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MECHANICAL-INSPECTOR RECORD <br />APPROVALS DATE <br />Appliances <br />Ivletal Fire Place <br />Evaporalive 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 Range <br />Other <br />Hood <br />Type I Hood <br />Type ll Hood <br />Grease Duct <br />Fire Damper <br />penings <br />lnstallation <br />F.D. Drop Test <br />Above Hard Lid <br />Above T-Bar <br />// <br />Rough Mech./o/////+lm/ru ,/ <br />Final Test <br />Meter Release ,r{tiltr')fl+twt4/ <br />OWNER BUILDER DELCART{TION <br />I hmby !fim udq podty olpqjury Ull I m dofl 8om fi. Co ncro6 Li.a* Lrs for rh. follosing ra$n (sd.7011.5 <br />BBin$ lnd hoadion Cod.): An, Cily or Coudy whi.h r.quiB a p6ni to onsrucr. aho. imprcvc. dmlilh or Ep.n 6L <br />slruclu., Fior to n! brw.. rl5o r.qui.6 inc lppli.el tor !!.h pa6ii to fik . rigo.d srdodi thd lE or shc b ltosal p!&&I <br />b thc Fovi3ioB of$. Coiracroa! LiccN.d Llw (CheflB 9. CoEn.n€ins wirh Sdion 70@ of Divirion I ofrh. Bulhd &d <br />Prot*ion! CodG) or lhll hc or rh. i! .xmpl lhd6.m ud th. b.!i! aor Ih. rll.g.d .rmFion. An, violdion ofs.dion 7011.5 by ay <br />lppli.al lo. r p6mii rubjdls rh. appli.ur ro acivilp.olryolnol doE th& Iivc hundnd doll&3{1500). <br />L a otrnd ofrh. propdty, or ny @! orc wirh w.sd & $.n !.k onpdld ion. ll & th. wml &d lh.3rr'd@ n nor <br />i,nad.d .r ofi6.d for 6L (S6.7044, 86iid ud PDftrsioE Cod.: Th. Codr..roa! Lk.M lls do6 nor @dy ro .n omE ot <br />th. F!pa, wh bikl or i6Fo6 th6@tr ed *,ho 66 tuh w* hielf or h6!lf or fiDush hi! o. h6 oqn dplo)6. <br />pro vid.d lh.l 3u.h inpovdMa e ml itrdxt ddoraldf.rrt.l[ hor'da, t btrJdiqs or trrporsEil i! $ldsithinom]r <br />ofotrpkiotr dE O\r@ tuiltq wiu h^r rlE hrda ofprovilB ti lE tr !h. d'd @l hlld or impE!. $. FDFry for fi. psrpor of <br />_1, a owtr6 of rh. Fopdy. m .rclBiv.ly conrrlciing silh li.6!.n coitr*bE ro .otr(rucr rh. rj..r I Sd ?044. RBinB <br />ad Fr!ftair Co&: Th. Co.krcroa3 Lic.nlc Llw do6 rcr dpplyro eosn6.fpror.ny*ho buil& or imrrove rhdFn. <br />!.d Nho onlE 13 for such Fljalr w taCo Eclorl3) li..E dpuRuml tolh.('.tudors Licd. Lnw) <br />.-l m.x.mpl onds Sdion .8 & P( lor rhi. r.Mn <br />l}48f,&Bll:AUtDNSAI0! <br />DECIJAAIIOX <br />I hs.by rrtrn udd6 p@.llyofFjurt on oalh. following &.le.rio6: <br />I h!v. ad will ruinuin r Cqlilrlt. of Co@r ro Sclf-la@ for wo.kd oE!dB.rio., a Fovir!.d for by S<1io! 1700 oflh. <br />L.tq Cod., for rhc pdfomuc. of rhc wt for r.ltth rlE FDn a is{cd. <br />_l havc and sill roinlain wort6 .omp.Bdion ins!ra.c.. B rcrtot.d b, Sel iof, I7L{ of th. Lrbor (od., ror thc pqfomuc. ol <br />lh. $o* lor which this pcrnil i! isucd. My sorkd cohFnuion iBUrM. c!ri6 dd policy numb6 d. <br />I c.nit thal i.lh. psfomu..oflhc worl for *hichlhi3 Fmit is isx€d,I shall nol otrpby in, pden in Bn! m n6s 6 lo b..oG 3ubj..l 1o rhc mrt6 .omF.srion low. of Cahlodir, and ,rG rhd if I 3holld Lr.oBc subj..r ro lh. <br />"orla' onpasiion pbvnioB of S.nion !r0o ofrh. tlbor ( od.. I dtrll, fonhwnh comrly wirh rh.s pF\ i.ioB <br />wARNINC Frilur. lo su. $ort6' comp.Niion .ore,gc is u.lasaul, .nd sh,ll sobj(t an dnployd to oinriral Frhi! ed <br />civil finc! up lo orc hudr.d lhoNnd dollm (1100.@0). in rddnion ro rn. cosr oa.onrpcmotion, d,n.!d rs oro\ni.d for th. <br />S-rion 1076 of lh. l.bor Codc ints6r ed .llo.rE! t?€",, -(7" <br />LIqENTO-COXISAqQE <br />DESAEAITON <br />I hcby dIIm undd pc.alr, of !frjury rhd I m li.6a.d und( Forision ofchipr< 9 (.omomcing \ ilh S<r i,ro 70i$) ol Dn bion I <br />of rh. aurine &d Poleiod Codc. Md dy lrcG is i. lull forcc sd.a[d. <br />..*-'.* 1u,,1 '?- <br />caxirxlJclloxJ,rotlc_acE!(t <br />IhE.by lmrm und6 F.dhyofFjurythll lhft i! 6 coNhdion kidin! rg.nc, for rh. Ffonnon.. ofrh. NorI [n \ ich lhi! FDir b <br />issu.d {Sd 11097. cir C) <br />ATTIICAIiTIJICIABAUA! <br />lhodD dlnr undd l]6.hy ol Fjury onc oarh.lollo*in! ddlad'trft: <br />Donolirn'n P6mns'Asb.slc Norifi c.tion r-cdsal Rcrul,tioN ( I i1.,10. P.n6) <br />R.quir.d lr(d olNorin.dion <br />I cdtily thd llE f.dcral rcguLlioE ESddin! lttstG rmul e. not r9,lk.bl. lo rht t"ol..l <br />I cadry rhn I h&. r..d fiis.pplic.rion !d$.r.rhar rh! !bov. infomrion is cor.(.I.srdro emply $ irh ellCirya.d Cou y <br />ordi,&6 &d Sr.l. L.* Eliins lo buiking conrNdbtr dd h6.t, rurh.riz EF6atlIn6 of rhis Cny ed Coumy lo mt6 l4o. rh. <br />abov. Mrioncd popdry lor iaDdrion oorlDs. <br />Applic&t or Arcnt Si8mtur.t lau ' t -v. <br />Farrir.. nJtrr rFrr) <br />rrD/stG.COMMENTS <br />FINAL <br />Noles, Remarks, Etc. <br />I