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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE tD/stG.COMMENTS
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bondinq / Groundinq / UFER
<br />Transformers
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilinqs (Hard & Soffit Rouoh
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough
<br />Service Meter I I
<br />FINAL ql ?\D*vk?
<br />Notes, Remarks, Etc
<br />OWNER BUIU)EN DDL('AiAII{'N
<br />I hd.t, rmrm lndi Fbhy of Fiury lfid I s.rcq{ tm6 llr Co.'lnr6' Lkm t r lor th. tollos'.ts l@.ls< 7011 t
<br />Blshs !d PtutBion Codc, Ant Cny or Cou{, $ti.h Eq!t6 r Fmn h s'drucl, tt6. int o\.. dom[rn c tc.n ay
<br />stucr@. ri'.
<br />'o
<br />n! ('@a. ako rcqun6 th..p?li(dl aor ruch p.nnil lo liL,3(n d rddml ltd lE or slE ir lkaB.d F!..,n
<br />ro rhc Fotuionr of rlE Co.rsloa. l-i..E d ll* lcn prd e, ( ommocin8 $hh Sdlion 70(Xl of DiGion I ofrh. Bri6 &d
<br />Profdn,nr Cod.) or rh,t h. or !h. ir .rcmpl lh6.fron ed lh. tBlb for rh. allqcd .rdFion Any $ohtion ols..1ior 70ll.5 bttny
<br />applicrnr fr i pdnir subjd!rhc applica.r ro.cililpdanrolnor Eor.rhan rrvc hun&.d dolld(ttoo)
<br />\lLt s nrno orrrrc pmrar. or h' mpl.)6 { ilh \5.B s rhor hlc c"nlpdsdnn. \dl tlo rh. n,rt EId $. rMrE 6 mr
<br />i,rsri.d molIs.d fo $l.lsa 704!. A6inB &d ftpfdioN Cod. Ils Codndoas Li(@ L$ &6 ml4tly |o d o\\G ol
<br />rh. FoFrt *'hd hi!& 6r inFDv6 thR)r. ni *lF dr6 srt \. hnelf or i@ltor ttmurh hi! d hd o{n 4phy.q
<br />Foutdrh.r3uch imF.rq6rs4N -norLdoro&d l 5h.l[ ho\6a. rlE hildhs.r nnForqt ii $ld {ihh.rc }s
<br />ofconpkion. rlE(\E t itb *ill h.rt 0r tudor orFD\iis lhi lt oI !h. dil d hild d inproE lh. pFFi,v 6rtlr F,F*ol
<br />l. eso$n(otrh.Fopcny, m.rclusn.ly(.nt.di.s\ h h..ftd $nlln.lrFtn conslruq rh. I,trl.('l(sd 7(x,1. t]rsir6
<br />and l\rlisim ( nl.: rh.Contrrclois l,iccnsc l,aNdo6 nor applylo !no\nroirotdyqho huildsot improv6lhEen,
<br />and trho conrdds rff sch ro.l<rs rv([. (ihtrcro(s) li.md pusm n lhr(onlrrcloa! l-ics. L!trJ
<br />I dn cldnpl u.d6 Sdrio..l -'/'Z? ""*v-z,Z.Z /.-*z' \roRrFRS rO{PiJQ{rrO\
<br />DICI.Af,AUA!
<br />I hdcby altirn undq lcElly or Flory o.. of rh. aollo*in! d..ldrir6
<br />I h,v. !.d \rill mim.i. a cdificar. o f (tNor to Sclf- rBur. aor snrkds $m!.tuanod. a! F.vid.{ for tySdion l7L{)otlh.
<br />Lrbr (i!., to. rh. lsfolfu& of thc tro lor $hich lh. paTii ir isu.d
<br />I h.r c lnd $ ill ran ,in q ort6 (onrFrsdl iofl iEurancc. s rqrir.rj br ssl ion r 700 of lh. lilr (i'd.. ,ot lh. Fr()Imnc. of
<br />rhc $ d' h ior N hi.h rhG pdnn is ir 6l M) s ortss ror.rEs,
<br />'oD
<br />iNtrer.. {eE td lslt}' nomhd r.
<br />Poliq Nunb.r: Erpn6:
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<br />$orksl .otrrforslion pmvisioos olSdtrn 171)0oflhc l,tor ('od.,l Jsll, tonh$ilh cdmply silh tho* proieioB
<br />N RNIN(i: r.iluE lo sr. \rorld' .onpotsdhn ..rd*c
<br />cnil li.6 up ro onc hun&.d rhoNnd {ollr! tlloo.ooo). in
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<br />ir unl!*ltl. dd ltolt $br..l e o0l'rr ro simi,.l FEllis."d
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<br />DEClJaaIloN
<br />I hd.b, amfln und6 Faht of pnjury llut I m lic(E d undcr proviion of Ch.pl6 I (comfficin8 with Salion 7000) ol Divition :r
<br />ol lhc B i6! Md PNleiod Cod.. !t nyliclM is in tul! forc.ed.flal.
<br />CAIIIAIJEIIA!]IIDIIGAGII.{:I
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<br />i.su.d (S< 1097.Civ. C )
<br />l.ndo'r N!rn.
<br />AEILICATfDECI.6IIIII,X
<br />I h6!tl allm und6 p.naly ofFjury on. ol rh. folh*ire d(lar ions
<br />D.no|nh. Pdnit3-Asbdos Norilic.iion lj.ddol R.sulalD (,r,nk 40, Pd6l
<br />R.qtrt.d l,.r16 of Nor'licalion
<br />I cdify rh.l rh. l.ddrl r.8uhlioN r.glrdin8 sbdos rdord e. nor .t plklbE lo thn pNitl
<br />llS€l 'rr rr', r t*. *a rtt .pDlr.ron rd rd. rhd llE lhorc inlomd'o. n corrdr I .ec ro ondy $ nh .ll cny ..d coury
<br />ordimnG.rdSr.rrssEhirsroh{ild'nsc.'rnrudion.!dEE}+.dh.ro.i.Fffiir6oflhi3(n}&dCountyloddr+.. E
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