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ELECTRICAL.INSPECTOR RECORD
<br />APPHOVALS DATE ID/SIG.COMMENTS
<br />Site-Work
<br />Underground
<br />Liqht Standards
<br />Spas, Pool, Fountains
<br />Siqns (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER
<br />Translormers
<br />Torqueino
<br />Sub-Panels
<br />Air Conditioners
<br />Boof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilinqs (T-Bar Rouqh)
<br />Meter Release
<br />Rough
<br />Service Meter \
<br />FINAL 4 Jaa
<br />Notes, Remarks, Etc.
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<br />OWNER BUILDEN DELCAR TION
<br />I h.r.by aflirs und.r lEdlry of Frrury rhlr I m.r.nq,r fi$m rn ConrldB ti.e riv fo, rh. folbwirS Een (5.<.7011 5
<br />Buiinc$ n Profcsion C{dc): A.y Ciry or Cou y *hi.h r.tun.s a ,E mil to rotr(rcl. !hs, i.ilnrw, dcmlirh or qrir dy
<br />{MuE l,tu.o its nrw...l!o r.aurcs rlE.I'rltul for 3kh Fnni io nh. s(ftd nd.r lh.l lE or nE ir lirtrEn [l@8tn
<br />r. rhc pmviibnr ol dE Conrnctoas Li.nEd Llw lctral.r 9, Commirs *irh Sdrion 7000 ofDivhbn I ofltE Busim$ .nd
<br />PmL$ions Cod.) tr rhrr lE or \lE i\ cr.n$ rhcfttud.rd rli lbiil ror rtE .llc8.n cr.qri,n Ary vioblhn ol Sarion 70,! I 5 hy.n,
<br />rpplicrnr lb, a ll.rnir rubr.crx rhc .mli.,or b ! .ivil Fn!x, or .or mm lhan fir. hundFd dnllaB (55!O).
<br />_1, !s o*mr of rhc r.oFny, (y ny cn{,ld)er *irh sd8.s ur rh.n bh comr.nsdion, *ill &, tlE *ot std 0r ntEr@ k a
<br />id.dLd nofi.Ed ad {,. {Sa.}o14. BuriEss..d PrDf.r3iitr3c.dc TIE Cod ror'rLa.Mt *&.ir q't yrodo*Eo,
<br />rtEI,n Fn, wth hiltr or in{x)H lhcm[ bd *ho dftr *t sll himr.lf or hdElf M rhn,uSh hir m hr o*r cr9hrlts-
<br />rovi{t{i rhd st iml,.o!w s e nn inc,n d o, o,LEil rs q!. l( hoEE llE tuildiq or inrNEm ir $ld wlhin nt t r
<br />oronlokriu, rtr o!,rr Buillc win hlk d! hnLn or pmvnB lhd lE or CE dn rll tuiH m irlet 0r tsFry fd ilE t[qns of
<br />L ss owirr orlh. tn,Fny. umcrclusiwl, co.rrrlins silh lacn{d conrero^ t' d,n{tur rtE Ir.'Fl (S... 101,4. Au1irc*
<br />and EDfesmCdc Ih. Conrr*kr's Lir..{ tjw d.f,s mr ttply kr e o$mr ol ImJ( y $lb hoild\ or inpnrws fi.ron.
<br />a.d who conu!.ts li'r such prcFt\ wirh o A,nrBcro.ln li.ctrsd fl(unr k, rh.c.,nrmols Li.nE L!w).
<br />I mcx.mpl undc. Scclkn
<br />D.r.:
<br />-.
<br />OrE.-
<br />J{O85EXIIcIIMIESAIIA!
<br />DE(;IJAATO!
<br />I h.rcbt lllr.o o.d.r !.ori, ot Frr!ry 6E of rtE iolh*in8 &.Ldbns:
<br />-l
<br />hlvc od u ill minrui. ! C.nilf,{rd of Con*nr r. sclr- In\urc n vo .r'srlFnsrion. o{ FoeiLd lbr bys6rion l7mol!h.
<br />bh, cdic. lor
<br />'h. FformNc of ilE trort lor *hich tlE pcmn n t{cd
<br />_l h{r rnd silloi.rn. *ort.R omr.nr.ri,n iBurs..i EquiEn b, Serbn 17(tr dI rrE lilor Crrl, for llE Frfllmre of
<br />th. qd* lorwhrchrh! pcmt s sqd I'la, *orlcF comp(nqlEn rnruBrc.mkr.rn pol.ynumbcre:
<br />S *"'teil,^ .
<br />! curlyrhlr ir rh. rtforromc of lh. work lor whthlnislcrmil tr tso.d.l \hrllB cnlFby .ny pcr$n in lny numr
<br />q' r\x' tEror subFr ro rhc *irlc c,orctul'i.n b*s or Clrirohir. I rgEc lhil i(l rlnuld txcoft $bFr ro rlE
<br />*orksl mnlFn$rhn rmvsb.\ ol SdrFn l7(l) or !h. kh, C.d., I shlll, lonh* h coqrly *nh lbe fmvirio.r
<br />WARNINC Failorc k, r.uft w(,k.N (unpcns&on .ovcnlc rs unhstul. lml !h!ll slhJc.r ,n [lortr k, ciminrllEmllls ond
<br />.ivil nn.l up kr om hu rEd rhoNarn dnlls (5100.fl1o). in lddiri{,n ro .or or.omFBrkr. dlEscr ! l,DviLd for llr
<br />Sdrh,n 1070 ol rh. Lltn Co.lc- i crc( md iuortv s lBs
<br />^,,.:&2- L--l *r,**14
<br />DECIJAAIIOB
<br />I hcrhy affrn urdc. p.dly of lEriury rh, I m Uc..$n urd.r Fovbion or Chrpcr 9 (otmrinS with sdb. ?000) of Divisbn l
<br />of rl.. 96iEr.id Pnfcrrio6 Cod.. rn n, lic.n- i! in tull foN.rd.lfel.
<br />f4
<br />w
<br />loG|3tLf32-zt "-,.".- X
<br />cllls[ElJcllllN.LElra liS&r
<br />I h.Eby lrrn uftLr pcMnyof Frrory lhd dEr n ! onnMlirs lc.dins.8.Ey ror rlE Ff6.rm of rlr rUl lor whth lnh tEni b
<br />irsucd (56.- 1097, Civ. C,)
<br />ATE.ISAdTIECIABAIII'U
<br />I nqdry,,Im undcr p.nrlry ol Frjtrry or of rh. followin8 &rLEl k,ne:
<br />Dcn$lhir. P.rmils'ktlelc Norific.lion F.dcnl R.srhri,ni lTnk,l{), Pln6)
<br />RcquiEd t llcr of aiorifrrion
<br />-l
<br />.inify lhd rh. r.n d ESuLtbc ESornirg sh.slos EmvJ N 'El {tplirh,. to rhi. |,oirr.
<br />fll,.-,r,,a ,t* *,n! !nelt.r6..,n stll. rhd rlfth,E Dlotu.r s ffir. I .sr ro otrpry w n tlr('!r.d cdnry
<br />idi tu$ rtrd Srrrc L,s! Ebrin! ro buiuins con{dcrEtr nl hGby lulrFru EFtEntr,iws f,flhn Cny rnd Cnu.ryro cnrd utbn rr.ffi:HilI",X"* [r ^,. -r-z'zt
<br />Pm,Eom(pri r tt, * z:Z l-
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<br />I
<br />Pole Bases
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