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ELECTRICAL.INSPECTOR RECORD
<br />DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
<br />I n Ehy rfltm uMLr Fbalry ol p.rFry rhd I m .r.q,t fDB lhe Contrctor' Liccnse Law for llt folhwin8 rcrsn lS( 70ll t'
<br />susincs . Prolcssion Codc): Ary Ciry or Colnty {hth rcluncs a lrmir ro condrucr, dr6, ir{roh, &mlth or qEn M,
<br />{ruclurc. prtu lo ilr issuffic, llso quiEslhc lprltdt for \u.h Fmi 6 fiLt li8ftd trdcmnr rhrl h.or sh. i lienrd puMnl
<br />rD rh. l)t)virn s olrlt Conksrors Lf,c.Fd trw (Ch$r.r 9, Comftrcin3 wirh Sario. To0o oa Divtion I ofrh. BnriElr d
<br />Itolcsk,ns Cqi.) or rh,r lE or shc h cxcmpr thdcanm @d rh. b6n ro. th. rlhgcd.x.qrion. Any tiohlion ofS.clbn 70.11.5 by ony
<br />.rpli.dnr ror i t rnr suhjdk ih. .pplicur ro !.ivil pcMhyofnol mE lhan fivc hutdFd &Uus {!500)
<br />l, d orftr or rh. |n,Fdr, or m, cmp!,Fs wnh wlBcs !s !h.n $b omrEns'ion, vill do rlE hll rrn E nntlm i\ t,
<br />ini.'ial or ofi.rcd nn $h ( Sd ?O4.1, B$iEr\ lnd ProLr\ion\ Codc. Th. Conrturoa. ti.cn* Lr* d.t d +ply b r oq*rof
<br />rh. pntEdy vhn t{iltr or i.tmB rh.rn. lrd uls d6 *h s.l himsf or h..slf ar rhmrgh ht or lht o*n.n!ilor..s.
<br />trotidd rhlr skh ihproEmnts ft tur iddrr.d orol[old tor *h.ll lDwE. E h{ildin8 or iqmEr i! sld *ithin orc J.e
<br />of (onphbn, rlE O*rr BuiEr will tBE tlE trrd.n of F.vins rhd lt tr slt dit 6i trrM d inpioE itE p$Fry rur rh l['FF or
<br />l. es owmr or rlE tmFdy, m.rctuliv.ly conrrdirS *nh ImEn @flrrtoN ro mNlo.l tlE I'Diir (56 7Or4. A$iEs
<br />.d Eo6sin Cod.: Thc ContBroat l-kcre Lr* d@t rcr apply io M owmr ol proFny who builds or inpmEs lhsen.
<br />rnd wb a,tuB lor ruch Fo].di *nh r Co,Ifuorts) laq*d pu6@ h rlE Cone|.|ds Lj(fr tir)
<br />I !n.r.n{,' !d.r Sdti'n
<br />D.r. OrE wonxg-,i.('oMPF\$rro-
<br />DICIIEAIIO!
<br />I tErb, lrrn n8t r F&hy ol FIry oE or rlE ro[owing d..hrrirns:
<br />-l
<br />h.r rn *ill mind. a C.niL.r. orcoM.r io S.ltlM fq *drd 6np.Mb...t F viLd fo, by S€tbn 3?m or E
<br />L.tr Cod€, ror d! pqfollrlre or rlE wt rq rtin d. Frrt k i!*d
<br />pl'h"*.,4 *ltt -inr.in *"*6 conF.Brbn insllfuc. E rcquir.d by sdi,n l7m of dE L.t r Cod.. fo lh. Ffl,rm ol
<br />rlE *qt f rtth rhir Fmir ir irr(I M, *Gl6 o.{dr.taon attsiJllG tri, rd !oli, runtd e:
<br />?t9?6<<
<br />W RNIT(;: Fntlft ro <m sdt6 odrFNa!. 6869. is unL*tul .fll shdl $hirl u ctpbF, ro oimin l pqulb rn
<br />.fril nft! up b oM hudrd rtbuq,i dolh^ (tlm.m), in .ddnbn to rlE or of @rqEnqrioi. dln t i s lrDvilcd fo, rlt
<br />sdlrn10?6orY-r,I
<br />-"' : t/ ttl
<br />cdL. idcd llt.rbfty'. ,6
<br />Xt
<br />DECIIXAIIO!
<br />I lErby rlIEm un&r Fnd'y ol Firy rh! I e lirnd un&r Fovisi,tr ol Clul,l6 9 (@n1Jreinl ,iri sdio. ,clD) or Dilarm l
<br />ot rlE Bori6r .!d PDr.!.bnr Cod., r,n fty Iin€ ir in tuI ror !i .fl6t
<br />/oL q(41
<br />f,,.t.-
<br />CI,IISIBI]SIIONIENDAIiJ(iEdCI
<br />I lEEby allmr !rL, Fol'y or Frury rhar lhd. is r onrMnr Ldin3 r8lEy for llE rEn()lrm or rlt M tu shrh ftn Frnt ir
<br />kun (S.< 1097, Civ C )
<br />IUI.ITANI.DECIdBAIION
<br />I tdrty dIm u.'d.r Fnlhyolpcuuryorc ol UE follo*ing.k Lribns:
<br />D.mlirion Pomirr-Asb.jos Norfk.rion tu r.l R.Bohrio.i (TilL,O. P.n6)
<br />'iLqquir.n L.n.' o, r,Jdirrzrhtr
<br />J 9! t ca,rv\o r* rc,rtrat nohrsn3 rlldre.\
<br />-.) Oaid!lr rhrr lhrvc rc!l rh''rlnli.r'i,)nJnl nric rh. 'hrv. inrorM i.n i\ comt I !8N lo mmdy wnh rll Cny.ml A'unty
<br />oniMtr..\ rnJ Srrrr lrw\ rL i'r! b hu'Lli',9 ad hfict y,urrb.iz rclmenrotivcs ollhn Cilyand
<br />ubvc mnri(nEdF,pcny tu hsFcr
<br />ADDIi(xnl.rAgrtrl Sigulor
<br />ltrrb 7;L{7t
<br />Site-Work
<br />Underoround
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Sions (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Buildinq
<br />Under Slab / Floor rl
<br />Bondino / Groundinq / UFER (xA D+kq-</
<br />Transformers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment 0 41 2l b**k v
<br />Factory Wired Unit I
<br />Walls (Conduit)
<br />Walls (Rouoh)
<br />Ceilinqs (Hard & Solf it Rouoh
<br />Ceilings (T-Bar Rough)tl
<br />Meter Release Dqu->.)
<br />Rouqh
<br />Service Meter -e 5L 7L DW E7
<br />FINAL t bn-*1 4
<br />Notes_, Remarks, Etc ol n
<br />l, Itt
<br />-Qt>,. s ott)
<br />APPROVALS
<br />L &PC forihilaasn
<br />.*,'P^,r,rr+ [,".J
<br />_-l enrryttu intltpslmor E vori lq $hih lhit p.rnn n ir.Ed.I.hrll mr dpby ry !d$n in.n,llI,lm
<br />$ ! ro b.r]ft $bjd ro rlE br6 6rFr6{b. hB orcdilmir . t8r lhn il I nEuB tdd {bn(r ro lrr
<br />srt6 .ortENii,n Fbviri,6 or sda'n lTmotrtE ht r Cod..l ilrll fonnwnh onply *nh lLE Fsvirir6..
<br />Communications Cable
<br />o ,0t4
<br />-?
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