|
ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underoround
<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 />Buildinq
<br />ljnder Slab / Floor
<br />Bondinq / Groundinq / UFER
<br />Transformers
<br />Torqueing
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soff it Rouoh
<br />Ceilinqs (T-Bar Rough)
<br />It/eler Release
<br />Rouqh
<br />Service Meter
<br />FINAL
<br />Notes, Remarks, Etc.t
<br />-t
<br />OWNEf, BU!LDEf, DELCARAI1ON
<br />I hcrchy nmrh trndcr D.elry ol perlury rh.r I m cxc,pr rnm tlE Conr(tm k.n€ L,* lor ttE ft,ll,wiry re$n (S..7011.5
<br />aurn$s inl Pror.ssk. CnL)r An, Cny or Coun'y whrh rqun.s r Fmil lo .onnrud. !lrd. itll,rot.. d:n irh or Ep{n uy
<br />(ruclurc. trnlo ilr is\urNc. lls rcquircr rhc lndicr $i uch Ir mi, lo lih ! \istd qdcftnl rhar tE or dF ! lhctr{d l)uNa
<br />t, rh. |,o i,6 of E Cont&krt l-i.ncd t E tctrpls 9. ConmminB *'rh Scrion 7(tD ot Dilirion ] 6rrh Ansia$ md
<br />Pmfcs\ions Codc) .r rhal lr or rh. is crcry1r rhcreiion adl rL tsrir to, rl* ulh!.d .x.qihn. Any viobrion of Seli)n 7o,l I 5 hy any
<br />nrr }rd k, . l{lmtr \uhrrr\ rhc rntlEnr ro ' c'rrl p.tuh ) ol mr tur. rhd nv. hundrcn Ln,lldl l35UOr
<br />.1!, -' l41L(a' 6*Kt "tttt w*nv. d m) .rst !c\ r hxrE.rr\rh.tr$h$qrnsr6n.*illdollEu*!nrltrurE!mr
<br />i:totr.r *.ncrc.r r,r qr ri* rDir. ni,"**,n,r t'ni".'r,'ns codc: Thc cotrr,mror'{ r-tcnic L{w dGs nor q,prr ro anoe@r or
<br />rh. truFny *ho tailds oi ir{m'rs dfr,n. !d shd &s \rh M* him*lf or lEBll or rhmuSh his o. lEr {un cnthrc\.
<br />pnrd.d thrl rEh rDnrenEnB @ rn intorh oltccl tur sL lt hrN\s. rlE tu mE or ir{ro!.mnl ir bld * hin (E Fr
<br />of.oifLrbtr, rh. O*mr AuiB.r will hlh h. thLnol pmvirS rh tEor\trdil nbdillorintmrclt t,qEl, nr lh. nutn$ol
<br />l. nl owm. of rir FnFny. 0,n cr.lu\iEly conrrd mB *nh lNtrcd conr6ri,6 ro on{lfti r,E ptrrixr (sr 70{.1, BBrfts
<br />t ,\r,ft.ri,n Codc: Th.Conrllrurs Li.cns. b*d*s.ur upplyr. unu*n.rorrmn nywho burldsor imlmlcs lhcr.otr,
<br />,nd $ho onrrch tu un ImFt\ *irt . Contk-r(s) lienaaj pu^unr ro rlr Co.r{ntri LirrE lrw)
<br />L ,,r'.,an nL(' \!.rtr,r
<br />,r-r, ' -/?/>t
<br />DtcL,\!{ Tl(rN
<br />I h.,rbr rlltrD utr,l.r p(nrlrvollirlUrv or ol rh! l,nLuin! Jr(llrrna
<br />I hlvc und wil I minruin a C.nificatc ol Concnr xr Scli.lnsurc tirr xnk B cotr{r!\d ion. {\ Fovid€d r.n hy s.dion .17m ol lh.
<br />tjlxtr Cd., rd rh.IErfonnflr ofrlE !o lor which rhc p..mn n L{ual.
<br />I h,vr! sill rEmtui. $orlcrs conpc$lrn'n inxuoEc. !s rcquircd hy S.Erhn 171, or rhc Ljti, C.dc. ror rh. p.riamtur or
<br />rlE work for whthlhisFrn ir nnx{ My *olkcr' ompcnsrn,n rn\orNc cdicl and Frlky nudb.r e
<br />/1
<br />Pol,cvNtrnlH _trtrE
<br />Di-r,'t,.*-.**.,* **
<br />^, -**h'sFn s B<u.d.I rrr.ir mr .opk'yany rEN)o in zny lMm.
<br />y, rn)b.rrrF {,hr.r k'rhc s"ltc (otrr.n\{rnrl.'$'.iCnlintrnrr.rtlr!r.rrhrr'll\h,lttonrsuh^.r()rhr
<br />sor[.r'conrNr\(n{r|rtrn!'nt iS..rion.r7(x) nlrlr lrhr C,rl..l nBll. l,trl h\ irh .oq,ly $irhrlr,{ tn'!i\i(rn
<br />WARNIN(;: Friln'c ro surc work$ con,F-ndt,n co\rr!. r\ unhslrl, d \h!ll \ubj.d in cnllllo}tr r, aminal ,Hrh.r.nd
<br />civil lln.\ r! ro onc hu.drcd thous.fll dolh^ (Sltro.(x)(r,, '. rdi! i,n t, rh. (u{.1 conln.trr.rn,n. d!tu3.1as p(rdd (n th.
<br />Sc.itrtrr:r076olrl[ lrtrn (ir]c. inrcr.{ rnd d[tr'f,y \ lrc\+k/-zt '(-.----'=
<br />DICIdEAIIIIN
<br />I hcEby loirr undcr Full).l Friury lhor I m lius\] undcr rn,vision ot Ch!r,t6 0 (&mnttuin8 wiih S&ri)n 7(m) ol
<br />.l rhc Bu.ircrs dd PmrdsiorN Codc. rd !y licn* is in tull tu.c dn cfir..r.
<br />,\,,-,,,,
<br />!aNiIA!CITT,INIENDU!i-dGD!gI
<br />I hcrcl,y rmrm uxhr Fn.ty of F rury lhnl llEc i! ! mnrMlbn blnins !rB_, tu ilE Ffdl1tm or rht *d* lor *hth lhn Fni ir
<br />issucd (sc.. J047, Civ C.).
<br />tuLlctt(flrEclllaauo!
<br />I lrr.tJ)'ullatr undrr lcnulry oI F!!ry om ofrhc folkrwiq tlccla6rnn\:
<br />Denr,lirirn I'crn r\ A\b.!l$ Noriil.irx,r F.ilcral RcBlhron\ a]-irl.4l Pad6J
<br />Rcquircd t tr.rolMriruri,I
<br />-lccnilyrhlr
<br />r hc fcd$ll rcsu lar ion\ rcsrdii8 a\hrro\ rcmrvrl dc .o' lpplir$h k, rhis pn,Jccl
<br />r&trd'ryrhJrIhrv.rJ.tlhrrlFltrrrr inl {JrcrhJr rrE 0bvc inn,mrirn nolh-r.I osrN ro 6,n1Ply r irh utl CiryandCou.r,
<br />'trJ'.drc\rfilSrrrc Ii,srrli itrx r, hurklrtrr cotr{nr(. !,rl h-.cby iurrr ruc rcrcs' Nrrr.\olrhnC y dCounryroctrrcrulInrt
<br />. i,r.,,.nri,nrLl Pl)F.nt ntr n\r..rtr frrF^r\
<br />nrr,,.rn, ". ^*-, a,*-u,* [
<br />l'"m -e '"rorirr), )<,4/.t //;4
<br />Yq)/
<br />vavtaf',i|n?$it
<br />Ro.v 08.O7-2O11
<br />Sub-Panels
<br />l
|