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ELECTBICAL-INSPECTOR RECOHD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER AULDEI DELC NATION
<br />I lErcb, r,frm !,td Fn lr, .a p.rpy Ud I 6 .rctrpr f,on t,E Colr.doa Larr. t w fo, 'll (olb*in8 Bsn (Sa ?011.5
<br />Susin.ss ad Pmfcasion Cod.): Any Cit, or Counly wtah EquiEr . Fmt ro ontlru.r. .lra, impmve d.mlih or EFir uy
<br />drEtuq Fir ro ir! i.rllrc, .&o Equict rlE qrplisr rdr Gh Fnu to tua r.ti.d flcd 0u lr o, dE i! liu-n pllald
<br />ro tlE Ftrvnioe of tlr Coird|.ti La.n=d L.r lorFs 9. Colwrin3 wth Sarirn 7@0 ot Divirbn I or llt BlriE ! ..<l
<br />Prof.si,nr cld.r d lh, lt r rlE n .rcrpr rl'ddtom .d rlE lBd lor rll .lLrd .r.ngbn. Ary vELri,n ol Sdi.n 7011 5 by .ny
<br />cr'?lkd nr . p.rni obr.lr rh. .pplicdr ro r civil !.dly of br mE th.n liv. hliddd doua (ljl@)
<br />-1.
<br />a o*E of rh. FnFnr. or dy cmployer wiri *u!! a5 ln.ir $h of,Fnlrlior! ,ill do rt! wl.r'd rlE dndE i5 or
<br />id.ri.d tr ofr.Ed rr rl (Se 70,i4. auilB od ProEsirB Cod.: Th. Cosd-! titE tr* .la ml .p?ly L u owE ol
<br />rlE F!'?dry ato hrE d inproB ilEl4 rd *ho dG ti wt hi@lf d lEftlf or llloulh nn d lE om.rpb)G.
<br />FDviLd drr Bh inFltrd & d irqi.d d olftrd fu r,. lllffi, ilE h,iuirr ( nF@Grr ir toU,ilind F,
<br />of olplraotr dr o!f,F auittt riu h.E rtr hrd.n of Foli8 tn.lr or rlr rln ml hdd q bp.oE dE Ft qry ftr dE F,r.- ol
<br />l4l.l. Noqsorrh. Fopqry. h.rcluiirclyco Eri^! with Ucr€d o r.dr ro otr('u.r rlE Feixr (sd. ?(x4. B6ims
<br />.rd PlDt.nn C!d.: IE C.nlBrd r Li.cM Uw do.r d +pty ro D orE or toFn, wtb hoiLk o inprDs dEEtr
<br />rtrd lho olfr.rt ftr *h FoFrt ,in . Co r-rdlr) liuEd pul'd !o th. Co{ft rort Lit& Lr*)
<br />_l e .r..ipr !id.r Sdion_
<br />,.,.,' -llzr lzt
<br />B. & PC Ifi lhn r..$n
<br />".*,,1 L-4
<br />DECIJAAIIO!
<br />I tErcby .rrrh un<Lr Fm!, or Firr oE ol lll (nloviry &clr.bB'
<br />_l hrv..,rl *illminllin ! C.niltcr. ofCon\.nrro S.lilnsurc hr *o sr ohp.nrlri,n, E{ FnviLd ad by Sdtion l7(xl of rlE
<br />tihor Oljc,Iir ttE Frfolruc. ollhc qo* tu which lhc pcrnn n nru.J.
<br />-l
<br />h.w .nd will mi.hi. !ort6 6np.Mirn i6nEc, ( rquiEd bt Smb.l7g) ol dE l-.ho. Cod., lor tlE FrtulllEN of
<br />rlE lqk fr whih lnt F n asrd. My rortd 6rF.db. ll:ffi ffir.!d rolry mh.r e:
<br />PolicyNunrtrr Ert'iE.:
<br />pt mity rrra o rrr parom oru! ro* tu Bnth lns F. ! nrsr.I rrul Er.npl.,y ryF$n i.eyllw
<br />, B lo t &r s6i.rl lo 0E rrt6 orp.Mi.m Lrr of Cnifomia !n .8c thr if I nu! h.@r obr.l lo tli
<br />hrt6' @tr'FNrbn pdiinr otsBibn lroof rlt t ta Cod.. I iEI. tdh*irh otrdy rnh rhor Fovirbd.
<br />WARNINC, rrilurc ro sw srk F'comrEndi.
<br />ciyil fiF! uI lo oN hu'nr.d thousd dolri (Sl(
<br />sati,n :10'76 of rlE L.tor G{., nlcr ni llldEy'
<br />)n oEBBc ir unL*tu|. ad drll rulrrccl u cn{ orr ro ainidl rEMli\ r.d
<br />D.om), h .rldrnn lo llE o{ oI oEFB.lio!'. d.drro B Fovncd fr llt
<br />lrG ,z //* :a7e< d---L^-lztlzr
<br />I lcFr{sm c'omR L_Ton
<br />DECITSIIII!
<br />I tE€h, .lrum ui&r FMll, ot Frrury llEl I 6 liand u!d.r Flvitiln ofch.Frs I (oImEi.B *ilh S.d btr l0@) 6f Divi$n l
<br />of $. EuilH rd Pref.rs6 Cod.. rd mr lriB ir h tull flc rn.ffd-
<br />Ij!]!jSIBUqIIITNIJ!DIIiG.AC}:!.CI
<br />I l*Eby rr(n und( FMlry or lcrltry rhd rh.c n . otrdnerion ldhB rl.r, tor ilr tE,o@e. or rh. krt 6r whi.h rhlr Fnn n
<br />issu.n (S( 1097, CiY. C ).
<br />AITIICINLIICIdSAIION
<br />, hdrt, lfm uBl.r Fnalty of p.rj!ry onc oi rh. lolb*ing delu.rirn.:
<br />Dctulirioi Pcnnil!-Aibcsror Ndiarc.lion Fcdcnl Rquhthnr lTirk la. Prn6)
<br />R.grind Lt(d oll*rifdD.
<br />_l cqriry rh.! ilE rc&.rl ralLrirG E8edinB !iE!(ol I!fuv.l N dx lp?ltrbL ro rhi! peln.
<br />@l csrify thrr I h.rc rc.d rhn rnpli.nrbn rn .htr $lr rlE abv. inroridi,n L! cor!.I I r8r ro o,q,ly wilh dl ciry .rd counly
<br />rdiMres .d Sr!r. L,us Eh ir8 ro hoildir8 .on{Mrhtr
<br />a-^
<br />.ur,srE Enc*dri6 of rh* Ciry .nl Coutrty ro cnrs ul,n tlE
<br />!trv. m lBd p'oFny fG i,tFd.
<br />.lppli.mt or A*.nt si*n.luF X
<br />r'.nrirec n,nr rp;nrr: X @o r ,- \,-Z,-rccJov-
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Life Salety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding / Groundinq / UFER
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Rool Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Solfit Rouqh
<br />Ceilings (T-Bar Rouqh)
<br />Meter Release
<br />Rough
<br />Service Meter
<br />FINAL 3-.1-Zt Dn-nf{:
<br />Notes, Remarks, Etc
<br />Transformers
<br />T
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