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DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />L ife Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rouoh
<br />Ceilings (T-Bar Rough)I
<br />Ivleter Release / /rd ba -na,/:.)
<br />1
<br />Rough
<br />4 I
<br />.Tfr1,/,/-FINAL 9 ///,//4 4 7
<br />Notes Remark Etc 7
<br />OWNER AUILDER DI'T,('ARATION
<br />I hs.try rmnb utuld pcuhy of paju.y th{ I o .rmp f(d rh. Cont.clo6 l-icdx hw for th. folloqin8 r6n (5<.7011.5
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<br />appl'(dl aor , Fhir 3ubj6r! rh. rmli.! ro!civilptuhyorn mor.rho fiv. hunrtr.d &,116(t5m)
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<br />'rr
<br />bri|dlB c ,l! $sEr i $ld vtt; In )d
<br />olconpldia dE (xE &ril& eil hlw E hd6 ofFulg rhi lEd iE did mr b'ld.r rqoE 6. FoFry ftj'rtEFn.*ol
<br />-1,
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<br />.,n hrtEir co&: Th. ( onlreu r Lke trs d.'€ .or @ly ro , omd olFopdy sho boilds or iEproE lhqotr
<br />&d *'lx' conrxG fo. sh FoFl!snn. Co'irxio(r) ltd!.d r'{Eur rollE conn.ddr'r
<br />I hstl'y .mm un&r Fr.lrr ol Fru' o( of $. tulhtr b* &d!rd
<br />I h.r. rn $ill mi.rlh. ( drf.d.olCoMr t' sdf-rMr *ut6! @p.f,srior, s FariLd tor U, S<riot r7m of rn
<br />lit r (-o<L. for rh. pslollll4. orth. snrt fd qhth rlE Fhn B is.d
<br />I hik..<t will (.int.in krt6' .onp.dirn i@e., B r.qur.d
<br />"rL
<br />s.dbn t7m of dE L6or Co&. f( lh. Ffolllec of
<br />'h.
<br />*ut 16! whah thB Fmn i! isd My wta omFE io, itum.6ir !d polkt tuEba e
<br />Potcy NuDbd:_ErriE
<br />-l.drify
<br />rh.t r rh. psfotucof rh. *!rl for $hrh rhi! psnn B su.d. l sn 0 Nr olploy m, prsn in uy n:3,lE
<br />s a ro b6om. iuqd ro rrE srtd onFraion bs ot( drloroa .nd .gE rn ial llrlld b.(oft suh to tlE
<br />sr 6 omlnsrkJn FlvihB oflEdio.1700ofrh.lrbor ( clc I Cull. fodh$ilh.otupl, silh lhor FovirioB..
<br />WARNINC Fdilurc lo suc $0*6' comFrMlon mvsaac i. unhw,ul. .nd shall rubj.rr e oplo'6 ro 6inin.l FE is od
<br />.N,l lin.s op ro fn. hunJrd rhotrenJ d.llrs (tl(xr.olx,l. rLl.l trr n, rh. (xr ol co'nFnsrrrJn,
<br />tr 6d MdrdotrB'3ld
<br />I hrby !firm uods p@lty ol psJu,y rhdl I !n l(oBcj uftls olCh6pl6 9 (com@.in8 vnhSdbn 7000) of Division 3
<br />ol' rh€ Dsin6.nd Pma6soB ( od.. ud my li.di. ir i
<br />(ollra!](ro!..LtgDtlclctilcl
<br />I hd.t, afrm unda Fuiry oa pqru.y th!| tnc. i! ! oirtu tb. ladttB .edy aor ilE FfM. of lh. wort 6r utth lhn pdtn i
<br />isu.d (56 1097.Civ C ).
<br />ATIIICAII.TECIAEAIII]!
<br />I hdrh, .eb u.da Falry of pdr-y oG of dE 6lb*in8 d..bdbN:
<br />D.!&lnbn innl^.bdor Norifrrlirn F.ddrl ieuhnu flnk /O. aar6)
<br />-R.q!ind
<br />Ldrq or Norifidd
<br />-l
<br />.d ify r hd !h. f.&rl rc*uLr rB ..rdinx 6tBrG .dmr.l i. mr {'olt!6k ro rh! rord
<br />-l
<br />.drf, rhd I hn. rdd rha.ppldior an cd. rh. $..tn\r inlotuion i ffd I
<br />oilffi6 r.d sd. L$s Eldit ro l! iln8 c.dturlrtr arl lE.t,, {d C.unry to aid uF. ilE
<br />M
<br />ib"\. nmrsxd rord) ftr dt.gr{ F,FB
<br />Appk, or ^ra, sroru( y- //.-*
<br />ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS
<br />Service Meter
<br />L,./
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