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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNEi EUILDER DELCAIATION
<br />I h.r.by.firm u t r lEnnlry ol Fqtry rhi, mcrcmfl 6nm tlr Codr-lm L(tr t w for rh. fo&rwh8 r.!on (S(.70]l5
<br />Burirc$ llld Prcf.$ioo C.n ): Ao, Ciry or Cq , *hth Ealircr 3 rf,.dn ro @orrrucr. .xo, iqrcE. dmlnh oi qln lny
<br />{Mrm. Fi,!o,! i. rN.at$ Epms rlx.Iphd for.uh Fnir !u 6t r.i8En rdlm rhd lEo. dE is lk.nsd turld
<br />ro rh. FotnioN of tlE ContrErG ! Lt.nscd t * (Ch{'rd 9- Conmrinr wnh Serion 7Om o, Divti'n I ot rh. Brtircs ed
<br />PDfcr\ioni Codc) d thd tE o. dE G cbrltr thdctom rtd tlr b.sir t6 h. rlLecrl cx.mprbn Any v.htNn of S.diln ,Ol I 5 byr.y
<br />.0plired for r Fmi subi{ r
<br />'lE
<br />tpplic.nt ro ! civil p.mlty or tur nDE $.n fiv. hu,rdEd &,ll sltlx)).
<br />_1. rs orE. oarlE FrFny. o. nr.,{,lors! wnh *rs$ ai rlEt $!. on{rMhn, h[ d, ih. r-t i,rl iE !!Me it d{
<br />i .rn d nofr.Eil for rk (Sd.7o.14. BuriEs. l Pml6im C.d. TIE C-.rddt rj..M t v &.r rn .prlr lo r orEr or
<br />tlE rn,rdy rr$ hlirlr or iqn)B dsqr .,n wt. 116 sn uoit hinell or h.rlt or lhmusn hn - li. om.q,kryB!
<br />Dm &rl rhr .kh iqmEfirB E rcr tu rxLd or oftud fo. rlc. ll, lxrtE. llE hiiding or i,qmtr n eld i$n m ,r
<br />ofosTtxDr d. O*E Build., wil llE rli hnlcn ol Fovins $or h. or .lE dd er hlild {r intrcw dE FsFry ftr trE F,Fs or
<br />-1.
<br />as o*m of rlr F$Fny. !n c!.lusiwly conrB-rins wnh !.ctred dfu*rm ro o'tu1 rh. Fotd (Se. 7or4. BBES
<br />rd Fsbsi, Cotlc TlE Crdrabl! Lt.ns L!* dB m' .IPly ro rn ownd or l,rcpcrly *ho bsilde or inpretr rhcmn.
<br />md rlr, odrxrsfc rEh lrrF.rt *irt r Cotlndont lensd p!E&I ro rli Colii..r.r'1 Liac ljB)
<br />I ancrc rr udq SNri,n
<br />llrll OrE:
<br />w(rR(r'lr\;(irliPr\a^TiriN
<br />ITIIIAEAIIO!
<br />I h.rcby rfltm undd FMhyof Fjur, orc or'lr nnb*ir8 d.ctuali,n\
<br />-l
<br />haE {i qillflinr.i. r Cdifr.r. of Cons Io S.lf-lNuE fn worl6 oqEEr.rior B |'ovil.d for by Seri.n ]7m of 0r
<br />tihd Cdlc, ad tlx Frroljm. or rh. won (' lhkh ilE Fni i! bru.d
<br />_l h.r rrl *ill tuinluin uorleB .onrrMri.,n i^rEe.- s ratoitn b, Serion l7u) orrtu Irhor Cod.. for lll FllmB! ol
<br />rtE hrk lw ahj.h rhi! Fmnl n n$.d My *irl6 ooFn lion i6ul,N .utr !d l[lt, Nn*Er cl
<br />-l..nfy
<br />rnlt in tlE F.nxnEEc of rlE *ork nn whtn rtt Frnn n nnal I rh.ll mr.n$loyrny F$n in rny MEr
<br />s &! ro tuom .ut'j.ir ro rtE mrrm drp.nsdiod h*s or Cthroru. nrl .8N rhr 'f I rrrNld t aar $bF.l lo lLqnt6' snp.mlrrn tn,vilbn! or sdrion l7m or th. t h, Cui., I shrll fonhwnh conply wilh rlD: pmvitioB .
<br />WAnNlNc: FdluF b .ffi mrk 6 .imp.Mri'n swE8. t unlrwtuL rn rh.!l subF an cnlploFr lo aidrd Fdi. rn
<br />civil 6n.r up ro om hlndrcd rhousd dolLE (llt[.fitr). in .ddnion to rlE coe of .on+cMbtr .lul!.. r Flvn.d ror rlE
<br />Sdi,. 30?6 6f th. t4n Codc. inr.d and domy\ fdr
<br />D.t.: --_ -- .,.- - Appliol: -
<br />'
<br />rcF{s_rpiiiiTnr-a_nrR- - -IEIIJf,AIII]N
<br />I hs$yrilmu Lr FElty ot rqrrry rh.l I dr lcnr.d u!d.r Fovnirn of Ch.Fd 9 (oicming *irh SelDn ?dro) of Divkbn l
<br />ol lh Burircs .d Pmfdsioni Codc. a.d m, licM ir h tuU fod !n .fia1.
<br />gQM:IBUqUQItrEDISgLtiBta
<br />I lEGt y.rtrm unihr F,uxy orF+ry lhd tlE i!. odMitn bnint lgcrc, tor llt,Eforlla. of llt wt tor *tkh lhn F.nr n
<br />iskd (s€ l{I)r, civ. c.)
<br />dISLICANLIIECIdE4II',I!
<br />! hoi:t, !trm und.r Fexy olF jury or nfrrE rollowin8 rk l&lonr
<br />o.mlrio. Pcrmirr A$.rrm l{difr.rhn tu nlRcSulii,.s (Tirlc.lo. Pd6)
<br />Rcqumd t rr.rol N(r'ficJr.n
<br />-l
<br />d iry lh.r
<br />'hc
<br />lcncrd EBUId on E8ardinB sttslor Emr.l nrc ml lmliclhL lo rhn porcr
<br />I .sril, rhd I lEr E6d rhn .prrltd6n dd {4. rhd th. .lhE intomrbn is cold. I EgE to o'q'ly rnn rU Cn, .rd C@ir,
<br />ordiotu.s &ld sr.rc trw. ELrirB
<br />'o
<br />hrildinr mtrnrucrion. .,ld hd.by surhoi4 EFrr .ri6 of rhr Cn, rid C.unry ro cnro lFn 0r
<br />rhw ndbEd prFn, t6 ihtEdion purlbEi
<br />,\ppliu lor1,sntSi,lBlnn
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Sions (monument)
<br />Life Salety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Buildinq
<br />Under Slab / Floor
<br />Bonding / Groundinq / UFER 3-1- zt h,WA
<br />Translormers
<br />Torqueino A\
<br />Sub-Panels 3-1-2t *j+rd)
<br />Air Conditioners v
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilings (Hard & Solfit Rough
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />A
<br />Rough 3 -1* zl \Jttl\l)
<br />R,
<br />FINAL 3-tstll u.t{-rd
<br />Service Meter
<br />Notes, Remarks, Etc.
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