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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS O\T NER BIIII,D'R DErI-ARATION
<br />'
<br />h6*'t.rm !nd6 Frt) ot Frur,\ lhd I @.rnfl 6ns rh. Co rrloE l(@llo for tlE aolhqiry lt*! (S< 70.115
<br />ttuh* .nd ftordion (i'd., A.t (-n! or Cdd! trhEh r.q{t6 t Fmn ro codtud. .l!q. imFo\.. d.ntlirh Dt r.Fr dv
<br />,ruclrq Frv ro n! isumc. .llo r.qun6 lh. qrlidl lq iu.h Fmn h nl. . r8xd 3ltldd rha li .r Jr i! lic6.d Flu
<br />ro rh. pn'vilioN of rhc Conra.roi! I-ic.Ncd b$ (('hapln 9. ( ommcncins qirh sdi.. 7000 of Dirllion I ot lh. BriB md
<br />PftrtNions ( od.) orlhll h. or tt. B.rdfl th..iiom and ih. baris tor lhc.lbs.d.rdnp(ioi Anr_ viol.lio.ofs.(ion 70lll ! br!n,
<br />lppli6nr f$ ! p6fln subj..r! rhc ,tt'li..n! ro r cn il pmh v o I mr morc lh& 6\ . hunrr.J dollas (1500)
<br />l. s o{ffi olrh. F.Fay. r mr.nph}6 snh $tg6 6 rlrn $k.ohFE r.. trill &r th. *rrt rddErrlriEirmr
<br />iddrid 6 olk lbr s]. (56 7or4. asiE rd Pr.iasi)N Co& Tlt Codisroi, l.kc L!* &6 (ll +9b l. d o"n ol
<br />ih. F.Fry rtn 6iti or rF.\E llEoc rd u ln .tE sh trnrt niN.l, d hdll or tlrcush hn or lE oen ct{)hl!a
<br />provid.d rhlr .u.h inFnlti1dr.. mr iidrlol or orH ft'r el. l[ rbns6, ilE tlildi8 or i"S.lErEn i! rld *ahi. G ]a
<br />of conpkior thc (),rF Eui{q *ill hrw th. h[&..f Fni.S lhd lE s rh. dn ml hild or inqo!. lhc FoFry ft'r !FnF-of
<br />l, s osF orrh. FrFl!, m -.hsiElt contkin8 r iln lnar.d cofidor to mldrucl tlE IFi<1 (sd 7o4'!. &arl6
<br />.,n Prtlsin cod.: Th. Co'nrFoir Lic@ L.u d(s hr .!pl! h d.$ r. of propdl) $ho &il& or nnr.r6 lh@..
<br />ud *no odsi! ld s.h FoF qnh. C.dr*1.(.1lalsd plre4d b rh.(i rrlotLa.eL.$)
<br />I n.\dpr u.dd S(trn
<br />D.r. o'n€r
<br />\t oRt r {s' colnPF-\sA floN
<br />TIIIAIAIIA!
<br />I hs.t\ rmrm unrkr Fn.hr.ftdND on. ofrhc f.lk\\ Illll d(hltri6
<br />Ih.v.rd$illmi rnt ! cdif$r. of CoEar h !dr.lM'. rd $ 16' omlElrhr - For idil fot I, S<li.n 1700 otllk
<br />lltr (-.de fG rh. Ff(ldr. of rh. {nt for stih
<br />'h. Fni' it isEd
<br />lhi\c nnd Nll ai.kin {otkc1' .omp.isarion 'nrnrin.c. a\ r.qtrn.d b S(rkrn r7(xrotrh.lihn (ndt. ft, rh.,crforuncc of
<br />:: :' ^ \1d;"-" li ".$pv " "" |j;ri:--.'
<br />,.,,,,..,*' to35( ai-4312o - ;..,,- S/ylqpno
<br />Irdn\ rhar in rh. pc.nrmah_. otrh. \o ( rd \hKh rhr aci'i tr Kq'd. I trlrll n{ dp[r(."' -.'J,. '.t *.*I$ B b ircod ruti<r ro rh. $nrta' conFdn'. hsa ol (-.lilortu& ed teE rhd if I rnouB b<oft subid b llf,q!d6' comF$rion I,61 iiidB o f sdion 1700 oa ih. l,hr (ird., I !n!ll aonh*ilh comply Nnh llili rotihN
<br />$''\LNlN(: l'r'lur. ro eatrr. \or163 ..mp.trqr kr ..\ d rr.is unh\ful, ann rhill luhicl tu 6pl.!d b aiminal FEhE tnd
<br />h.. d,ms6 6 tmrii.d aor rh.
<br />:::irff,t*"{. im6.< md nlonE_t r lc
<br />ApDlorr:
<br />I hftby imrn u.dd pdaht ofpqjury rhar I e lrcd<d lndd F)vtio. ofan ds I tcoomtring snn Sdn'n 7000)ofDivirn,n r
<br />of rh.Bulinsond hoaBi.N(.d.. &rl my licmr i in fullnraed.iT(t
<br />^" 't lt
<br />b (?>
<br />fa 41oq\
<br />Cp\A",-.ur t@a
<br />laNral]g1arl[NulNc-&Gr:ll:r
<br />I h6.br i,li.n undd pcnahr olrrjuD lhlr lh6c ir i $nrrnti,,n lmdins.soct nn lI. Ff.llMc. ollhr $orL rn (hi.hrhis Fanil k
<br />isrud (s( r(F)7. cn (' ll.kl( s Nam.
<br />ATIII$ILDECI,AsATTO!
<br />I hftt, iflim uid6 ,.nahy ol psjury otu of lh. f.llo*ins d..l.rttions
<br />t).nohhn Pmns A3t6k s Nolilicrlion F.d6.l Rqrlhnrn. (Tilc,10. P!n6)
<br />R<quird I:rrs 6t tldi6.dirn
<br />I .ntr( rhd ih. f..l€hl rquhl ioB Eirdi.E atErtr rffi\ ,l s. d *rlt.hL lo rna FF
<br />i,n i! or.d I .sr lo ondt *ih tll cil, tnd aou.ly
<br />riu r.F.*lndir6 ofllur Cn, od ( ounly lo dlE uro. lh.Kn:l'' th.t I tavc rdd rhlr irplic.rnin,rtsr.r. thd rh. itrr. infotu
<br />0(l sral.l r\s tlnr *n,ln'r
<br />atnr. nmr i('n.d propcnr tu iNp(rion
<br />\prrrl..rl or A16l Sknrlur.1/rf tn
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications 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 & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough
<br />Service Meter / /F|NAL ?/7 //? FL.0z ,.fu /,a./
<br />Notes, Remafks, Etc I
<br />.nil n.6 uI,lo om nu..t'.d iho$..d doll,B (llm,fi$),
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