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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.OWNER BUTLDER DELCATATION
<br />I h.Eb, !fin undd FMlly of Frjury rhd I d.r.trDr frbm rtE ComBk,N Lt.n€ t,w tot rlE aollo*in3 Er$n ls< 70.11.5
<br />Busircss rd For63i.n C.n ): Ant ciry or C.ndy f,hah Eqrms . Fni ro !'ldtur. .lrd. inomK. &mlitt ot ..Fir sy
<br />nutu, l,ir ro ik tm, rlrl ErluiEs llE q't'li l tu rxh ttmn ro ,ilc r ri86, <d.rmr rhd lt or dt i. lianed lrd.n
<br />n, r,E rrolirhnr of rtr Cooro.rd r l-ien<n l.w lchlFtcr 9. (onmrin8 wilh Sslion 70(r) o, Divi.io,,l ol rtE Burin.s lnd
<br />Pr,r.rsi,n\ Cd.r 6r rh.! lr tr ltE ir .r.npr rrEEftoh !d llE bGn lor lhc dLs.d .r.n!,rnn. A.rvbhrionofs.a'litn?0ll.tbylty
<br />+rlkdr ro. . Frmr .utrra rh. q'dr..t r. . dvil Fmhy ol mr mrc rh., fiv. hdftd doll,t l3J{x)r
<br />-1.
<br />a\ owmr ol rlE In{Err!. or my cmplDyei *irl w4!r B th.ir sk d,mFnrdbn. will do llE *dt dn dE {nrrN n r,
<br />i od.d or oll.Ed for {k ( Sa 70,14. Buim$ rnd PmL.rirni Cd. TIE OiflrEloat l.it.c lls &Er ml +Ply ro o o*Er ol
<br />ilr rnr!.ny rtb ho :Lr d !qm6 ltEEtr rd rho db.! *h srr himkr d hBll m t,rugll hn d tE om .nlr,y....
<br />I.orlt d rhn uh rFtrffi. ft d irdndi dotu ld qt lt bw, rli tliB!! n itF$tld ir rnd litn G )r
<br />ofoq'klion. rlE o,rffi Builtr wiu h,E dr h"rh orFovi,{ irt rEd.lEdil rDl tliUor irpmE tr Pdrsry n rh F,posol
<br />-1.
<br />!r o*E oa rh( F |Eny, r.r.turaEly.odd,r8 *nt knr.d odBlo. lo c,n<itl rlt rmj.tr lsd. Ix4, EBrs(n Piottli Cr,&: TlE G,nrftrolr Lt.ns l,r d6 mr {,rrly ro u o,ffi of tmFny pho boildr or impmtt lnc,on,
<br />rnd wk! .nnrGl. for \!ch rr.Fcrr wtn . CoNBro(n li.mt d puruunl ro lk Coiltuloai Lt .nr Lrw).
<br />I rm.(nnr unLr S..r[n .B &P(_ f thnrcne'tr
<br />l).r. ()rEr
<br />t!( tRI(r k{' (t tntPr-Nsa aloNlr(laasrg!
<br />I hr!'bt rllno ufrkl F Dxt ol lErlurr o't ofrh.,"ll,f,ng &1hrri.nl
<br />I haw dkl will mi.rdin r C.niff,nr. of Consnr t S.ll l'Furc lor $brkdr .onP.nn n,tr. as Pn'vidci ror hy S..r6n l7l frh.
<br />l,rr" ctxL, ftr rtE FrronNm or rlE qft for *hth rlE Frmn n isr*n
<br />lltrrc ind *rrl hlrn*o m cnottnaii{ 'Mrr., I E1uiftl hy Sdlion ]!7(r) ot rlt lrhtr (-.d.. tor
<br />'lE Frf(m of
<br />rk wt( f.r*hrhthn p.mil i\ irnxd My$n'1.! ft'qrndi'n rn.uhh. c.ns .,ll Fli(y numhq ,c
<br />6-tt
<br />-l..nilyrn
<br />r in rlt Fr,o'lllN 01lh. *ort td whth rhn Fd n ilqEd. I ndl bl.q!by..yF$n in.ny .MF
<br />s 8 ro bNrm sbrrr io t,E mrt6 onp.nrrnn hB ot (il'fonn. !n +R rhr it I rlDld ktor ol*xr lo tli
<br />k,l6 $n{E.di,n p$ririons or S.dir 1?m or lll. L:tq ('od.. I rhtu. r.flhwnh orpl, silh lhE |,odrnnr
<br />W ININC F.iluE lo tfu *rld\' $qEndr'n rarts8. ir unh*rul. JrJ 3lBll rlhiir u drl)hF k' di'nin l Fii6 rd
<br />ro oE hldEd ilhuEd dotL6 (!lm.frD,- i. ridirin to rL .t{ ot.oqENrnr. d.E!.i 5 Folir.d tu rlE
<br />s..rN,n.i176ollh.l.rtitr rixtc. tr r,r{ n d drr t'. irci 'P1-+.14J utl}lrl)la::l&rl-lra
<br />DITLT&I.IIOT
<br />I turcbyllfirm undcr p.nltty of pcrjury rhxr I am ltun{n und.r tmvhn,n of('haFl.t 9l('mrEncina *irh SNb.7m0) ofDivisn,tr I
<br />u( ih. a!aB! lld Pnn issn3 Cd.. rrn my li_.nE i! h full tqrr ad .fi(r
<br />Clt>
<br />7-1-r'{
<br />I oo'1t 6 7
<br />L..-
<br />Il,lNlilauquqN.lEdlld,i-acE$.c].
<br />I hEty.lTun ud.r Fn lry of Frrrry rhi rE a. conirxrhn Lidins.$ry ror rlE F folm ol llE uxt tot *hi.h lhir Frni i
<br />i(Ed (S( Ir9?, Civ C ,
<br />aEtll:lITECuSAI()N
<br />I hft+ry lnim und.r pd.lly oa pcrrury oe of ihc rolkr*ing d.cl&rionll
<br />D.Dlirbn Pcrnn! Art!{or N.tifr.rb. tu nl R.3ublion! (Tirk.l0- Pd6,
<br />R.{!ir.d t.(6 ol N<r,ftatbn
<br />-l
<br />c.nify lhd E r.n ral E!!hlim! EErdans .rtr.ror Emrval e d {pltlbL lo rhir ,'hl..r
<br />-lclrlirythrtL\rrc.drhi!lErt.ra.nrdi{.rhdfi..h,EinfoirdhnLrc{rEdIr8Bromflpl,whrICny.rnCoulyxrlmoxs $d srrrc L.*i Eld ins ro ldljr+.o.d{{lun.
<br />'rrd
<br />tEEb, .lrhfit rcIrrsnr.riEt or ftn cir, .rt C.unry ro .trr6 uPn rlt
<br />rh'v. mnrirrn pmp.ny rur inlFdbn n'tpoct )
<br />^rdkr.rq&6rsi@ru. Hrt- f D.r. 7-H{
<br />P.rd.e*n.(Pn ): 14, L- U-r.'
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Sions (monument)
<br />Life Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communicalions Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soflit Rouqh
<br />Ceilinqs (T-Bar Rouqh)
<br />Meter Release
<br />Rouqh
<br />FINAL 4h,/tl ialfl/,1;I
<br />Notes, Remarks, Etc.-F{.} . -
<br />COMMENTS
<br />Service Meter
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