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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER AUILDET DELCARATION
<br />I h.E6y rmrn u.d.r F,.lry ol Frjury rh.r I m .rry nDn In Conrdrm LtcM tl* ,o. tlE folk wing ltsn (Se 7011.,
<br />Businc$ un Profsiotr Cod.) Any Cily or Counly *hih tr{oiB t Fftrr rd 6rnM. rlld, impmw, &B)lnh or r9.ir 6y
<br />llrutN. Fi.r ro il3 iliue., .!o Eq!i6 rlE +plier ror *h Fsi b 6l I rig.d nr.lHl lhll lE or ft i. lited F i.!r
<br />ro rh. Fovtiod of dE CodEd i lirnr.d L.s lctri,rs 9. Comriq *ith S6ri,n 7m ol Divirbn I of E BBiEr, .r<t
<br />Prcf.sibn! Gnc)n rh.r lE qtL n ckrir EEfto6!nllE b.ir rd dE dLr.d.rcn+6.. tuyvioLionofsdbn?011.5b,u,
<br />.pplt!.r ror r Fmr sbirk rh. +plic.nr ro . civil Frhy ol mr mrc
<br />'h3r
<br />fiv. hrndEd d.lLn I lJ00).
<br />_1.a owE otrE FoJEny, or my.nploF whh wrlsu ilEt $l onp.N.rion, wil& 0E *r rnftirnEfti\or
<br />i'rdrd.d q o crcd fd {t (Sa.l(x.{. BGirB .ad Phadia Co.L: Th. Coff.!( i Lat@ a,* &6 d +'1, to r o9G df
<br />'h. Flrdy vt hilds d i.s!B tlEsa ad tho dE st wl hiElf d ltGlf m dElln fi d lir oh.npbFa
<br />pmviLi rh. trh itr,romG e d i&d.d dolErd 6r.1.lilntE, ln hdlliE q i,F.wrEn ii! arnh @ F,
<br />of@drbrbtr ir Osc Euil&. BiU lrE d. hriot ofFDvnU r lE d JE ilid 6l hqild d lrprct [E FDDdr, fDt tlr Frpor o(
<br />{Lt
<br />-I.6wEof
<br />lll FrFdy. m.rcluiEly studii8lah licdsd o a16 ro od,Er tlt ,fDFcr (Sd ?Oq. BEitB
<br />]n hGsi6 Cod.: Tn C:dnrtloar LkcB l,* iL.: br .pgly 16 m orE or FoFnt rlb t{ildt d trrpnB 0s@
<br />lnn qM onlr-r! (' sh FnJ..r3 unh. CodE-lo(r) larnEn
<br />I xrrrrrpr nnncr Sr.{trtr'_.8/ 7'" z -21
<br />DESAIAIIII!
<br />I h.r.by ofirm und.r Fmlry or Frrury oE ol rlE lollowinS dcL,0lionsl
<br />-l
<br />b.E rn *iI Ei.hh. Cdifd. o(Corn' r. S.U-ln@ fd wrt6 o,p.ndbtr a Fovid.d td brsdrbn 3?00 of llE
<br />Lihd Coile f6 ln. pdre of th. wl ld rvtit rlE pqrin i! i$r.d.
<br />_l hrh dd *ill tunn.in wo d @nFn{lb. inMr.. r. njui rd by sdrhn l7m of 'lr t hor Cod.. for lh. psfo,'M. ol
<br />rh. wort for whkh lhn 0.mr ir ir$.d. My,orkn 6np.adi.n iffi. cMir i,n po|ty nunb.r N:
<br />l.cniiy rhd in rhc F.li,rturcc olrhc wnrk lir whEh rhN l.rnrir is Nsuci. I lhrll trolcmpk'y trny pcMn [ lny nrnE
<br />$ !s lo tr.onr ubj.{t ro lhc s crl.ompcnvrion hwsor C,lin)mi!. anl $E rh'r irI rh,lkl h(om sut!.d t,'lE
<br />*0116 oniEnerion Im,vsr)N olsdi,n.Utx)otrL LrtI Axl.,l {EIl. ftdhr irh on{)lr f,nh rhx rmvtri'.r
<br />\\.rR\l\(j lJ r,. k, artr'. tr,tr|.h (.tritr'tr, ktr, .,\r,]$ tr nl,'sni I bF !n qnpl? b airud F rB.rd
<br />n cone.n lqdsrrc, $ pnvncd 6 ttr
<br />k,*,-,*,.".,
<br />rnil fit\ trp t, om hu Rl rhou\rnd dollrft (!l(x).lxx)). 'n ld[i(,n
<br />slyrirrr l07r,or rhc lf,htr crxl.. .rr{ rtr xrrtrry'\
<br />D!r.: 7 -77 -Zl ^tut ,2zzr,:/
<br />, IEqIIEAII'A
<br />I hcEby rmnn lndcr Ftutry oI F.jury thar t !n liened ndd lFrjlion of C1lipld 9
<br />of tlE B$iEs .Jn PmL$hn! Co<lc, un m, licns ir in hrll n,N .td .iItl
<br />sols:rBuqllq!,jeDllE.AliBcr
<br />I hcr$y.fmundd Foly olFrrury dlr rlE ir.or*Eri,lddilg.rd,fortEFffiof0Ewtfor'ti.hthi.FaEli
<br />irtrd(se. t097. civ. c ).
<br />AIETCA!1.DECT.68AITO!
<br />I hoEb, aflnn und.i Fnlllt ol Frjury om .f rlE folloping d.cLnriof,s:
<br />D.mlirion Pdmils-Asb.slor M,rirr.lbr kr.l R.8!Lrhnr (Tirl.rO. Pln6)
<br />-R.quirn
<br />krld of Nriftrrion
<br />-l
<br />cd'fy lhd rh. lcd.El E8!t riors EtrdinS 86.slB rcm\d N ml agr,ltlbL lo thn prcr.{l
<br />r. s ..ld. I .!r ro .!ri{,|, vilt .ll Ciy rnd Counl,
<br />.iE EF.-n.liB or lhit Cn, .d Counly lo .ild uI,. llE
<br />---: n,,1- 22-2t
<br />arc 1^P.l'rre m (prr : 1 l'tartO M
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Lioht Standards
<br />Spas, Pool, Fountains
<br />Sions (monument)
<br />Lile Salety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Bu ild inq
<br />Under Slab / Floor
<br />Bonding / Groundinq / UFER
<br />Transformers
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Soflit Rouoh
<br />Ceilinos (T-Bar Rouqh).,
<br />Meter Release 1.2/L,Ll lL-Ltrt /?ro, . ?,1
<br />Rouqh
<br />Service Meter *
<br />FINAL '742-.-l /L C,;F{tt'at
<br />Notes, Remarks, Etc.
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