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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER B!TLD?R DEITT'AXATION
<br />I h6.!y rlrm und- FEhy of Fjury thal I d.rdpl fmm rlE Codr.clon Li..nr tr* torrn following llmn (Sc.7oll.t
<br />Buins !d Prordion Cod.) A.y Ciry or County vhah r.quna . Finn ro @dtuct. rh6. inFolr, daDolish or r4.r ey
<br />tu@ Firro irt b.@c..L Eq!i6 rh..rplf,d fn Mh Fsn h 6k.4i.d rrml lhrlEor!h.nk,!.d F,!ad
<br />ro rh. FortioB of rlE co.rr'd r Lenr.d l.* {ch.F6 9. coffinrs enh s<rhn 7ffi1 oa Diviri.n I olrlE Duild !d
<br />Pr.ldioB Co<k) or rhrr lE or sh. b .rdpr thacnom .Id ilE b.!n tu i,E dkS.d darFioi. Ary rioLl.n orsetb. 701 I 5 t), ey
<br />spplic! for.p.nnhrubjEl!lh..pplicerlo!.ivilpcnohyotnol,mrclholiv.tundr.dd.llat(S500)
<br />l. s o*M of llE FoFr). n ry dlployE Enh f, 46 E llxn nk omFlrrtr *ill do dE Bt ttd E tuc it mr
<br />doiLd d oturd fu d. {Sc ?Oart. &Bi!d md FYof6i'6 Co&: Th. CodEi r LkaE lrw d.6 d +?ly to d otrE of
<br />th. Fipary wlr blill or iEFtrs tlEE( rrd slb &E *h Erl hih..lf or h6Elror lhmush hii or hd 6*n dpbr6.
<br />prov .d rhar !u.h inFo\66ll e mr itudqj ( oIH for s]c lr. ho*dd. rh. &ikiry or inFssns i! Fld within on. rr
<br />of@rpkb( rll O"E &il.d wiu h.E tlE hnbr ofFovitrs thn lEoriLddtu' h or rpro\r tlE FF,6rtlEFrForof
<br />-1.
<br />sof,EoallE Fopsly, ffiqrlu'r.ly codr.clhs }ilh licded.o *ro5 rir.odrud trE F.i(t (SG ,O.l.l, &BN
<br />dd P&fr!&nCod. Thc Conlrrcroa ! Licm!. L.* Jo6 nol !p?ly r. s ownc o f propGly who blild! or infior6 rhdon.
<br />&d l'ho cotrrdr for such Fojd! vnh r Codmlo(r) licd*d puau&r ro rh. Conlrrckn r Li@ t!w)
<br />-l
<br />o ddF @d.r S<nio.-, B & P C for fii! r.&n
<br />Drk Orn.r
<br />]llJnXI;85:rcIltEdSAIIA!llEgd&ll]g!
<br />I h-.6\ rmmun,td tEslD oaFJUD okof rh. nnk\* inr &rl&ri)B
<br />I havc &i wil! minr.in a (difr(.r. ofcolsat b s.lf-lNur. for wrkdr cohD.nsro., a! prcvid.{ lor hy Sriion 1700 ol lhc
<br />L.h'r Cod.. h. rh. t cfol:@.. o I rh. sorl for which lh. Ff,i! i i*o.n
<br />, h.r. md sill mmrrin *o*(r' o"pqEnan itMmc. 6 EquiEd b S.dnn !?@ of rh.lrto, Co<L. lor rlE F offi of
<br />rlE hrt ar *tin rh! FDh ir iu,.d My edtd onFson iers. cmit al !ol.y nuobd &.
<br />I cdiryrh!! in th. prfo,:m. of th. w.rl fo. *fiknrhis r..nit is isuql. l3n!ll ml nploy D, p.r$n in uy EeE
<br />$ o lo h.c!e.ut'rrt lo rh. mttd'.onFsrion l,vs of c.liaomia, dd lsE lhd il I shruld tE(od suqd lo tlE
<br />sn6 o'nFd ion FDvirioB nf sdio. I700 of lh. t bor (-ode I ddL fonhs'nh shply u''rh lhos F$nirB
<br />\+ARNINC: Fihr. k, su. *ul6'comFFdKn cor
<br />civil lind up xr orc hundrd lnouud dollo! (ll00.cl0
<br />6!s. n uhr'tuI. ifil .lull 3!bF o onp
<br />), 'n aldnion io rh...i ofc
<br />Cel. in!6d drndNr'.lG
<br />z>F x
<br />DICI.ASAIIO!
<br />I h*by .rm und6 p.n ly o I pdjury thal I o licolscd uds Flvision of 'r
<br />(.o.rM(in8 wirh s(lbn 7000)of Divtn n l
<br />of rh. BBilB ed PmldioB (-or!., eld nr li# L in tull nrcc !d
<br />L \1 (-..c,..F
<br />Y1
<br />I hftby a,nrm undd r.nrlty ol pgJury rhar lhd. ir a connrucr
<br />isu.{(sd 1097. ( n c).
<br />olrhc *orI nn *hich rhs tEftir i!
<br />AIIUCANLIEI;IASAIIT,U
<br />I Eurq dtE uo<lq F .ty of FJury oc ot rrE follrnins daLr.rDN:
<br />D.mlnbn Pomir!Atb.n6 Norificdio! F.dr.l Rc3uLriotu (Tnlc.l!, Prn6,
<br />-Rcqui.d
<br />lllE olNotifi cdion
<br />I .dti! rhd rlE far6rl r.guldbB r.grd'nr atBtos rm\.1rc ml qr (3t .lo th! Fjral
<br />Lt\d '6 , h, r h.'. 6d lhB lppr
<br />ofuman(6 Ed srd.lrs! rcldiu ro
<br />!b.r. MtEn d pnDsty ld iBp.<r
<br />is.Dtr d. I asrcr..omply snh lll Cny dd ('ounl)
<br />^pplk.nr
<br />or A*6r slrn.r ure F
<br />**.U.* ,".",,nr,, K
<br />'-':,'_';'l;;'il;
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Frre 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)
<br />Meter Release
<br />Rough
<br />Service Meter
<br />FINAL I {zo/,,8r*/6J
<br />Notes, Remarks, Etc
<br />-+
<br />,--' (.F
<br />,,,,..,.-,*' q > \05-1-1
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