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MECHANICAL-I1{SPECTOR RECORD
<br />DATE ID/SIG.COMMENTS OI!NER DT]ILDER DTLCARA1]ON
<br />I lrrchy dfinn u cr t^-rurry ()f FrJUry rhrr I rr cr.mni rmn rhc conlra.ron l,i.ctr{ ltrw tu rhc nrlL,winS rclqrn (sc.7o:1r 5
<br />tlu\irc\\ rn(l l,.oltr\i(nr C(il.) A , Ciry or C(rnry wh(_h [quirc\ r frrBir k) roNrucr. rlr.r, imln,r.. dcnx,lish .r rl,Jn In!
<br />{rx.rurr, tri.r r, ir\ tstrancc. rl\o rcqun s rh! r|]Ilicrnr itr \u.h pcnnir r') ilcr sgtcd {d.tEnr rhnr}Eor shc s lic.n{d rrsu$r
<br />n, rhc pmlnn)ns oi rlr Cotrlrrcrolr Liccn\cd Lrq (ChrDIcr 9, Cu nnci.irA sfh Sc.riotr 7Ux) of Dlrni,,n 1 oI rhc BrnNs r t]
<br />Pn,rc\\i(nn codr) or rhrr hc.r\hc i\.r.mpr rhcrclio r rhc h$i\ turrhc r lcs.d ccnDrio. AnyviolalionoiSccri,nrT0.ll5byufy
<br />aDplrdtrrlnr rlxanirnrhjc.rsrhc dfflirrfr b r.ivill.nrlryofnornxm rhln llvr hrndrcd dollars l!5m)
<br />-1,
<br />N own.r otrhc poF.ry, o, my cnphjci wirh w6gcs &s lh.ir sL otr'pcnsdio.. will do tl* wt !d tlE $tulr is mr
<br />i,tcfldcd or ofrircd for eh (Se.70:14. Busircsi and PmLssioB Coder Thc Codncror's Lie.€ lrw &,cs nd apply .o an owr, 6f
<br />lhe ,bpcny wtnt ilds or itr',hB lhctun. Md who dB uhm* hins.lao, t.Nlforrhmllh hir o her ow. cEphycci
<br />F ovidcd rh& su.h inpmsmnlc @ nor i cn&d or ofisld for uh. tf. howrcr th hidin8 or impshm n soh wi6in orc )Mr
<br />ofcomptlim,lhc OsEr Blilds eill luw th. htdcn of pmvin€ $!r lEorshcdid mr huild or inpmr the popqry for r pqbsof
<br />-1.
<br />soqncroflhe !mI.ny. !mcx.hsivclyco rac'in8 wilh liftnscd .on'mdor lo of,ndd rtE pmjd (Sft 7014, Bu$ms
<br />.nd Plol*siJn Codcr Thc C..t.rctdr's Li.cfie Lap des not attly lo !n owncr of prol'cny who 6uilds or impotcs lhcrcon.
<br />0nd who onurcrs for such p6iFk qiln d Co dr6tl9 ltco*d tusoa ro r Conn&rdJ Liccnse Lsw).
<br />-l
<br />am.rcmrr undd Scclio
<br />OsE r__ __
<br />{OAtrESLSOMIENSAIIAN
<br />DICIAaAUON
<br />I hcr.hy rltutr,rnd.r p.nrlryofp.rjrry onc oflhc &l!rsirg dcchnri,in\:
<br />-lhrvcundrillmoinrrioaCcnifi(rlcofCnnstrrroSclrltrsurcrorworkcrJcon:r(.sarion.!spmvidcnforbysccrion3?uJolrhclihor Codc.ld lhc pc ornMccolltu qolt lor which rh. r.rdi n nsncd.
<br />-l hdre lnd will 6aint,in wo*cis co'npcnslli.n inslrancc. &s rcalncd by S€crion l?m ofrhe til,or Gic. for rhc rsao.mancc ol
<br />lhc work aor which rhis pemn is hsucd. My *orkcs onrFnglion ior!6ne cdic, dd polic, nuobd ac:
<br />.*t1 lQt U4 /rY4 €.--
<br />./1./tt/.nT-7-
<br />-l
<br />c.dify lhar in ltc p.rforroncc ofthc work tor which lhh txrmil is isswn.l shlll mt cmploy lny pc6on in any manncr
<br />5 N lo hLcom sublri ro rhc workdc conqxnhiion l,s 6f Califomir, ud agm ih.i if I slhuld bi.otr rubixr ro rn
<br />wo es' mn{,.ns.lion pbvisions of Scclion l70O of rlr Libo. Cndc. I ihlll. to.lh*irh omtly snh ho$ ,,Dvi.ions .
<br />WARNINC: F,ilurc ro surc rcrkcG compcnsorion covcmBc is u.and xtull subi{t an cft{,lotrr ro riminal lrmlli.s {"d
<br />.i!il fincs !! lo onc hlndrcd thou$nd dolhs (SlO0.iJtD)lhc cosl of corycnsalion. dlms.s !s provircn for lnc
<br />sfdbn 1076 of rh. Lihq cnda inrcEn snd anomy s
<br />y'p.n /- -2t, n or-",.-
<br />Lll[!$LcaNra^rto.f,
<br />IJf:Ctdttrrll.)dIh.rcbyritnu cr Nnrlrrolpcrj'try rlul I.m licctr*l und$ I,ft)vison olClrn'c.9 (corDcnci,r8 wnh sccrion 7(xx)) oll)ivisnrn l
<br />oi rhc lltrsi,rcss md PmfcsorNCodc, dnl nryli..n* i\ in lullf{tr{dlclra{r.
<br />(.^"
<br />\*
<br />Z'zr:
<br />l-|-b c""-,a*
<br />CAl AU.IQliLEIilDrcrrCllI
<br />I hdrby Llfinnoid.r t--n hroff,crjurr rhrr rhcc i\ a co.{rutlhtr lcndiDg ngcry tr ih. lcnnrmN. nlrhc {orl ln! which rhis trnrir i\
<br />isucdlscc llDT- Cn. C )
<br />\fl .cniry rhxr I hvc r.r rht, 'l
<br />q.lc rhar rlE alnvc infornDridn n comr. I dgcc ro .omply sirh rll Ciry .nd Counr,
<br />ordin!rc$ and Slltc liwsrcbrins rudbn- ond hcrchy !u I lsrizc ,cFc snt.r ivcs orrhis Cilyalrd Counly x, cnrcr uF,n rlt
<br />rh,v. nrf!i(nBl |n{]runy nr
<br />Al'Plicanl or A8cnt SiSmru o"rc, / - 3-22
<br />Appliances
<br />Ivletal Fire Place
<br />Evaporative Cooler
<br />Furnace
<br />Compressor
<br />l\4isc. Equipment
<br />Duct Work
<br />Pre-lnsulation
<br />lnsulation
<br />Smoke Detectors lnstalled
<br />Rouqh Ductwork
<br />Vents
<br />Toilet Room / Clothes D ryer
<br />Residential Ranoe
<br />Other
<br />Hood
<br />Type I Hood
<br />Type ll Hood
<br />Grease Duct
<br />Fire Damper
<br />Openings
<br />lnstallation
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Above T-Bar
<br />Rough Mech.
<br />Final Test
<br />Meter Release
<br />FINAL tlzrlto I>A^n-<8n
<br />Notes, RgmErks, Etc.I
<br />I).la- |tllzd - c lfL-D(trflt L#-51 z -IEUA\Frukp-t\[ ]--r-I
<br />^
<br />APPHOVALS
<br />*-"",, A/aza3+aa ,-,,.,
<br />J.IIu(AILIrIiCIAATIION
<br />Ih(rhtrflnf,utr{l.rI.ulryol!.rjur}.nc f rh.tulosinE(lrclrrrri,!n:
<br />o.Drlirir)n I,uini\ A\h({o\ NorifiQrnnr I;cdcrrlRc!|hrnnr\ ll irlr.1o. Prn6)
<br />R.!ltrncJ l.Ird nl Norili.rri,)n
<br />I.cniryrhrr rlr fcd.rnl rcgu trr io ns rcllrding r\hc{o\ runovll r. nor lpIlicrhlc ro Ihi\ In,rt{r.
<br />T-------r------
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