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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE rD/srG.COMMENTS
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards !
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />Life Safety /Low Voltage
<br />Fire 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 (Rouqh)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough
<br />Service Meter
<br />FINAL <-/0-u o- (r,t :z/czU9 vZ V
<br />Notes, Remarks, Etc
<br />OWNER AUILDER DELCARAIION
<br />Ihdd,yrmdsddFEliyofFioryihdIDddFfr.Drh.ColrrdoBLtoet*forlh.folloei.l,en(5670!I5
<br />Bsrn6 "!d ftof*ion Cod.): 4., Ciry or Couny shi.h rcqqtB a pomn ro on{rud, ah6, mprove dqnoliln or qin e,
<br />.r,ucrEe Fi,r lo i'r isN.. dlo rcqunB lh. $dter tor 3uch F,nn lo 6k , ris..d nd.lMr tha lE or rlE i! licds.d F,er.,rl
<br />ro rh. Fovili.tu ol rhc Co r&ror! l.icokd lrw (ChaFd 9. Comftr.8 snh Sdior 7000 of Divrior I of lh. Bditrd ed
<br />Prol6ios cod.) or th.r t o. ih. ir d@F rb.nDm Erd $. b*ir lor th. rlcg.d crdFion. Any violrlion of sdbn 7031 5 by ey
<br />dne\cr liv ! e6E lubj6Bth. ryTl'c&l ro a(nrlt.nall) o|i.l no.c lh@ fi!. hunJt.ddollmtlrool.
<br />l-lf s owE ofihc Eapdy, or m) dplo)c sdh *.!6 s rh.n $k.onp.Ndion. wiu.h th. edk &d dE nrut6 B dl
<br />I i, drd.d or.fid.d lo, $L (56.7044. ButrB ud Pdf6ri6B Cod.: Tt. (-bdsroas l-kdB tls &d ml !0PIy lo s ouE of
<br />rh. Flrdr, sho hil& d introG rhnbtr lld eho dE sh m* tifr*lf or lEslt or 0mu8h hi or hd oB 6pkJyc,
<br />provid.d thlt sch nrFoffils {. bl idcd.d oroltc.d tu sL lf. ho*N. U. bildiry or trnFssG'l b $ld wnhin otu td
<br />ofompkri,'l. nEOwE BnilIE f,in h.EtlE hrdarofForirg lt lE or iE dil tut hrld d urfrctr lhc FoFiy tq dE FlF&or
<br />l. B oq ns oa$. popsly. dn s.lusi*ly coflracrins s ith li.6!.d conk.cloE to cotr(ruq ltE rroj61 (Sa 70.14. B6'ne
<br />,nd Aoasb. cod.: Th. co.tdor'r Li..G li{ do6 mr .pply ro s oqn6 olpllpsl} Bho h{'ld! or impmv6 fic6..
<br />und who eilmcls for such proj(l! qirh a ConlEcN(s) lic@d puBu.d h
<br />'h.
<br />Contldoi! Lic.N trw)
<br />I tun cr.mpt trnd6sal0n
<br />x","f9 | qlzo ,X.
<br />t hsclry .firm und6 F.alry of Frury onc or rh. lollowing d.ltrrli.B
<br />Ih.v.sd*ill@i.inrCdifi.rt.ofcoreort S.lf-tdurc for worl6 co,trpolarion. B Fovidcd for by Seiion 1700 ofrh.
<br />tttM cod., for E DqaMc of rh. qul for rtkh lh. Dotn i islol
<br />-t h!\r.td sill nanrft vorld @nFsdion nBrmq s rqrir.d by Sdio.l7m of lL tthor Code for 0E Ffdll1.@ of
<br />rh. trolt for whkh rh! pdrir i! a$r.d My wortd ..npd{ion iEua. ffi( rnd polty nuob.r e:
<br />Policy NumlE
<br />-
<br />--Erpn6:
<br />-
<br />Q!{niry 'hd
<br />D rlE FrolM otrh. w.rt ror wh'.h rh! Fnn i! sEd. I lhrll Nt apr,y o, F$n E &y nM
<br />lo a lo hroft lubF.r lo lh. wort6 @nFEdion bBof Cdifomn &d Bc lhn if I should b6od tubid to lhc
<br />$nrt6' onFMior Flvirio6 ofs.rlion !r00 DfllE L.tor Cod.. I lrdl [dlhwin or4ly {in $o- pmvirioB..
<br />\f,ARNING F.ilur. to su. mrr@ coftlcEalion ov6ir. n unh$'ful, dd shall 3ubjd d o'rlotq to qiniMl Frltis sd
<br />.i!il fi.d !p lo onc hlndrcd rhouud doll6 (t100,000), in .. d!,ar6 a Foridol fo, th.
<br />sd'kr.1016 orrh. bhor CGL. i,r6d d
<br />KP.,.
<br />I hcby amrd urd.r p@lty o I pojury thd t m li.dtr<! ondq FDvilion of Chl,ls 9 (cotucins *nh Sdior 7000) of Dilitiln l
<br />of rh. B6ilB &d hDf6Fu Co& .d nt la.e n in tull aoR d cfi6r
<br />qo![[8lq&xJrllDac.Ac[!I:1
<br />I hdlby .lIm uii|.r Fdly ot Ddjury thi rhd. b . ointudb. Lrdi.g .gcy for rnc Ffffi. of dr eul h. lhjch thi! FDi b
<br />L$u.d (56. 1097. Civ. C.).
<br />AIIIICANLDEO.AAAIIO!
<br />I ho!& rtrm uivlo podty or prjury orc or th. rollowins ddlaarhns:
<br />Dntuhbn Pdtu'Alb..ll6 ltorili..rior rc&r.l RcSuhioc (Thl.,r0. 9ar6)
<br />Rquircd t 6 oaNo{ifEllbn
<br />I .diry 6, rh. fcds.l r.sularioN rged'ng db6rG rtur al e. ml ar'pl@bk to ttu pmr.(l
<br />#;*',::t Ih r.@d lhi!.pplicltion !i s6r.fid lh.lborc inaonndion i ordl | 6sd lo .onpl, *ith.ll Cny rd Counry
<br />lar. L,*s Elanry kr blildrns &nklriz. r.F.ffir.! rv6 oarhi! C'ry dd Counry 16 oid upo. {r
<br />atI\c rndrbrcd pmFry fo, irora-lion
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