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ELECTHICAL-INSPECTOR HECORO
<br />APPROVALS DATE ID/SIG.COMMENTS O\TNET BUILDER DIiLCARATION
<br />I hcrch! nliirn lndcr n(ulry (), Dcrury rhd I m.r.nlnr rmm
<br />'h.
<br />(t nttukn Licnc L,* tur rlE n,lb*m8 rclen (S.r70.]l5
<br />Bn\inc\\ !d P,or.\ir cldL) An! Ciry o. Counly whi.h rcilut s ! Iffin n' .on\lol1. ,lrd. mlpdt. &m irh or EFn lny
<br />nnkrui., ritr k, irs issunkc. rto r.aui6 ltE applta nn luch Fmir l,' lilc ! \istd llcrcft.' rhar tr or shc i( li.cncd ,Esunr
<br />h rnc I'tr)vi\inr\ or rl* ContDcr \ l.tcn*d Lie toEp'.r 9, chnuftminS $ith Saln,n ?(t[ nf Diriin n ] or rlE Bu\ifts 8nd
<br />lin'llrsi.n( Co!. ) or lhd tE or rh. Fcrcnrfl rhcrcfrondRlri. horh f(r rfir llLscd .r.mflion any vi.larbn ot s(lM 70ll 5 byrny
<br />!n!!ica rhr a pcro'r \ui'rctr rlr .,tpltanr br.ivilp(Mhy.ra Bft thM ivc huBlrcd dollir (S5llor.
<br />-1.6
<br />owmr oarn. pmFny.,, my cnlPh)$s rrrh *.8.s c\ rlri vrL.tnrwnvrirn, w ld, rh. $olk !d llE nulw i\ ft{
<br />idcd.n or o,Icrcd fr sk ls6.'.?Ortl. Busi,rc* rnd Pr't isx,ns (ixl. Tlr conetni Li.lnE L!* df,s ml q,Ilt lo u o*rcr (t
<br />rhc |iqrt, *tn tdild\ or ili{mEr rhNn.0ffl *h, &Er uh H}* hrmrclfor hcrrlfor rlhl8h hk or lEr o*n.fl0loy.cr,
<br />provi&d rhlr st.h inqn&mnls c mi incndcd orolcEd lor $L lt l$ssi rlx fnilJi4 or itq,lftft ir5u*lhinoNF-
<br />nlcoq,ldnn. rlr oumr Au'&r lill IEE rlE to,n n of F)vnr8 lhd h. or \hc dil rn huill o. mrrew lh. I,r{El, Ln rlE rDq* of
<br />_l. r.o$mr orrh.toFnr, ancicln\ivcly.onr.&rih8 snh li.rnrd conk&1oR 'o.on(tu|lh. atroF-r (5.( 7044. Btr\ims
<br />ltl F Lacir GxL: Thc CoNlcnn s Liccnse Luw do nor !01'ly h an o*mr of porEny ull' r,uiLlr or imBrv.\ lh.rcon.
<br />and Blrr a' Bk f.r \u.h tsrcts *irh r conrGrr( s) licn*J Ix^urnr ro rlE conrrulf i l.t.ns li* I
<br />lndcrrnrfl 0tr,1.r s(r.n .lt &l'( l1''llnr.r!,
<br />Drr{ (hner
<br />w(JR(ERS CO rpr{SATTON
<br />UECUIAAIII']
<br />I hctny rmiinundcr Fn.lly oI,f,.jury o'tr olrhc n,ll,'ums ducllIlli,nr
<br />I h{v. !*l witr tuinrln ! (tn iff,.tc of Cntr$r lo Sclf ln{urc ln }orlcB .oqro\d nn. !s Fovd.d fo. hy sftrio. 1700 ol rlE
<br />llhtr C( .. fd rhc lEdrr'Hrc. or rrE {r} tu uhi.h rhc I'dmil i( isrsd
<br />_l hiv. and will mdi un *orkcri' .oinpctrs,rtr'. nBurincc..s rqtu"cn hy S$rit l?(x)oarhc litrtr OrL. i{ rh. Fronrl[*c oI
<br />rh. sork ftr*hthrhi\ l.rnrir ir i\{Ed My10*6{ (olnti etrcn inu. rc cnrrr ed Fni.y nunlEr a.lprl
<br />llq uqt tt.q.)l
<br />l.crlriy rhrt in rhc lIrhrfr'n(c ol lhc work ri)l whi.h rhir ociin n Nslcn.I \hill ml cryhy nny p$r,n n',ny'M.rf,r
<br />1, N ro bcdnx \uhJNt r| rhc !.rkcrr rorF-n{ nr ltrw\ ol Cllifrflir, rid rFN. rhd il I $o!kl kt-om ruhrLtr l,' rlf,
<br />rorl.F.onrFnsri.npmrisi'ns.tScdiotr]7motrh.LlhtrCrxl(.t\h!ll.lonhrnhlrnnl,ly*dhrnorI'mvi\xn$
<br />WARNINC. l'ailurc n, surc *ork n cor{Enslion colcnlc r unh*ful- .!d stall slbr.r !n .rlllk,Fr r. ai nnd Fehi* rri
<br />civil fiNi ut ro o,E hundrn rhoo{d d.llu\ (Sloo.dlo). i, ldlirnn ro rhc .o{ or.omn .s.rion. tlom8ls !s Frvn.d for rlr
<br />Sc.rn'n lr,Tnolrhc lrhrCnlc inrcr.{.Ji { urm!'t lir\
<br />,,,", : l?7/4, ,,,-,, x-
<br />Lt!:ENtEl;0Nr&tctrla
<br />DECI.AMIAI
<br />I h.rcbt .firn u l.. pcnully ot pc,rury llur I an liccnd unds rovNFn ol Ciaprs 9 iconntncinB $ h scrtbn 7s[, o{ Dnisn'n ]
<br />ol rhc Brstuss aotl l!ft,f.:r6nr CnL, ,rn my licns ( in lul tu..t dn c['al
<br />r'rrh\dNunttr' 181'l tl
<br />t/tz/zr #- uJitt,"
<br />g!,lN!'lalEulruEBDDg-drilill1
<br />I tuEhy untnruolcr En.llyornctury rhal rlsc t ! sndocli,n lc.dina rac'F, n, rh. rdronrsmc oflh. *! tu ctahlfiisFmir n
<br />(suM (SL! .1(})7.Crv. C )
<br />A.EIIIIANLDEIL/TSAIJAN
<br />I h6dly im' trBld pcnil' y.i tErrury or of lh. Iollo*in8 d.cluli'n\:
<br />Dcndirnrb P.n rs^stEllos Noliftrrion ttdcrul RcSulirhn{ ( rnk,(,. Pan6r
<br />Rcquircd l.ltcr o( No{irrrlion
<br />_l cmifu thd rhc icrhBl rc8lbrirB Eg{din8 lsbcao. rc'n,vll d rct {,Dlic0hh lo rhl\ Doj.{r
<br />ll cdirr rhd I lEvc Norl rhk lnnlicarnn lri norc rher rh. ahoE intomdbn h.dml.l,8c lo.onDly*ith Dll Citrufld Counly
<br />ordi&tu!\ &d Strtc b*s rcbin8 ro b! il{t in8 .o.(tuc1ion, en trE y {rbrt. EF.snl{iEs oflhirCny&d Counlylo cnld uFln llE
<br />rbrr r oriomd rrslEny lar insD.<tiotr ruqnss.
<br />^ppli.ur
<br />or as.rr sknrlt, 4- - - -
<br />I',,.,.i,".-**rn.i"lr, ;</mr, f"t",
<br />1/v7 /t r
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Lile Salety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor I I
<br />Bondinq / Grounding / UFER 7ll at btqd+r I
<br />Translormers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners I I
<br />Root Top Equipment 7ll 7\vrfiDj
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Solrit Rouqh
<br />Ceilings (T-Bar Rouqh)Ir
<br />Meter Release 'tA\7rl !)'l{'i*r5-l
<br />Rouqh
<br />Service Meter I ,l
<br />FINAL 'l)t 1L bk*v7
<br />Notes, Remarks, Etc
<br />Rov og-o7-201!i
<br />(, lO
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