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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS OATE ID/SIG.COMMENTS OWNER BUILDEtr DEI'ARATION
<br />I hs.t') .lId udb padt, of Fjury 6n I m .rdF nDn lh. (d.cid Licd L.t' for tlE follo*i'g r-$t (Sc.70l L
<br />Burins lrl Phf6hn Cod.): Atr) Ciy or Coud, which r.qun6 . Fnn lo odru.l, .!o. ioFote damlah or qrn E,
<br />trrudue Fsr ro n. isue., .L rlqlriE dE +rJiat aor sch Fhn k, fiL r ti!..d nar@d rh, h. or r& i lk6.d F8!r
<br />ro rh. F.eirbN of tlE Conucld'r L@nr.d Lls ((n.9ld 9. (-o,Mina *'ih Selbt 7000 of Divirion I of lh. BBn6 -d
<br />PhftsioN Co&) d rha lt d rlE a .,dF llE 6om !d llE b6rie aor fi. ilkScd ooFion. tuy ttlrbn of Salio. 70ll t by o,
<br />+pli@r for ! Fnn lubjdrt rlE
<br />'p?Ii..fl
<br />lo..ivil FEly olml rcr. tho liE hr.&.d tlollml t500)
<br />-1,
<br />6 eG otrn FoFry. d my .hplor6 wnh w!s6 s thd elc onFurbr rill d, E el !.d dE slrlErN ! rct
<br />idad.d s otu lu EL (Sd.7O{.1, BqiB Dd ProldhB C.dc Th. Coff .rd'r l.t.e ts &E mr +Ply lo & om ol
<br />rh.FbFry *lb hliLl if,FlE tlE@.d vho &6&rl wI hiru.lf or ha*lf or lhmush hir q hd om6plo'6.
<br />Fovid.d rt r Mh inFovdEr! e Br Irart d d o&Gd 6r st It lD*6s. tb. hiltiis or i,4ro!g6 i! iLl wilrn G
<br />'cofcorpkbtr ttE o*M ltuil& *ill h.E dt hrds' ofFlrilB lh. lE d ,E dd d htild or n{rcE d. Frqt, tu tlE F,Po& of
<br />-t.
<br />6 ownd ofrh. ptup<ir. E.trlcivcl, conl,-lins r-ilt licds.d corlrldos ro odrud tlE Foj.tl (sq 7o{,. &M
<br />lrl PDfrsin ( od. Th. Co n.roir t,icce lrs d6 mr .p9ly r. e owE o f prorat y *ho build! or imptor6 lhq@a
<br />ed sl$ cod,.clr tor 3uch F.j.s. wnh r Coido(r) lic.B.d FEq,n to
<br />'lE
<br />( o.lr.doit Li* L!w).
<br />I m.rmd uirdd \dti,r t] &PC forthstwn
<br />Drr. 0r!6
<br />woR{ts&s' (irnrPENS rioN
<br />Dl(]J&rll9rl
<br />I h€cby alnn und6 p.nah v ol rrcJury on. ofrh. follos hs .k lrd ioN
<br />-lnv.-dwill
<br />idrin r Cdifi.r. of Co.gl lo s.tf-lw for wt6r'6mpodi,\ ! Flvii.d tut Ly S6ltr !?00 of tla
<br />tdor Codc, aor ttE Ff.rtlre olllE *D.t lq $ti.h $. Fnn ir i!.u.d
<br />-l h.$ rid *itl tuul.rn wort.r' comFnntb. iBultre 6 Equncd by 541ioa l'r0o of th. L.bo, Codc, ror ln. psft)|]'lftc of
<br />rlE wrt fq vhah rltir Fmn n isuld My wrld onpcBrion iBUl . oi, tn po&y nunbd t.:
<br />PoLicyNumbq: Elpn6
<br />-r
<br />cdiry lh! i, th. FfollMc of lh. uorl for shth lh! Fnd ir its.d. I th.ll ml @ploy @y Fsn in uy 0!!6
<br />$ s ro h..om lulri( lo dE *.rld'oDFllbD L$ of C.tifoni& ard tsc lni ial nDlB haoB sli6r t6 rlE
<br />wort6'mmF&rio.Forlio6orsdi,n1700oflh.L.torCod..l!h.llfontu onply vnh lhor prollrio6.
<br />UARNII\(;: failur. !o sE ro.k6 comD.M i{. .o\6.s. 6 uhwtuL Dd .lull 3lbJat e apbtE lo simi,.l Po.liis !d
<br />cilrl nnB up to oN hu,rtol rhouqnd drlLE (con of.omD.$rrcn. du.rsd B F.ciH for lh.
<br />Ser6n 1016 olrhc litFr Cqlc- rl(.n
<br />lrIll-lBi.ra!
<br />I had, .lIEn un<b ,a.!y of Fiwy thr I d liclcd utb PDvib. ol Cn fl6 c (ontll4ar, lvirh Selbn ?000) of Dinio. !
<br />ot 0. BdilB dld Pmf*b6 Codc !'d my licua n h tull foc.id.Gr
<br />/o=27/6
<br />I h6.by altm un kr rE lq of FjuD_ lhd rh6. i!. cotr(rudio. Lwlhs tadc)lor rh. paf(nrMc ottlE trort rtr shi.h lhis Fnil ii
<br />'isu.n(sr 10)7, ( it ( )
<br />APPI ICANT NF(-I AI'ATION
<br />I Hry !trm uds d.ny of FjE r..- oE of tlE folbwiry &.b,.rioro:
<br />D.elirbD PmiryAlbdror Norincar,oo F.ddl R.sulaioa (Tnl. ,10, Prr6)
<br />-R.qun.d
<br />kla oI N{tifxdion
<br />-l
<br />cd'fy rhn rh. a.jod r.guldioE Esrdins stGtor rfl\ tl e mr gpli.tbk lo lhs Foj..i
<br />g.r.lhd rh. .hovc i.aolfui,n 6 cor6l l.srct'onrly$ith.llCilytid(odi,
<br />BrNcr ioc &rl nd.ty rurhoru. r.Fsiin 6 of rhir ( nt td couu'lo dta up.n rh.
<br />tpplicrnl or 8enl Slsfl.r 1fu,fit+<;,t ^,.41r1e
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER Uz,Al4 fufuYZ-,'a-'
<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 Rouqh)
<br />Meter Release uhw/,tAlez*/02-'
<br />Rough ,J/W// ,"27rffi&tr-)
<br />Service Meter
<br />FINAL <Uu/,//t/ r *?/E//w fv//
<br />Notes, Remarks, Etc.
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