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APPROVALS DATE ID/SIG.COMMENTS OlryNER DUTLDEN DELCARATION
<br />I hcrrby rffird uid.' F alry ol Frjury rhd I dn.r. rpt lbm lh. Conrmlou Ltcnt ljv rttr rh. r.llBing Edyrn (ss7orl.J
<br />Bosircs !fl1 Pert$ii'n Cod.)r A.y Cily or Couflly whih rcqoiEs i Frdir t, .oNtu.!. al'er, nnptuvc. d.ndish ot ENn ony
<br />srururc. r 'o 'is '\srnm., {le rqniEr rrE rr0lt.nr frtr such Fmi rir filc a ii8Bn \rrcmnr rhlr lE or dr G liGn{n ItNd
<br />h rhc lnlvisi(tr\ of rh. Conrrs $ r l-i.cn{d Li* (Chufler L Co'nnrNh! sirh SNrhtr ? 10olDivhioi3oflhc Buencs ahd
<br />Pmrc\\i.ns Codtr or rhrr l.t or rhc i1crcnl0l rh.Ermn nnJ rh. hssir ror lhc,lbscd cxcdpri,i A., vihrionorsorbn 7oll5 by lny
<br />.pdi.,nr ror . IE.nn rubFu rlE !ptli.$t lo . crvil pcnllty of oor flnc rhan fir. hundftn do .6 {!vn)
<br />-1..\
<br />o*w orrrE |n,Fdy. or nry.n{rh}t s w'th $u.s !i llbir srL d,npcMrhn. w l d, rlE vI* {n 'h slrulG s ml
<br />ml.dcl or oflcr.n ro. qk (Se.70!l. Br\itusr lnd ,toldsions Cdl. Th. C.,.lmt, s LienE Lr* &Ec .ot q'ply lo !n oDrr ot
<br />rhcpn,Fny whlt ild\ or i,pnMr th.E'r !n qh {t$ ruch u'* hnNclf or hcr€lr.r r]hlsh hi\ or h.r ow. cmllo]tcs.
<br />pmridcd rl6i \kh imrtumdr 4 mr hrcir&rl orofi.Erl lorsb.ll tnkw. rh. hrtlit{ or irtrNE, n$B $rhinor re,
<br />ormr{'lcionlh owmr B t a *iI n w llE t{r.lc. or lmvinr ttd hc ot rtE dil mr h.iU or n{toE ttu I,DiEl, for rh. Puqr4 or
<br />l. r\
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<br />iwncr ol rh. psln.ny, a (\clu\rvclycodtncr'n[ N hli.cn{ .onndo4 x' i,n{rucr lic pnlc.r (S( 7ol,l,lluvtu\\
<br />,ri P$rla\i)n Cdc lhrContru.rr,'' l-i$n!c us,lo.\ or apnry t) m ownc' or |B)Fn y $ ho huilds or inprovcr rhcic.n.
<br />rnJ r'ho (ontNr f({ \u.h JnrFs *irh a cln tu1.n1r lf,.n{.| rur\unr ro rtrCotuz.rols L{.nt k*I
<br />_l M cr.rfl ufrLr s*Lr
<br />w(rRKl tls' c()rtPFNsaTl(|N
<br />uEcld&trtlt!
<br />I h$cbyrlr],trrn dcr lEndhy ol'n.rjrr.nc oflhc n,l[rui.A d(lurlrtr,ns:
<br />-l
<br />hrvc url will tuinrlin . C.nirr{. of co.*d lo S.lr.ln$rc lG *rl$ .nnl|lctrsridn. .\ Imvd.d n bySall'nlr(r,ofth.
<br />Lltor C.<lc. for rhc p.raortu . otrhc w.A fo, whih rtr lcmrl ir issucd
<br />\{ r'o'"
<br />"na
<br />*itl *i,rout *ort.r' conttner ion inru,lrc. a. ,cquird ht sftr hn l7m ., th. Lrhor Codc, tor th. lxrforne! ot
<br />lhc workfnr *hirh lhil,'.rmil is hsu{. Mywolkds coot'.trrarhn in*u.nkc.riur xt plicy numtEr m:
<br />sV o*1- 1r1
<br />tnri"y..unt,. ??t) b rL) lf7\'7 { e,pi*,6-7 (
<br />_l (ditr rhar ir rh. p.nnrnuro urrh. wo.k lir whrh rhr lcnnil r ir\ucd. I \tull nor .nfk,y ttry r.rv,' n' rny nnnr.
<br />v, s h lx&nr \ubId lo rh. \orlcr'(nDcnvrnn Urs ol Crhfonin. nrd 4rr rtut ll I rh,u5 E(om suhr.r ro rl8
<br />eo c^' comprnq(n,n Imvi\i,,.\ ol Sc.rotr lTlX) nf rh. L!lr, C,r!., I stu l, i(,nh* rlh coq'ly *rrh lnre Pn'vr\n.l
<br />WARNNC: Fliuic ro ar. eort rl $n{Endnr co\tn8. ir unl.urul. dnd \hrll \obrcl an sploFr t, dimiMl JEMII-i ad
<br />(ivil ltrrr\ of b otu lrtrn,l(d rhru\(trt oLldn r!l(Xr.(x[)r. r l n,n n rhc.on,'l .o nt :nr(n,. d! [E.\ n\ Uortcd nr rh.
<br />sehn 1076 oi rh. tjntr Codc, inr.rcr md arlorEy s I
<br />L-KL1
<br />uclls@-glNrx.6gtr)B
<br />DEIIdEAIIq!
<br />I nedhy lntur unilo Fnrlrr ol p.rjury ltur l ,m li.cr*d und.r Eolirion Df Ct pis 9 (.omft(inB *ilh ssliin ru)o) or Divkk,n l
<br />ol rlE Bunrc$ od Prnh{'.r Codc. &n my lt.n{ ii h fu[ 6N od.r€1.
<br />L'4"Ll
<br />llllfIE.llcIIoNMDM-d{iDNCr
<br />I rEEhtnlfr unds Flully of Fdury lh.l llErc t ! @n(o.ri,. lciii.! t8.fty for rlE Finmmc of lnc ert fo, *hth rti\ Fnn ir
<br />h\rd r sR. 109r. civ c,.
<br />Lcnn.ax Numr
<br />-
<br />knd.i{ Addrc$
<br />-
<br />AIIUI]ANLDECI.dSAIION
<br />I MiylIi undcrpcllhyotn rjlry onc ofth. n,lhwrs d..l,tolnns
<br />Dctuliraon P.oirs Arbcnoi M iferion td.hlR.gublhn< (Tilh.(), PIn6)
<br />Rcquned lllrcr ol Noriliurion
<br />_l (.rr'fyrhnrrlf, fcrfurJrcSulrri, \r.Birdm! r\hc{.\ rcn})vil rrc nornptli.rhl( k, rhi\ nnrJt.r
<br />---vtd'ly rhnr I hok E.d rhs rrlnlrrr hn nn {rh rhi rh. rhrvc 'rlomrir is ctul I .sN ro 6r{,ly silh rll Cily rnd County
<br />o vmnl(t.Jkl srtrrc bw! Elards r, hurldrns cotr{ru.rbn. rn n€rcty aurtornx EFc{nhiirct ot th,r Cny and Counry k, cnld uFn r,E
<br />i::,:.:::Ii:"":#E --, -u:,-
<br />Site-Work
<br />Underqround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Lite Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor tl .\,-4
<br />Bondinq / Groundino / UFER 6 D{buJh.W
<br />Transformers
<br />Torqueing
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rouqh)
<br />IuejlqrrRelease I I A(x)ar la u t\w*v,q{a
<br />Rouoh
<br />Service ltrleter lt
<br />FINAL )A ft]WfYtm flv
<br />Notes, Remarks, Etc.rl
<br />Rnv nA-t)7-2015
<br />ELECTRICAL.INSPECTOR RECORD
<br />"-,.*". (1-
<br />Sub-Panels
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