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OF CITY SEMMES ELECT L LA B/C ONDUCT (City of Semmes)

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ELECT
R
ICAL
INSPECTION
R
ECOR
D D
ATE:
CITY
OF
SEMMES
REC.
N
O
.:
VICINITY
A
DDRESS
B O H
:
RES. COM.
O
WN
ER-
APPL
I
CANT
ELEC.
CONTRACTOR
G
EN.
CONTRACTOR
TEMP. SERVICE INSP. D
ATE:
S
LA
B/C
ONDUCT
INSP. D
ATE:
ROU
GH-
IN
INSP. D
ATE:
SERVICE RELEASE INSP. D
ATE:
F
I
NAL
INSP. D
ATE:
MOBI
L
E HOME INSP. D
ATE:
I
N
VES
T
IG
AT
I
ON
INSP. DATE:
OT
HER I
N
S
P.
D
ATE:
I
N
S
P.
I
N
S
P.
I
N
S
P.
I
N
S
P.
I
N
S
P.
I
N
S
P.
I
N
S
P.
I
N
S
P.
DIS
P.
DIS
P.
DIS
P.
DIS
P.
DIS
P.
DIS
P.
DIS
P.
DIS
P.
CAUTION: READ
CAREFULLY
I, the undersigned, attest that I/the company I represent will be performing the work necessary to complete
the electrical installation herein permitted. Said work will comply with the National Electrical Code and all
other applicable provisions.
SIG
NATURE:
_
PHON
E
:
QTY FEE
SERVICE
DRAW DIRECTIONAL MAP
LIGHT FIXTURE(S)
LIGHT OUTLET(S)
SWITCH OUTLET(S)
RECEPTACLE OUTLET(S)
AIR. COND.
BATH FANS
CEILING FANS
DRYER(S)
RANGE(S)
MOTOR(S)
POOL BONDING
SPCL. SYS.
H W HTR
HEAT – KW
TEMP. POLE
OTHER
SUBPANEL
SERVICE RELEASE
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OF CITY SEMMES ELECT L LA BC ONDUCT (City of Semmes)

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Completed 18 January 2021

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