Laserfiche WebLink
MECHANICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUII,DER DELCARAIION <br />I hd€by arm undcr p.nrlty olp6ju.y lhdl I u denpt ftorn rt Coihc1ors Li..n.. Llw for th. following r.sn (Sa.?oll.J <br />BEi.$ {nd Prol6ion Codc): A.y City or cool, vhich r.qun6 a poail ro @n$tucr. dt6, inprolq d.solili o. ,.oot dy <br />,ruc1uc Firr lo ilr i&ru@, al$ ilqun6 lt applic&t fo. 3u.h Fmir lo filc 6 3ign d {alqMl lhrl h. or si. ie liccns.d pulsMl <br />to rh. FnvisioN of Ih. Corlr&r( r licnsd Llw (Chatr6 9. Comddtrg wnt Scrior 7000 of Divi3ior 3 of lt!. Bciils dd <br />Pofdio.i Cod.) or ft hc or sh. is .xop tlE flom ed rh. hci! lor lhc allecd qmFioo. Aly lioldio! ofsaion 701 Lt by e, <br />applicml for . p@il subjalx rn! applicel ro a civil pc.aly olnor noc rne ,jvc hnndrcd dou6 ($500). <br />_I, a ownd ofth. FDpsry, or ny ddorB vitt was6 a rh.n $k @dp.tudion. viu & th. worl ed th. 3rDd@ ii .o! <br />inrad.d orofqd for eL(Se.7044. Buine Md ProfeioB Code TtcConrEcidt Li.ae t w &,6 nol rpply ro e osE of <br />U. FoFly who hil& q i$FD6 dEon &ld f,lD dG *h w* hitu.lf or hdltor fteusb hi! or h6 om .n loyd. <br />povid.d lt.l such inpovqol3 @Dol into:d.d orolIs.d aor $lo l[ holrcE.tn. huilli.B or irllroml told wnhin on. ]@ <br />ofcotrpldiorl $. O*{d Buil&r win law t[. bud.r ofproeiie dar hc o. sh. did mr hrld or ioFDrc O. FlFry tu UE purFE of <br />_1. d osrs oarhc rroFty. m *.laiv.ly co .acliu wnh lic6.d conrictoE ro conirucl th. Fojcd (S*. 7044. B6io6 <br />od iilfBin Codc: Th. Conrrldols Licc6. Law do6 nor 6pply ro an ovnn olprordry trto blild. or iop.ov.! rta@i. <br />md who contEcls lor su.h pmj..ts wirh a Co,tEcto(9 licft.d pNunl tothc Conrrocloi3 Lictr. t w). <br />_I e .xcmfl md6 Ser B. & P.C. for lht rcen. <br />Tq85E8E:COM[E!!AIIA! <br />DECI.AEAIIA! <br />I h6.by ar@ ud6 F@lty olFjory o@ oftt folloeiE d..ldatioB: <br />...-lb\. ad * ill @i.rd. a cdiEclr. of coaor lo sclf'lNoE tor e{qa coopcMriotr, a plolid.d hr Ly s..rio. 1700 of ttE <br />trdrtcodc. for rh. p6rcm ccotrh€wo tor which rh. Fnn b Bu.d. <br />lfl* oa . r ."im"i, *-l.E mmpa!.rion irowc, s r.quncd by sdtior l70o orth. kbor code ror rh. pdfom&a or <br />1116 @( for u lnch tha pdh B isEd M, wrl6' onFMiotr iNulm. Miq .!d polty mbce.t7v/Z //4 f,alzu,') <br />4 ), <br />-l <br />c6liilhal i. lh. Ffomec. oaln wort aor whi.h ihis p.mn is isu.d,I shallnot mploy a.y peo. in anymend <br />e a ro beon. sobjd lo !h. {ort6 @bFEsrioo L{. of Cllifonu. ed ,sc rhlr if I ihould b(oEc .lbjcr ro lh. <br />wortm o'npaetion pBvisioN of S..lion 3700 oaln. hbor Codc, I 3hnll. lonhwilh cohply wiln thos p@virio6.. <br />WARNTNG: F.il@ lo 6@ @ri6' ooFsdion covGagc ir u&wtuI. dd rhaU eubjd u @plog ro cioinal p<ulra aU <br />civil 6nd up lo oa. hmd.cd rho@d &116 ($ 100.000). i. 6dditio. lo rh. .Gl of .o6poa.rio!. dan g6 a prcqd.d lor rh. <br />inr66r dd,troNyt t6. <br />4 /z ZDTO / tt{fuDz<tt,tu <br />II(IIIIDIANIAACII}B <br />lltioraa:IloN <br />I hc6b'.fl]!n undcr pcnaltyolrrjurylhat I d licd*d utrd.. provistun olcnaplg s (.om'ndcinr siih S.trb! 7000) ofDi!i.io.3 <br />of the Rusin€ssand hoftssions Code. dd nryliccGc is in tull lorcc.ndett(r <br />/0 4{ z6z- <br />Z 't D coo,."",o.L /L<t/o,cr4 t t-14 <br />qONIIBUqIXINIEIPIBCJCENO <br />I h@by affim @dd pdalry of p6jury rhd thft i! 5 oBrruclio, kndirS .86.y ft'r rh. Ffolrl4c of lhc srh for *hich thi p6r!t i <br />islu.d {sd. 309?. civ. c.). <br />ArIUCAILDISAAAIIO! <br />I hdrly !fts undd parly oapcjury oo. oftlt. followilg ddbrllioBl <br />D@lhion Pmn$tutcto! Norifidion F.dal RcsllarioE (Tirlc 40. Pan6) <br />-Rcqun.d <br />L.tr6 ol Notifr.dion <br />os Gno\ .l d€ not opplicabl. ro this prcj€cl <br />infonnarion is coE€d. I agr6 to comdy *nh r[ Ciy and Co!flly <br />6d h6cby alrho,ia i.FBarariv6 of rhj. Ciy od Coury lo 6tE ug)n rh. <br />8bov. mmlion.d popaly aor i6p..tioi <br />Pmi6 le. (!.i ):_ <br />0(6 <br />Appliances <br />Metal Fire Place <br />Evaporative Cooler <br />Furnace <br />Compressor <br />Mlsc. Equipment <br />Duct Work <br />Pre-lnsulation <br />lnsulation <br />Smoke Detectors Installed <br />Rough Ductwork <br />Vents <br />Toilel Room / Clothes Dryer <br />Re sidential Range <br />Other <br />Hood <br />Type I Hood <br />Iype ll Hood <br />Grease Duct <br />Fire Damper <br />Openings <br />lnstallation <br />F.D. Drop Test <br />Above Hard Lid <br />Rough Mech. <br />Final Test <br />Meter Release /._--\ <br />FINAL 3/r/% ,/Ma4/ ) <br />Notes, Remarks, dt6. ' <br />Above T-Bar <br />Applicdr or Alst Sisnarur. <br />I <br />=