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ELECTHICAL.INSPECTOR RECOBD
<br />APPROVALS DATE ID/SIG.COMMENTS Ot{NER BUII-Df, R DELCARATION
<br />I lrEby rlfun uftlcr FDlry (" F,ru., lh:l I d cr.iry lnrm tlx Conrrdou Li.n{ L* tu rh ntfir]ry G.a'n lS.. ?0ll 1
<br />BBrcs rd P(n.sron Cqla): Any Ciy or Counry *h(h rqou.s r Ftu tr (onnru(. .116. idInov.. &mlarh or qbr rn,
<br />{urm. rrtr rr) [r No.h-..-:1l' r.quft1rlF,Ii rdr f rkh lrmir r,r nk. sisEn {r.dnr rh.r li or slr 6 lt.trBl lrBrnl
<br />ld rh. Fo!6[ni d rlE Co.rrnr'\ L$nd L* (Ch.trs 9. Conmtu'n! sirh Selir nXIl of Drv6$n ] ot itr Bu.trri xr!
<br />Pn'Essors clnc) ar rl'.r & or sh. s .t mpr rtRli.n,J rh. h.!. r,r lh. .llsed .$mflm Any *'L'Nn or Sernr ?o.!1.5I'y.oy
<br />aml'crr ftn r Fmir rub).alr lh. .mli..nl t. a .rvil lt.nllrt ol lor nrc then fivc hundEd d lldr ( lJflr)
<br />-1.r\
<br />owmrolrlE|noFny.,tr rtcnrtl,rrc\w hw!p.\r\rh.i.v'[u mpctrsrinr. $illJo rk qtrl( lnl rh. llnlrN n nol
<br />hroriil oroll.r.Jl' !& (SN 7(,,1,{. luws utrn tr ol.slotr\ C,rlc: l hc (inr.(tt'( Lf,.nrc liw &)c\ nor lPply (, r oqn.r.l
<br />rhc pn)!'cny wli) hui!\ ! tr D,proks ilt6,n, u] wlx, J,{s $ h k{* hrnrcll .r hc^eli.r rhn,uSh hB o, hcr o*^ .r{ "yccs.povknd rh,r \urh mfn,v.nrnk d ftn nrc.i]Gl o. orlchl r!tr !k ll. h&.\ti rh. ho Jru or trnllnrBnttrr A erU c (hm otu Fr
<br />oa lompLrxln. rlE ()*N, tl! J.r w l h.w llr tunk. nl fn*n8 rh! lE or \h. Jrl nn l,{il] or urF.k rh. fn'Fny ntr rlE PUlIr,E ot
<br />-1.
<br />ai o*F ol rhr |h|Fny. m.rdunvcl, s.taln! enh lklnGl.o rakE ri'.an{e1 'rt lnriir lse.,044, BEcs
<br />nrl PlDftssir C*L: Tlr Ci'.rr&ror'\ Lr.tr{ tlw JrB n, r[rlt kt $ owncr ol t'tFny sho nu'!r o, nlmwt rhdetr
<br />xnl rt$ $nrmrr if rBn Fitrr *irh. conF&rul, l.rtr d F6Usr to rL conht -. Lrd- L:*l
<br />-l
<br />rm.\.tr,t in(l.r S.(rn)n
<br />t il.:_ OB
<br />woRKl'Ls' conlPiNs/tTIoN
<br />UESIABAIIA!
<br />I h!'c6y.llrn unJ.r lxnrlrt ol Frury Drc Dlrh. n)lL,*ar tl.(l!r!rrln{:
<br />-l
<br />nav..d w'll frnr.{ { C'.n i.r. or cotr{nt h S.ll-ln\ur. irr wt6 .on{merirtr, I ttrvlal tu b} Salu lnD nf rlE
<br />lihx Grl.. lu rh. p..for'tr[.-. ol r,r k'* rd sh.h rlx Fnn n N{E.i
<br />_l hrv. u! w,ll nu'nr.,n vD*cB !\DIEi .rrD mstrre.. r Btuurl hy SNron ]7(U ol rlr L.&tr (!tL. l{r rh. Ffot:rlt. ol
<br />rh. *o* fo. shrh rhtr Fm 8 snBl My worlsi con{xtrr.rir n[uru. {.rc d t .y runhcr m:
<br />.*.. '/D Pot (e
<br />,r,.r",.*,, t ?//0 ,D? - 20)2-**g:,/- "e)"1
<br />I dn'ly rl'nr 'hr,r tr.rlornu,r(c t rhc wolk li)r *h(h thr r'.rnIr ^,\\o.J,I \hrll trorrn!'lov! y Jt^on,nany mankr
<br />*',\n)ltdrmqrhF(rn,rlnso.^rr.$nsrr()nltr*\ol(rhr(trnh,mlr!rccrh$dl(buldh<ror hlcd b rh.
<br />*ort.r( u,nDcnsr trtrr pnN,\k,tri ol SRrr,n r'7(lt, ol rh( l]htr (iil.. I rhill. turrhw h roDPly *rrh ih& F)virDns
<br />I{ARNING: F IIE t' ruE *r cr'$nrEnsrnr cornfc !. nnu*6r1. dl rh,I rohjd o minroFr nr mDl Frls .d
<br />r,!'l rft\ up ro otu hunlFrl lh,u$J Jolls (Slln.urr,. r rrlnrr h rhc .od or $nFn\rix . .!!m8.r .s nroYdBl lnr rlE
<br />S..r$n lll?6 nl rh. ljh, (,rL. sr.rc{ .nl .rr.By'< l(\.7- tz- tg Pot/ s;,tv -
<br />DECIAIAUg!
<br />I hcrcbyilltnu lfi |ttrully rl p.rjury rhar I am liccnBl !nil$ nt,vtrir sl chr0rd 9(onlmn!int wrrh Sc(r,i 7fix)) orDi,N.n I
<br />ol rhc Eusinrs lnd thLr\i,'n\ C,ic, rr my lir.n\c tr n! llllI()R.ul.rt t
<br />. csf
<br />- 27-/a ,t"c ON CT
<br />D *'"n,,'.,.,,-,*..,',., *,,o,*,,
<br />; r\ucJ rs( nrr? (-'\ ('l
<br />CONSTNU(-TION LENhING AGENI-I
<br />hcr r | 6nntuur LoJo! ,8.fty n rh. FrlomlNc ol r& k'rk li'r *hth thr Fmd 6
<br />AIIJ,II:AtrI.I}E!]IA8AI]ON
<br />I hry,trm uhld JFElry or JEriury orc ol rlr n,lh*|n3 Jel!.rir!:
<br />D.rnirpn P.mrirr-Arlr(or Nolfrrrs. Fql$.l R.8!Lr rn (T k .|rr. P.n6)
<br />_Rcqurd tdt$ol N.lllulD
<br />I .c.r rty nl{l ft icncrrl ,.!rl$( s Esdds! .sh.{o\ rcnrrvll rrc nor {','l.!bk r,} rhn lln)r(
<br />[y'/."nryln,,*".*,r,nF:nnlk.rnn.,r]nJ,c,hrrh.rh,v.mnrnurtr'n6r,,Brl3s6k,conll'lyw,rhrllc(y.ndcounry
<br />onlmncc\ rd Srarcl,Nwr Elrtrh8l,, hu ins consrnd i,)n, nd lrEby uurhtrnc Err.\cnrrrivcr ,,l lh! Ciry ,trd Counl, x' cnrq uFr lh.
<br />rlx,v. nirtrtrBl Pl,Iin! htr nrlx!rnr
<br />*,. .9- r2-19ApDli.{nl or ,\s€nl Sirmlun t o
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Founlains
<br />Signs (monument)
<br />Life Satety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Translormers
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilinqs (Hard & Sotfit Rouoh
<br />Ceilinqs (T-Bar Rouoh)
<br />Meler Release
<br />Rouoh
<br />Service Meter rl
<br />FINAL 217 7,t >lI*Yl
<br />Notes, ,Remarks, Etc.-.4
<br />,o,
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