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MECHANICAL.INSPECTOR RECOBD
<br />APPROVALS DATE ID/SIG.
<br />Appliances
<br />Evaporative Cooler
<br />Furnace
<br />Compressor
<br />Misc. Equipment
<br />Duct Work
<br />Pre-lnsulation
<br />lnsulation
<br />Smoke Detectors lnstalled
<br />Rough Ductwork
<br />Vents
<br />Toilet Room / Clothes Dryer
<br />Residential Ranoe
<br />Other
<br />Hood
<br />Type I Hood
<br />Type ll Hood
<br />Grease Duct
<br />Fire Damper
<br />Openinqs
<br />lnstallation
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Rouqh Mech.
<br />Final Test
<br />irl*rrle.l.l /FINAL 4 q>
<br />Notes, Remarks, Etc.[ 'l r I U
<br />t t
<br />owNFiR Dtrlt,ltDR Dllt'can 'r()N
<br />I hcr.by rmrm und.r p..Jlry (n ltrjry rr'd I un cxcn|n rhn rhc (intr(rors Li.ensc ljq lor lhc li,lk,si.r rcrv,n (scc703l5
<br />Bu\nr\s x l'iolt$i.n Codc): Any Clty or Counr! shich rcquircs r I.rntir t, co.{fl.r, rlrcr. i'nlrn,vc. t.trknish or Eriii any
<br />{fl.Nc,lnn kr ir\ nsunncc. lho rcqlncsrhc applicur f{, such pcrniir!,lilt! {i8ncd {lrcdtrnr rhrr hcor slt is li.cn\cd pu(urrr
<br />t, rhc ptuvi\tun\ or rhc ci,nrn.rors Li(ctrscd taw (Cllaprcr 9. CoNncmin8 wirh sd.ri(,. 7un ol Diuhi.n I ollhc Bd\inc{ rnd
<br />PdtssioN Corlc) or rhrllE or shc i\ crcnrfl rhcrcturmlnn lh. hris rar rh. allcgcd crcDf ion An! violllioooiSccrioi 7i).r 1.5 hyrny
<br />0pnli.nn brr psnnir \!hjccr\rhr otrli.dr t, r.ivitp.nnlryol nor nnrrcrh$ rivc hundrcd n.lhr\ {S5(x)
<br />l, * ovmr of ln. lmDcny. or my .q)loles wiln eagcs as lh€t $lc @nFdqlion. *iI do llE *ort 3.d tlrc slrtt@ n ml
<br />intcndcd or o6.rcd for sh (56.7(114. Brsirc* od Profcssi6$ Cod.: Th. Co.trlcrols Lian* L3o do6 nol opply lo !n owr of
<br />!h. tm!.ny tho t{akr\ or inprovcs ttE6( rnd who {kB sh w* hinscll or h.Mlf o. rlttuen hh o. h* oM cnplortci
<br />pnvidcd tnd srch impmwnls @ ml i cnd.n $ ofcrcd for slc. l( tD*w, ilf, lirilding nr inprMEnl is sld *nhin o* )ts
<br />of conplcriotr. rtF Owmr Buildr eill tEw tlE lrrdcn oatrcvinS fid lE or srE dA d hlild or in{,or dE tfttEry f.r llr Fapos ol
<br />I. asowmrolrhc pmp.ny. omcrclusivelyconlocrin8 wirh liccn$d conr.&ro6 ro.onslfl.l lhc pmisl lse ?044. BuliR$
<br />and Eolix\ion Codc: Thc Conr(rols Lic.n.c Ldw d6e. .or aFtly ro M owncr oi pmp.rt, who btilds or inpiov.s rhcrcon.
<br />and who onrEcls for such F,ixrs wirh! ConrractodO liansd DuFoanl iurrE Contra.roas Lk.n3 kw)
<br />_lrnlcxcn,pr und.rS..ridr .A &PC hrrhi!r.u\rn
<br />l)'Ir thr .r
<br />Io8f,E8s:llllltElsAlraN
<br />DECIdf,ATON
<br />I h.rcby alrrn und6 lco,xy ol Frury om of lh. nnbwire dc.hBtions
<br />-l
<br />nrve ! sillnflinr(itrrC.niltrrco,Cir*nrt,Sutfltr\urcf(,qorkc^.onrlcr\rrioo-!\ poridcJ fttr brS..rio.lTmollhc
<br />ljbor (-oJc. lorthc F-rlbirrBn.colrhcsork turehi.h rlt prnnir i\ i\suc
<br />_! hdr ad will minrai. worl.6 .omF6olion insur6nc., as rcquircd by SNlion 1700 of fie Labor Codc. for lnc Frfotmna of
<br />the *o for which rhh pcmjt is iinxd. My sortcB onll.Nlion ins!@c trbt lrld Flby ,umbcr m:
<br />Policy Nlnrbcr:Jiptcr
<br />-I
<br />enify thd in thc p.rformmc oflnc wori for *hich lhh pcnnn is isrucn.l lhau oor cnploy my p.Fon in ony nEntur
<br />$ !s h bEom sutjEt ro rhe woildl onFnrdior Lwi of Califohia .rd alr rhll if I snould &.oft subirr ro ihc
<br />*o*s con{Ensrionlmviiions olSerioo lT0O orrh. Lih.rCod..l sh,ll. fonh*ithq,mfly Bilh rhoc povka.B..
<br />wARNINC: Filurc b surc sorkcr'conpcnslltnr covcruec is sh0ll subiEl e cdrploy.r lo dini.al p.Mlri.\ and
<br />ciyil 6ncs up t. onc hundrcd tthu{nd douus ($l(D,000}. in addir mFnsarion. damscs as providcd lor
<br />'heSccrion 10?6 of lhc tjtnr Codc, inrocsr and anomy r Lcs
<br />UC}:IIEJLCANIBAC:IIJB
<br />IT:ELAf,AII9X
<br />IhcrchyliirmundcrpcoJry.rntrjxryrhdrI n lien*l u.dn ttulniotr olCh0pt.r 9 (cnmnttun,s wirh sccri.n 7ur) ofDivnion l
<br />ol ric au\i,rcs md Prensio's Codc. r t nry liccn* is in tull6trcc md cllltl
<br />?/d?a
<br />C0NlilBIlC[D[fU)lN(:rrc[Nl]
<br />i\{'cd rsrc .1097, ( i! C I
<br />I ..rrify thal rlrc tdcrl rcBlldions rgrdins aslx(os rcmval @ nor ap,li.ablc lo lhn prot{t.
<br />lhc !h.vc inromlion is coBl. I aec ro.onq,ly wirh lll Cirylnd Colnry
<br />fth Ciry lnd Counly ro .olcr upon llEauiterizc nJrcsntalivcs o
<br />Pcmi'eu\ii'*r>z-
<br />6
<br />tatlar,l
<br />COMMENTS
<br />Metal Fire Place
<br />Above T-Bar
<br />Meter Release
<br />Csicr-
<br />landcir AdJrcs
<br />,rrpr rciriliEiJiiiiF
<br />I lmty Jnim undcr r.nulry ol lcrjury Dnc orrnc hlkr*ins dcchrsii,rns:
<br />t)trnnin,n Pc.dls Asbc{.s N.rin.rk Fcd.BlRcgulrrions(Tirlc l0, P!n6)
<br />R.quncd kiicr of Norifrrrion
<br />-I 'crdrh\ r,rtlifrri0r { c
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