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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS Ow.B{ilda Dcdlnid
<br />I haltr.fiim u&r Fnry of FjuyrIII DqdF f6 d'. Cdr.cn Li.6. L.* f6 tti. foll@ing l!.m (B 70!l t B$iB
<br />ed Pol6i6 Cod.) Any Ciry a CNV rl d Equi6 . Fnjr to 6riruc1. ala. ihFoc. daelhh or r.!.,. sy 3nucl@. Fid rE itr
<br />i,5ee,.l$ r.qltB 6!.IDlior lq tu.i pahil lo 61. . lirD.d inml rhr h. d dE t li.aed p{66l6rhc Foviti@ of lh.
<br />cmEele., uc.*d L.w (Cll+rc 9. cd!M6n8 eirh Sedo ,0o0 of Divino I of rh. luin6 ud Ptoarid Cod.) d rld h. d
<br />th. ir.rdDr lhdt6 ed rE hrir ra tlE.llcald qcnFio tuy violaid orsdio 7031 5 by ey.ppliol td. Ffrn lubld! rh.
<br />rp?ri@t io . civil Frltt of id mc tl'a fivc hu&.d (bllB (lJoo)
<br />_t, { Md of dr. pro?crty, or hy fiploy.6 wilh *r3.! a $.f iol. @mpd$tio., will rto th. *ort ad th. rn!.ruc r! nor r.ldd.d
<br />or ori.r.d td tn! ( s.c.7ort., Aqins od Prcfdi@r Cod. Thc Cmi'&d! Lrc.nr. Llw do.r nol rpply b e ownc oatn. pmpfiy
<br />vho buil6 or inFov6 thed, bd *ho d@ luch wdl hifl.lf orh6.lf 6 tlu@gh hir shq dn mploy.6, Fovid.d rh.r tud
<br />irIprord..B rc .or in.ad.d e ofi6.n fn rd. ll ho*.vs, fi. buildini s imprcvdal
<br />'5
<br />cold si$in on. y.e of Mpldion. ln.
<br />OMd-auikla will h.v. thc buda of proving $ar hc 6 rhc nd build d imp.o!. fo lnc purF!. of s.l.)
<br />_1, E oMaof th! Flpqty. a dcluiEly atdirs with liffi.d @lreu lo ceriluclth. prcjd { Sc ,0..i ABind ad
<br />Prcfdid Cod.. Th. CdE ad'r Uc.@ Lv dG &r .prly ro 6 ffi ofpopq9 who b!il& d imFlr6 lha@ , &d who
<br />@r&n fd sh FojcB *iO . Cdl'lrd(, li.dld pGur ro rhc Cor.td t Li@. !:* )
<br />IOA{EBS-E9MIEISAIIOIIDTCIABAIIID
<br />I hd.by ailim udd p.n.l!y of p.rjury 6. of th. lollowin3 &clanrio3
<br />_l h*c ed will nlinrin . Clnificdc oa Cwat to S.ltln$tc for w6tcn ohFrulriofl, a Fovid.d f( by S6do l?00 ofrt.
<br />L.bq Cod!, fd lh. pcrfd1Mc. of th. wort for *hich thc Fhn i3 isud
<br />_l irv. od eill mini.ii *dto' c6pd.da i ld@, B r.quir.d t, Scd@ l70o of tn. lrhd Cod., fd il. Ffolue of tErdr f( wh'd Un Fmr it i&.d M, *dtd' .dnF!.d6 'itime @id ad polq nunlq E.-, E1311 ,f-
<br />lolicy Ndbf;_Elpic
<br />(Ilir t..tio !o!d Ic b. qtDla.d it lh. Frri n 16 O@ hucld dolln lll00) 6ld)
<br />\Z! cdrfy !h.r ,i
<br />'1. r.fdrDe or !h. ,qt fd ehid 6n Ff,it i. isuod I lrdl nor qiploy -y Ftd in ey ttllM rc . b
<br />h.cr@rubjdbrncwdta .mp6!.!o l.Bof Ctl'fmi!,.g.. rh4 rt I.hould b.cm. rubj.ct b th. wodd
<br />cMD.tudio provirid ofs&rie l?00 ofth. L:ba Cod., I sh.lla.o
<br />WARNING F.ilE 10 lauc wrkd' cmp.nrlriq @vcEsc i! urh*ful, ed rhril iubj.cr e nployo !o 66in.l p.nrldd ud civil
<br />fin6 up ro 6. hbdrd tlEusd &,lla (31OO.0OO),itr .ddition to th. con ol c6FE.rin, d&.s6 a provi&d fd lb. Setion 1076 of
<br />rh. L.bu cod., incql ad .lrm!y\ t6
<br />LrcENSED CONTRACTONS DECT-AR TION
<br />I hdhy .nid 6&r Fr.lr, of ,ajury $.r I m lica!.d qda Fovitid ol ct.pra 9 (.omiq.8 wilh Sed@ 7O0o) oa Dvirid I of
<br />thc Buitrd dd Preadid Cod.. &d my lictr t in fdl rw &d r[.cr
<br />)
<br />G->
<br />goNgrBJcftoE.t llDBcrcElta
<br />I h@b, .fllo BrLr FrJty ol pcrt!.y d'x lh@ i! . c@tEti6 l6din8 .8dcy lc rh. Fdo'lltag ol thc wot rq which lhir D..n,t i,
<br />n$.d(se !0e7, Civ C.)
<br />A'IIICANT'S DECLARATION
<br />DqDliris P6iB-A.bdrd N.nficlrim F.ddrl Rlaltais (Titl. .0, Pd 6)
<br />_ RcqujEd tara of Nooictrio
<br />-l
<br />cyE d
<br />'nc
<br />rcdarl qdadr E Edina !ha6 lwovd E d .prl,qblc b lhtr Ford
<br />tzll Gtfy rlE I h.w dd lh! qptidid 3ld .& d{ dE.tow iDfd id n ffil I aaE b 6lpl, vnn dl Cit Dd Csty
<br />d.lin&c6 ed Sd. L.a Ehi.8 b boildin8 xd h@b utluia EF!9Eiv6 of tni. Ciry 6d Co@ty ro 6i6 uron th.
<br />lbovc mntionc<l proFn, fd
<br />c.->
<br />v )--
<br />P
<br />L 'J
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains Atibq (t&mi
<br />Signs (monument)I
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER 6/2tlo1/,3)41
<br />Transformers I
<br />Torquing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough
<br />Service Meter A\
<br />FINAL ,-2r"4 >twt
<br />Notes, Remarks, Etc.
<br />_I adlrr 6r& S.cid .B t I C f6 dit 'a6
<br />L4dat Addrd _
<br />I
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