r.lEr dld h. d.tc n I.sE d F],tlEl to th. Flnid of lt.
<br />C6EE{! Uca&d t:r (ChrFa 9, Cctr'cxir8 ,ilh S..rid 7000 of Divilid I of lh. Buii€r ud Prcf6dd Cod!) d th.r hG a
<br />.h. i! qcnpl lh@fM sd thc bait rd dr. .ll.8.d qfrpd6 Any viollid or Scdd ?03 L by u, rpplior rc . lqmn $q..rt dE
<br />.rtli.d !o r civil Fdry of Id ffi 6e fiv. nurdld dollE (1500}
<br />_1, a ohd of lnc prcFg, d n, qtplord *ith r.g6 a lhcir slc cdFtqrlo.. willdo 0E wdl Dd lhc !l.!.luc i! nor inla<Ld
<br />or ofiEd f6 ..1. ( SE ,0.a, Burird ud Prof6id Cod. Th. Cdltfut Li.aE Lry dc nd .!tly lo e ffi of dlc Fqdr,
<br />sho bg'16 a idFoc ln46. od tho rkE hEt rat hitr*lf d harcla n ordsh hn d [6 wn dployq Fovid.d th.t Nc[
<br />ihrmvodtr E not in16d.d or olTdcd f6 d. ll hmd6,lh. b{ildinl r imFDvdar n dd viinin w yd of .6prad\ ln.
<br />OsE-Boilda *ill fi.E tlE tod6 ol Fwing lh! lE d tn. nor b{ild * ihFov. fc rhc puFr. of r.l.)
<br />_1, a M6 of dE Fordty. m dcl6icl, 6t .ci.8 *id licaa.d 6t-r6 !o cdntu(, 6c Fojct { S€ 70a.. B{ind ud
<br />Preldio Cod. 11. Contr&bir Lic..r L.w .bs ror.pply !o e o*nd orFoFty rto b!il& a inF.c thtu . od,lb
<br />cod&t fq rucn Fjanr *ith r CdError(, li.6..d Fr!@t to th. C6E rdt Li.4. Lrw )
<br />_l m.xfrPr u.& Sfttjm _.8 & I C. fa dir !tt@
<br />WORI(ERT COMIEI\SATION DECl-AR^TION
<br />I h@by .,nm odr paulry of pqjury 6. of rhc foll*int tL.lDriw
<br />_l h.v. ud ill tuirr.i . Cqrifiqt of CdMr b S.lf-lnie fd rata cepsfitio, s prcvid.d fd by Sdio 1700 of rh.
<br />Lbor Cod., rs bG plrfdrue of th. wo* td which $G Fmn it ir8u.d
<br />_l h.v. ed qill ruinldn wat6i cmFndie iB!tu@, B rcquir?d by S4ri6 J70O of rh. L:!or Cod., ad tn. F.fcfue ot d.
<br />qort fn ph'.! fin Fnn ir isEd My rdta' .@Fr.ri@ iNl@@ ffiia Dd policy .umbf E
<br />lolicr llmbf Et9|6
<br />r T1ll. t.qid ned nd b. Mplq.d rf rh. pcT{ u ftr On. hun.lrd dollE It l00l q lG)./y'.dify lh.r h $. Ffffie of OG roL fq *hi.h dir ldhn i! isu.n. I th.ll noi.iploy uy Frcn 'n
<br />ey lmrn $ ! !o
<br />r. Ertbja!!odE*dld .@Fs161.6 of Crlirmi\ ed.88 dl.l if I 'llsld b6o.rc ouer tol,E *6td
<br />dtrFdio PrDvitid of Sali6 J70O of th. LtDo. Cod., t rhdl, fdtwil,l c@dy *ilh lhdr Fovirid3
<br />o,'" t 1-9 ,/o /
<br />'-^-a
<br />WARNING Fnlr !o EUE *rt6' .o,Fa.rio @v6t8. it 6Lwful. D.l thdl rubjet u @ployd !o qimin.l Fn.hi6 ud civil
<br />fin6 up @ d. h!nr,r.i t[@d tblla (t loo,Ooo),ii .ddi!6 lo $. cd ol .dFs.rj@, d.n{6 r ,.ovi&d f6 O. Sdri6 ]0?5 of
<br />0E Uhd Cod., iola6l rnd &dnqt f6
<br />LICEN$DIqNIBAqqBS.DECI.AMTqN
<br />I h.Ety .mm und6 Friiy or Fjury lnr t D li@rc<t odr Flvirio or ChFa e (cd.xfti.8 *ith S€rn 70@) of Dnri6 I ot
<br />tn. BqilE Ed Prcfdi@ Cod., Dd Ey li.!e i! ii fdl fos Dd.rcr
<br />o*Y -r- - * ./" /
<br />qqdSIAUCNOIIEIDAGIGEdCI
<br />I hs.by a,Im u.da pa.lty of Frjury $d th@ i! t drlluctioi ladiu .aac, fc. fic Fr@.E or U. wat fa *hict d,it FDr i!
<br />'r*d (s6. 1097. civ C )
<br />ADIIIC NT'S DrCl ARATION
<br />Oanoirte Pmn}^rbdd Ndifod F.dstl BrSul.!@ (IirL ao, Pn 5)
<br />_ S.quiEd L.rir olNodfic{id
<br />-l
<br />@!i'ftl.t lh. r.da.l..rd.rtd rtrdd, !td.. lmtn & nor +pl,ctbk t. rhtr projar
<br />Jdry u I l'lE Ed
<br />'nL
<br />rr?l'd6 Dd .r& rh{ 6. .tEw infdnr.rid L 66! t rsre b cddy airh .ll Ciry &d Canry
<br />odi.&c ud Srd! Ld lllaiit ro toildins @tErci6, sld idrt, l,hdia EFgllli€ of dti. Cily h.l CoDry ro ora uFi rh.
<br />.bov. !Mli6.d Flpsr, la intp..do F,F.€
<br />^t --*=-* z-->
<br />Y
<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 />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torquing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />Meter Release EXF IRtD
<br />Rough FEB f I 70!3
<br />Service Meter
<br />FINAL
<br />Notes, Remarks, Etc
<br />e1-1d
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