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ELECTRICAL-INSPECTOR RECORD
<br />ID/SIG.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 />Bondino / Groundino / 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 Rouqh
<br />Ceilinqs (T-Bar Rouqh)
<br />Meter Release
<br />Rouqh
<br />Service Meter
<br />FINAL ) tE'Z//- Ctrt tzzLc-> - Z/7
<br />Notes, Remarks, Etc
<br />OWNER BUILDER DSTI'ARATION
<br />I h@try rrm und6 p.i,lty of Frury lhll I d dmpl frln th. ftolt!.tda LE.e lr* lor rh. rolbwry rdsn (Se.70l,.5
<br />Bsins &n Prct*ion Codc): Ary Cny or Co6ly whi.h rcquiE r pann lo oElNcl, dld. imFovc. dmolilh or Ep.n oy
<br />3lflduc FiJr ro it! isuee .Lo rcqrtB rhc +pltor ir $cn p€oil ro fi1. ! trir..d id6d thr lE or dr. a lico!.d Pdn r.
<br />lo rh. Fvi!68 ol ltt Contretoa! Ltd.cl t w (('h!Fa 9, (tnn*in8 wnh Setbn 7000 of Dilobn I of th. Bqi.s od
<br />PrcfsioN CodG) or firl lE or JE iu ddol thE tum .d lhc b.!i! lor lh. .llcg.d qan|ion Art vioLlionofsdlhn 70115 br&y
<br />!p?li.6l for a pdmi tubjd. tn lrplicel to. civil Fulltofml mrclhe liv. huidrqtdou!.(lrm)
<br />l. 6 orE of rh. Fop.ny, d ny mploy€ rnh *ry6 B rh.ir $h cohF[nhn. snl {b tlt sdr !d rE rnxlr.. mt
<br />inr6'.t d or ot[6.d fq lrl. (Sc ?O{,4. B6in6 md PmadioB Co& Th. Co rrioar l.aog lrw dE nor +91, to o osffi of
<br />rh. FtrDEry *lD Uril& or u,p.or6 ttEa( od * ts dE kh srl hi|elaor nd*lt o. itmugi hn d lE osn anplotq
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<br />'lE
<br />hlilnlB n ltsDwEEr it $ld vJb oc )a
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<br />l. 6 ow of rh. ImFry, @ dclBir.ty .6d.dfil snh ftd!.n .oddoB ro corEtud llE IrJ<<l (Sc 704-1, &6i6
<br />Prntsn Codr: Th. co.rtuor'r Lkd. lrw &B mt .Fply ro o o*E of Fordy r lb buildr ot inFovd rhqon.
<br />odrell ror $ch F!j.r!r uni ! Co'idro(r) lrqs.n Do,!d ro rlE Co doat La.e tl*)
<br />! h.rm[ un<r S(rDn
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<br />I h€.by lrm und6 pqulo orFju4 oft ofrE foll,$!B d..l,taioB
<br />I t v. ad will mhrrh . Cdirrdc olcold ro Sclf.l@ &'r $dt6' otrVd.btr s Fovii.d for t, 56ln. !700 olrt
<br />L!- Codq 6r rlE Ffffi. of dr rql t stah r,E FDh i isr.d.
<br />I h.E od *ill Mi .h vorl6 .omp.dhn ilMu.. s r.qutld bt s.d.n l7m of rlE l-.bor Cod.. Iot llE Ft(ir]l.e of
<br />t,E $ort f, *tth lhL D6nn i isrdl My wnl6 oDpdirM icula. ffiit -d Flty nuhbc e
<br />PolryN@bd
<br />-l
<br />cmiry rh'r ( $c Ff6lrj4. of rlE $ort 6r wtth rhn Fmn i! e.d. I rh.ll @l onploy uy Fnn ir {y Ile
<br />$ s ro b.€m $bj.d ro th. s!rt6'comFlipn h*t of Cdln)lu lrl.ar rni ir I {'o!ld b6oe stttl lo llt
<br />mrt6' onFB.rDn Fo6ios of Sclbn 1700 oarh. t t r Codc I JEll, fodh*nh onply *ih rLi FoEi.B..
<br />*aRNlNC f&lurc ro su. *!rL6' conFMbn (016+. i3 u.b*nrl di rhdl sbJal o dplotq lo onnd FtrnE lrt
<br />civil IinB up lo on huod'.d lho@d dollan (l 0m), in ddirnn lo IE cor of cohpddio,L d.rr86 d Fovid.d for dE
<br />I h@by,fim undd pdahy of prjury thd I dn l(a!d unds F{vilii,n of ('h!t o 9 l..mmd.ing wilh Sel bn 7000) or Divnion l
<br />of rh. aBi'B sd Proa*ioN Cod., ,ri '.y li.d. n i! full ln . drl.rTdr
<br />cQ!fl8l]cuaNtElDllc !!cr
<br />I h@by lmm uid6 Fulr, of pcDUry lh! lh@ t r onIru.lion lG'dinS .*dc, for lh. Fhmdc. of lh. wort for "tich lhis Fnit ir
<br />bsu.d (Sc. 1097. Cir. C )
<br />tadc s Nm..
<br />I-d( s Addrsl
<br />AfIU(AII.DECIJAAIIO!
<br />I hody ifu, uftla poihy of Fjury 6n. of $. fouowing tk l,t lioNl
<br />Danolirion Pq,ir.-A!b6ro! NolifEdion Fdsd Rcsuhnoo (Tilc 40. Prt6)
<br />-R.{uit
<br />d l!16 olNor,tudbn
<br />Z c*ttlJ- rU t*a,q.'ldioB,qrdus lbdoi rEm,.l c br rrpl(.bL ro rhr FnF.
<br />ffi'x,T tr.rmtrffi *1"Hy.r#sx[['ffi iffi [tr.*. 1
<br />!bo\. lMi ioEd prcpqly fo,
<br />app,i..nr or,Uor SiBtr.rur.
<br />/ e.-e.1
<br />o2t
<br />APPROVALS DATE
<br />Rev 08-07-2011
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