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APPROVALS DATE IDiSIG.OWNER BUILDER DET-CARATION
<br />I tdrby.,Im urd6 Frly oaFJUry rhd ! m crdF non rh. Cdr'slfi txaE te fc tlE folb*iis E-di (Sd70!1.1.
<br />Buira !d Profdio! Cod.): A!, Chy r C@irt stah r.qut6 . Frfi to @nr^Er ttc. inFo€. d@olirll or l4.n ey
<br />rtrucru.. Fi,r lo il' isuG., dso rlquir6 lh. .ppli-r 6r iu.h p6mi ro nL . 3i8n d rrn@r rhi lE or tE a licdu.d FMI
<br />to fi. Flritio6 of dE Conrrxrdi LErt d tt* tOrF6 L co@i,, sih Sdrbn 7ql0 of Diri!i6. I of
<br />'lE
<br />Bsilr ed
<br />PtutBio Co&) or rhlr li m dr ir qdB rhqdrln .d rlE b.sa f.r rlE dkr.d adFih. An, rioEran orsalb! 701 L5 by oy
<br />rpgli@r fitr ! pdnar lubjcr! rh. arpliot lo . civilFulry of not turc fid livc hund..d doud (1500)
<br />-1.
<br />a owot'h.F.paty. Eydplqc *nh *.96 a rh.n $k onFdioa *iU& tlE *dt !n E *lxrru 'biinrad.d or olfd.d lor sl. (Sd.704.1. Buine dd Prc{diod Co& Thc Cont..ror'r l-ic@ La do6 nol .pply lo u o"G oa
<br />llE FoFq sno hild.d in!.oEtlEo( rd *lD do6r.l wr hieror hd*lf or rhDU3[ fin h6 oxn atrpbrB,
<br />FoviLd ihd sn iBFoEcrt & d no'd.d dotu 6r sl lL ho6q. rlr hillilB q itrt! lid i Dld viln m
<br />'rolon{trDc dE O*E tuil& *iU har 0r hrdo otFtrri'\r th,lE or rhc dil d hild or itrD.lr. th. FDFIy 6rlrEF rEor
<br />_1. a 6*G ofrh. Ilopdl,. d q.ha'd, co'ntdiss urh licd!.d conErroR ro.onntod llE F.j..l (sc 7044, Uul6
<br />d Pmtu!6hn Co& Tn. Conlr.cloar Licm!. t * do6 mr ,p9ly ro r ownd o f Fopstr who boildr or inprovd lhs@n.
<br />&d *ho o'rrrl' fd i*h Foirrt w'th lcodrr.ro(r) lia.d F)rlar ro rh.Co r..rd', Lio& l*)
<br />-l
<br />m.rdpl 6dd Sdrion-. B & P.C. tor rhi! rl&n
<br />D.t., OrG:
<br />.soaf,[al](o!,lE8tartl]!
<br />DEC[-ARATION
<br />I hq.t, .,Im uftja pqdly of psjur.v oF ofllE follos'i4 &(lir.lh8
<br />I n !. dd will m.i.rain. ( dirrclt. of ColBr ro S.lf-16@ for mrkst onrpd6linq 6 F.vid.d lor by Sqtion l70O ollh.
<br />Ltor ccle for th. Ffom4. oafi. hrl for "ti.h rlE Fnn i is.d
<br />_l havc &d will n.inli! wo*Fr' .onFNt io. iNffi.. B r.qliEd hr Sfrl on l70O of llE lrhot Cod., for lh. p<foll1@. ol
<br />lhc @rt lor shih lhir Fiil B ireuql My wrka .onrsldior iEu.Mc. ni6 erl ,olty n@b6 @:
<br />-l
<br />cdiry'h.r r lhc poirmrcolrn. wo* fG which rhn Fnn k nrucd. I !h.ll nor s.plo, !.y Fkn in dy .fr.q
<br />v' 6 to bdoft rut ftl ro thc wrl6'.onF6.li6n b*! orcrlifomj^ ed '3G rtr ill nmuld bdoR $t'j6l b dE
<br />Ert6' N,nFdion FovitirB of S.di'.l7m of rh. lrtrf, Codq I iru tdrhqith ompl, {,nn lb- proviriod
<br />wAR IN(;: Failu.lo GE. srt6' Nn drrion cov6.sc ii unLwtul. i.d JUI .ubifl 6pbtE lo oiDql Fdi. u,
<br />cilil ao6 sr ro oG h@d.d rio6-d dollr. (ll00.0@,. in.ddnii lo llE.o! of sopaB,lio|l. dD36 a F.tiicd lor llE
<br />Sana. 1076 ofrh.l,htr Co&, i' qd.xl.ftriEy ! f6.
<br />,\ppUtut:
<br />I rcFNSrn corYrn-Acfirll
<br />DtgiSallo!
<br />I lE !y !fiBn ufft6 Fdy olFjury rhd I m licsE d u t6 FrvLion otctq'tq t (Nmflrdil8 *nh SdrD.7000) or Divbion l
<br />oa llE UBiK id Prca6io6 Cod.. !n ny lt.E ir h tull fom rn dId
<br />(OXiIAJ](IIONITIiIIAG.&GEd(I
<br />I h6bv ,mrn utuld rEnalry .l rrjurr thd rhd. ! ! coNrucr nn lcndiry ,s6cv lor $. t6folrrm.. of rh. $orl lor which rhir lEnil i
<br />BUcd (s< l(rs'7. ( r\ C.)
<br />AISI.II]AtrLDICIJAAIIO!
<br />I h6by.lLh ulitn Fi.lly of pdrd r: oB or tlE tollo* uls &cL,niod:
<br />D.mhnn Pmirg^rb6ror Norificnio! Fcda.l Rqul,rhN (Tirl.40, Pir6)
<br />R.quircl t-ct6 otr,loti&{n.
<br />-l
<br />rd iay rhd
<br />'h.
<br />f.d..rl r.gularioN E8adin! ab6ro3 rtuv.l r. nor rprlic.bl. ro rhi! pro.i.d
<br />-l
<br />cdify thd I l$. rad lhi] eplirbn .d 11. lhr E .trt. ifo. bn i cGrEt I .rta lo @rply unh .I Cny .d Courny
<br />oidlma 6d Sr3l. tiw E!.ia ro hrildiry .odrucriotr .n fidlby ruihort. EF*rniv6 of thn Ciry &d Co@r, ro 6ra uFn th.
<br />.bov. mdnnEd popciy atr Gpdlbi pEFE.
<br />,tppli.rnl or,t86l Sitmlur.
<br />Site-Work
<br />Unde rground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />FireAlarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueing
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough):l'r t,.'i>,. ,,,,.1
<br />lQeilings (Hard & Soffit Rough,z >\rt,-l lry l'l*l'6D)
<br />Ceilings (T-Bar Rough)6.t/,Ittt fr 6i-6,r '22/
<br />Meter Release I \l \,1
<br />Rough
<br />Service Meler
<br />FINAL '.l^r*"rn
<br />"r)Notes, Remarks rl ul \=-t7
<br />ELECTRICAL.INSPECTOR RECORD
<br />COMMENTS
<br />Sub-Panels
<br />Ll /"1 4 Tt
<br />Etc.
<br />Poli,cy Ncdla-
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