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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNl]R BUILDER DEL(ARATION
<br />! hcrcby lllrn unds Fn.lry ol ,E,rury rld I utr crcnfl th( ihc Conl'rtoE l,t.n* tl* ntr rh rolbwing rc.$; rs.( Turl IB!nn.\\ del Prorc\* Cixlc,: Any Ciry or cmnry whah Eqrirc\ ! Fn r !o .nnl1rucl. ulra, iry)mlc, dcmlnh nr EFt rny
<br />srructurc. pmr k' il\ n\urmc, rle rcqrrc\ rh. rpl'lE. lu 1kh F.nii nr lilc r \iA({l {dcftnr rici h or \h. n liccn*d tEitrlm
<br />ro rhc !mvi(i,n! ol L Conrrcttr \ t-f,cn$d bu (Chaptc, 9. ConnrxE-'i.A *irh Sr.ri'n 7(XD ot Division ! ur rh. Bu\itus
<br />PncsionlCodclo.thrlhcorshciq.rcnurtlh.rcliomandlhchasrtorrhc.lt8cd.rcmprir.Arylindio.ofsk_li)n?01l1by
<br />rpnli.nnrti)r rlf,nii \ubj..rrrhc rDlicuntft, r.i!ilFnrhyornor nbrcrhln fiv. hundr.d dollr\ ( SJ$r
<br />''":,:,p
<br />_1, nr owtr. ol llE lroltny. or my.flployer silh wo8.( a\ lhen $k omp(nro'n,n. *i d,llEhltunrlExrnlr@ i!ml
<br />i cft.kl .r or|lEn tur slc (Sa 7044. B!\iesr dM I'r.tc$irns Codc: Thc C.nkkkn\ L'r.ns trs d€. mr {rply ro e ovBr ol
<br />rh. ttutf,ny *lll ttuius t, inrFrrs rl@,r drl wll, .txs sRh wort hidxclf o! hcMlf or lhmu8h hir or lE, own cri'lortcs,
<br />pnvdcn rh,l .uch i,irtmEmflls e rn hrcod.d r .lTcn! for slc lt k,wcE llE hikin8 or irq)mtm.r ir sU *ihin oE ,3{
<br />ol.oipLrb[ rh. O*mr ariH.r *ill tutr rh. hlnjc. ofpmund rh{ lE or rh. did n hikl or in!re\r llE tn{E!, ror lh. F,JiE or
<br />l. n\osRaorrlE l)npedy. .nr ercturncly cn.rracrins *irh liccnql coorrlcx,F n).on{ru.r rh,,n,Fd (sd 7l}l.r. BuiRs
<br />rtul th)f!\\ir ci,rlc Th. Conticnr\ L i..rr ljs d(B nor rpt l, h $ o*n., ol pn)F y who nurld\ o nrpruvcs lh.rc n.
<br />and sno fun'mh ntr !u!h pmFcls *irfi 0 (l,orrrrf,l s) lrcned |[nunt to rlE O'nrrdr '\l,t(n{lj*).
<br />I rrcrcnrfl undd Scl(
<br />]TABf,Ef,5:c9llTENSAIlq!
<br />DEg.AaAfto!
<br />I h.rchy rffrnr unn r n nrllyol Fr,lryorcof rhc f.rk,$ia! d.$brnri,ns
<br />_l hrla ond will minrlin a CcdifMk of cl)nE roS.ltln$rclor(.rs.ul!.ns.rn,h.as!(,ridcdr.rhysdrionl?motthc
<br />Itrh, Cod., lor rhc Frfomkr .fth. Nll ft, f,hth rh. p.mfi k r!u.d
<br />Vl h,!c dnd w,llrunrrm r,nt.^ .nmFBd.n m\uhmc. !r rcqut.n hy SNrhn llr(D ot llE Llbor Cod.. for lhc pcrlotuc nr
<br />the work ftr ehi.h rhir pcmtr i\ is{.n. My vorlch 6np..di[ '.rurN. @ir .d l,lt, numbcr e
<br />,"*,,?{<tfesY
<br />-l
<br />lrnily lhd in
<br />'lE r.rlnrnEh-c ot lhc w.rr tu *hich rhn I{ m i! n1en, I rrBI fr .n{,loy lny Fmn i. r., m xr
<br />$ .1t, lt6n{ iubJNr lo rh. w.rr.n'.ofr|.nsri)n lnBs or C iror.in,,nd !8N rhnl ilI \hrld lE om slbral ro llE
<br />$r*.tr N,nt trsli.r provisirins or s(rion 17fi).l lhi trhrr Cod., I shull- fonh*'irh.u{'ly *nn dn$ p,ornin\
<br />\trARNlNc Fdlurc t' {.urc *ortc^ co Fn\ruon o\crl8c i\ unbwlil. r'tJ \h!ll \uhjcd r c 'Ik')tr t,.n mtrl ttMn$ rfrl
<br />.ivrl ftrc\ u| h orE hundrLrl rh,usnd i.lh^ (Jl(x).1)(x,). in jt](lirior t' rhc rnd oI $ntr{nqri( . driut.\ !s pn,vdcti n, rhr
<br />S( ri,in h,)6 or rhc I itnr ( .d. int.rc\r,",.,1}]eufi 'u/1,MWL'$tL.-
<br />l2f:cLaSauoN
<br />I h.rhy,rtrnr u*l$ F.nrltyorn rjury rhJ' I ar I'ccnsn u cr pn$nnnorCh.pl€r 9 toxrnEtiu wirh Sr-.rioo 7(xlr) orDnGdn.l
<br />ol rl! Busin.$ url Pnna\rionr Codc. urrl nrt lacnsc is in ftll lor.. mi ciTftr
<br />,". I
<br />.r\.cNL,,,EL, 7-q q\aT.
<br />W|uk\ tttw|+vt-I 1 >()
<br />lx.rlcfs Ad&c*i _
<br />IIPLICAI{ISiCIIMIIO!
<br />I lrJdiy nitm undcr Firlry .l p.rrxry orc of rh. folLerE d..lr ion(:
<br />Dc niirn ltrmirs-A\&\lo\ Norili(llnrn Icdcrl Rqrhlrn\ (1irl..r0. Pan6r
<br />RcrJunsd L.n.r ol Ndili.rri'n
<br />-Ic.dyrhdrhcrcdc'rlrlubrr{h^8JrJnr!i\tr-r*rcrrdlircntitllFihhr'rhanmFI
<br />ffi-nr,t, , t* .,o ,nls Jrlr *nrkn url {ar. rhrr rh. utr,vr inrormrio. ir c(Gr. I uc ro.n.t U *nh sI cny d coury
<br />ndrn,(c\rnJ s'{c li*rhunns1,,ho lm8conirudbr !'dtur.bylulh,rc rclrcrcnmn!\or rht Cir y.td c{,lnry b.nr., u|nh rlE
<br />!tr!. nrnrk,mrl mmnvrd n\'ftrbn nqm*r;-Jffi:,;--H#)a/a Wl+nq.--,. t, ]U)d
<br />pemi,edm,p.ino: k'lV; WA vlrCly- 1^,1 @--
<br />Site-Work
<br />Underoround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Salety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Groundinq / 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 & Solfit Rough
<br />Ceilings (T-Bar Rough)
<br />Ivleter Belease
<br />Rough
<br />Service Meter l.r l^trt ^oFINALqlt /d/APl|,lfr lltK.
<br />Notes, Remarks, Etc
<br />Rov OA-07-2O15
<br />oelzlbL
<br />l?-Lrt
<br />CQNSIA!,8:IIOM.EdDIAU-ACEII:I
<br />I hcEby rrum urLr Frulry oi t rjlry rlur rh.E n ! coorr^rtir, r:idins rs.my lor th. Frforntr. oI llr *ork ,or whth rht Frnir is
<br />irsu.drse 3091. civ. c.,
<br />lfiLr'\ Nr'E _
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