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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNEN BUILDEII DET,CARATION
<br />I hcrc$y !rij. u.dcr Fnohy oi pcrjury lh,' I un cxcmrl fmn'hcAn nrnn l,i.c.{c liw tu lh( inll'witrB rcuvr lS..70llJ
<br />Burine$ !.n Profcssnnr Cfllc) Any City or Cou.ry whih ,rqut i d !.rnrir ro .o.\rdcr, dlrcr, inwovc. dcmlhh or rcI).t n.y
<br />\rruc1!r€. prhr ro il\ is\uamc- ilv, rcqlncsrhc q,plicanr fe \uchlrcnxr lo lllc s sistud dll.ns rhurtEo.rhc ir ltchcd tu.rlnr
<br />b rh. ImvfioN of 0r Con'n ttr \ Lntns.d ljp lchalt.r 9. Com,ncmins *iih S.(ri(,. ?(x)l) ol Divisi'n ,l .l lh. Butift* rn.l
<br />thfc$iotrs Codc) orthd rEorsh. t cxcq,r rhcrcrior a rtcb{\nforrhcollcrcdrrcmflir)n AtrtvidrrimorScdnn r0:ll 5hrry
<br />aapli.n r for a p€mn \uhJersrhr rmli.nni ro trcivilpcndlry.lnot mr.rhnn nvc hudr.dJollur (S5t)(ll
<br />l. !r o$nc! ol rhc pmFdy. or my cqrorlci ((h aa8cs !r rhcn {nc c nll].nu irr. q rll J
<br />'lE
<br />s,yl orl rlf, ndm n 'r{inrcnlsl or ofiircd for slc ( S€ 7(!,1- Eu\incs ud Profcsi{,tr\ CRl. Thc Coitrr$n \ Li.cn{ lj* &f,\ nor unllv n' $ olmr ol
<br />rhc toFny {ho horlds o, nq,tuvcs rtErsn. &ri sh. d,cs luh ** hN$lf .r hcr*lf nr r hr outh h^ or hcr owtr .qnnyc$.
<br />|iirvdcd rhrr (uch fllmrltnE rm kI i,rc .{ oronitn nn sb.ll hi*cw, rlE trilliq r intn,EnEnl is $\l s hin{rFr
<br />ol corylerion- rtEO*Nr Buils sill hr{ rh! todeootl,o ns lni hcor\h.did ml hdiki or i'r{,oE rhc !n)F1y r,n rtr purF c ot
<br />l. .s oprcr or rtE FoFn!. rD cklusiv.ly contrdrinS wilh liccnEd conlrrckrn k, drslEcl llE ,roF t (Se. ?Or4, au.ims
<br />!n Pl.&ssi Codc: Thc ConrEclofs Lian{ lj*du\ tur.pply r. uouncr of |rn,!cll y err, hoildior iol|( Er lh$on,
<br />ond *ho.o.rtuhrM.khFDjdswnh,co.rmro(tlitncdnuru b'h.('onrrod.lr l-tunc ljw)
<br />_l m .,.npr u*Lr S(Iion_. B & P C. t ths ,asn.
<br />D.|e_ O*n.r__wor(E-Rsafrmairld
<br />DECI.Af,ltrON
<br />I lErcbyamrmundd pcMxyof tciuryoEolrn folbvin8dccLnrklm
<br />_l hlvc a,n will mi .in r CdiaE.rc olcore b S.lf.lNE for wl(6 ompcnsrirn. !r FDvnrd for 6y Sdrion lr(I) of tlE
<br />titd Cod., ror dE Ffir|rrtd ol rlr qrt lm 9hth rlE tErd k ir$d.
<br />Ih.v.andsillmi.inM*cFcon{E6rrionin\uEE..dErrundhyS.rlirn:l?(DollhchhorC(t,titlh.F,forru$ol
<br />rllc mrr tu *htt rlic rErnil is ir{{ My w{trtcK mmFrdi'h iEuratuc catr !.d F)lq n!r{x, e:
<br />(rrir: - fu.^.++o-) V,ttd-0.rrxl{tt!3. a
<br />-2.,-r v.)€AA ?Y--I
<br />I cniry rhrr in rh. FtonEftc or $. *ork for rhich rhE |Ernn $ is$cn. I $.ll fl{ c.rpl,, !fl, F.$n nr nn, mnE,
<br />s a ro beE strbFr ro rh. wns 6np.Mio. hw! ol c.litomi,. rd oeN rhd if I inrb b.oft sbFr ni rlr
<br />vo 6.onqx.sionFovkbniorsdionlT0oorilElnborC.dc,l{Ell.fonh rh Lorpry *nh rb€ pnlirbn..
<br />WAiaNINc: Failm ro rcm *r*.u snFneron rurtuE. is unl,wtul. ,nd sh.ll strbitr a.'i!'bFr b $ininrr FEhi6.nd
<br />civil 6ms un ro om hundEd rhousrd dol!6 (S|G).0o0). in ! drlion h lnc .o( ol.orfrnsln,n. dm8.r at roviJ.n ror tlx
<br />Sslkn 10?6 of rh. Utor C.de. mr.Ej ard .nomy\
<br />'2,1 '2,\ a
<br />I hcEby alftrm !.d.. Fmxy of F.,ury (hd I m Le.{d undcr lmvnbn olCh.t rd 9lcomnEkins wnh Sdir 7fln) ofoivilion l
<br />.f rhc Bu\in.\\ rnn P(,lrnrn\A r. nl my l'..n.. s i', lull ntr.. :uxl cllc.r
<br /><'q@
<br />Li.c.\.cr.,\,: - ?6iq3 4 Li.ci,{.N n,,r,: o 11,,,, - tlztlzt .",,,rf\Gvi ft J
<br />IhcrbyllnrmuhdoFmlryurlrrruryrhdrhctuisdcun{ru.rionLnding!gc..ytlrrhctk,undcolrlr*or[tuwhdrhi\Frniis
<br />t\urd(SN 109?, Civ CI
<br />APPLICANT DECL RATITJN
<br />I hdEn, anim und.r renolty .f ncrjuly o& 6f rhc I'olhqin8 drhrErionsl
<br />D.rmlition Pc.nik.Asbcaros Norificrlion F.dcnl R.8!!0rions (Tiilc to. Pan6)
<br />-Rcq!tcd
<br />l,ncr ol Norifrotion
<br />-r ""n,y,r,, t*r"a","r ,"g,lrtionr egmling Nb.srocrumuvrl e mr llFli.dbk t' rhh tftrd
<br />-lccniryrhdIh3rcrcJdrh.\Jnrlf,dri.nJrlq!rrhdrrh.h,ecfirnrtui.'nnJnc.rlrF,Nr,ranflytrrhrll(.ry-Jnl(i'utrryn,Jm"Re\andsrrrclrtrsrU'ryr'l"{,ldrnr.^n{rucrL'n.onlhachyrr'hr'arrrrsnkntc.,'lIhnCiry!ftjC.urr)n,.n!6uF,,tr
<br />ltmrc .Enl,orcd polcn, Ior
<br />€\t b€.\+\ xq
<br />- ,,.," tl zllzl
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Life Safety /Low Voltaqe
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor I I
<br />Bonding i Grounding i UFER ,l q 7L
<br />Transformers
<br />Torqueinq
<br />Sub-Panels
<br />Air Conditioners
<br />Rool Top Equipment 2-l Nt5{/
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Solfit Rouqh
<br />Ceilinos (T-Bar Rouoh)lt
<br />Meter Release h \1,. \I
<br />Rouqh
<br />Service ltrleter
<br />FINAL 1 u,l 1,()wYb 7
<br />Notes, Remarks, Etc ,t I
<br />Flcv 08-07-2015
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