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MECHANICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Appliances
<br />Metal Fire Place
<br />Evaporative Cooler
<br />Furnace
<br />Compressor
<br />Misc. Equipment
<br />Duct Work
<br />Pre-lnsulation
<br />lnsulation
<br />Smoke Detectors lnstalled t
<br />Rough Ductwork 4 ,1 ,tl K lTttiartx ff),,
<br />I
<br />Vents
<br />Toilet Room / Clothes Dryer
<br />Residential Range
<br />Other
<br />Hood
<br />Type I Hood
<br />Type ll Hood
<br />Fire Damper
<br />Openings
<br />lnstallation
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Above T-Bar
<br />Rouqh Mech.q I C$ sth
<br />Final Test
<br />Meter Helease
<br />FINAL a
<br />I lt)/\T 6tw(,w tot/
<br />Notes, Remarks, Etc.
<br />\+
<br />OWNER BIJII-DER DEI-(:ANATnN
<br />I h€reby lmrm ud€r p€nalry of pcrr!ry rhar I m cxe!ryt fhnr rhe Conro.ro6 Lhcns Lrw tor tlE followirg Msfl (5(.?011.5
<br />Busincas dnd Profc$ion codc): A.y Cny or Counly which rcquiB ! |rmt ro m[nircl. !llc( improve. d.mlnh .r Eprn uy
<br />srrurua Fi.r !o il3 hsuncc. aho r.Auircs rh. 0pplianr for suh Froir ro lilc s siSr*d sral.tu th.r h or ehc ir lien*d puNut
<br />ro rhe rNlisions of rlt Conrradot Lkcn*d Lrw (Chrpro 9. Co.m6in8 with S.crion ?0o0 oa Divtion 3 of lhc Busin(s .nd
<br />Pmlcisions Codc) or thar lE or shc ii cxcq,t tt Earon .ri rlE bdsis fo, llE dbgcd crcmplhn. Any liolation of S*lh. 70l l .t h, tny
<br />apllicanl for ! permit rubiccls lhc lpplicant to a civil pcnally or ml mrc lh8n fivc tudE{ dollas (5500),
<br />_I. !r owncr of lh. pn,ncny. or my.mpLtccs wnh wags rs rheir sh elI,.nsrion, will do lhe wo* ad lt snrtim n mr
<br />inrcd.d or offcrcn for sL (5<.7044, Busircss ud Profssions Code: 'llrc Co.rEcrols Ltcn* Lis d.a m( rpply lo m own$ of
<br />rh.tmpcny wls hrikls or iiimB rt.6a ard wlb &Es Mh m* hilMlf .r hcrslf or lhmuBh his u hcr own cn9lor*r.
<br />rmridcd rhar ruci imrmwftnt! @ hr inr.d.d oroftu aor ek. lt,x(c6, rh. h{ildinS or inF(Nffil n $B *ittin om yw
<br />of coDphtion. rnc Owmr Build.r *ill h!rc rtr lDdcn of ImvinS lnlr tE or shc dn ml hild or inlew lhc tmtEiy lq tlE p{rpoE ol
<br />TOAf,ESS:TOMPIISAIIIIN
<br />DS:IAAAIIQN
<br />I hcEby !finm undcr pcnalty of pcrjury otu ofrhc follo*in8 delahrionr:
<br />-l
<br />tuvc !d will mimain r C.niaEslc of Consnt ro Sclf'lnrurc for wrlcs dhFnsarion. as pov'd.tl 16r by Sdlion l?m of lhc
<br />rlbor Codc. for rh. Fdo,rtEm of llE w* for whih dr. tEmil ic isucd.
<br />__:t have ud vill mirhin workcA conEnsll ion insumncc. ar rcquncd ty Se.r ion :17fi) ol rhe tjbor C.dc, ror rhc ,'crformrcc of
<br />My compcisation insurrn.c cxri.r d4.l fniry ounb.i ml
<br />.(-f]rU.(
<br />-lcrniryrh
<br />intt pcrfo.nurc€oflhc*o.krbrwhichlhispcrnrilishsucd,I\hallnorcopk,yanypctro.ina.ymonncr
<br />$ !{ro trcoft $birr x, rhc worr.^ om!.ns ion laws olcrli,brnia.,nd l8m lhd iil snouE tE om subrcl to rhc
<br />wolrca snl*.s.rn,n tmvisioN orsNrion l7(x)of
<br />'hc
<br />t t r clodc.I stull- lbnhwnn on{ y wilh lhos lmvhn,ns
<br />WARNING: Flilurc lo scurc workc* cbmpcn\arn,n covcrlsc i\ lnhsrul !trd sh.ll subi.r 0n cnploycr ro riminal l)cniltts and
<br />cieil ftN\ n|] n, oDc hondrc{l rhor$i (lnll[\ (!,1 rn. (rn or () trrrn\rr !trr, Ll] r]L.L x\ J,'.\ ,l.Ll ],tr rhc
<br />sccri{'. 1076 olrhc lrhn Gxlc. idcrcn trnd xnonrr's
<br />tlurlsturl)Nl&[ta.t
<br />Dl,lt^xllulrN
<br />I h.Eby .flirm undcr p. lry of Frjury lhal I !m lien*n und.r Folnion of Chatlcr 9 (ommftin! wilh Scdion 7@0) of Divhion l
<br />of ltE Busimn a&l PmL$ior. Cod.. qld ny lic.o€ is in tull fo@ .rd .flar.
<br />o"",'-.)-aS\
<br />tQNsrxlJcrloNL!:lDlNlitaliNll
<br />I h.L-hyrllt uods |ttralryofpcrjury rhrrrhcrc is x con{ru.ri,r Lndir! ngricy f(tr rh. Fnnnrhn.c ofrhc *ork lirr shi.h rhn Nnnir n
<br />n$cd{Scc l(r97.Civ ( )
<br />AITIIIANI.DECI,IAAU!]N
<br />I h.n:by mhn u ndf lfn,lry of Frjury orc of rhc following d..hr io.sl
<br />Drmolitiotr Pcrnib'Asb.ios Norificarion Fidcru, Re8ul0liotrs fhb 4U, P!n6)
<br />RcqutL{l.!crof M ifi.arhn
<br />ak'vc nEnrn,Ed pbpcdy f
<br />Arplicanl or ABent Sisnat!
<br />and Colnry ro enrcr upon rlE
<br />Grease Duct
<br />{t)l
<br />I. as opnq or rh. pnD.dr. 0m crclusivcl, conrding wirh liccn*d conracroN to consrtocr rhc roicr (Sa. 7II44, Burimss
<br />!d tlnri*sion Codc: 'fhc Conr,lcrois l,kcn\c liw des nor apply ro an owns 6t pron ny who builds or introlcs lhcrcon.
<br />a.d who.o a.h tur ruch FDjcdr wirh ! Conrido($) lic.nrd pursu ro thc Clnrrocrols Ltcns L3w)
<br />-l
<br />nflcxcnDt unds Scdion-. l, & PC. rbrlhh rcuv,i
<br />.1\-\
<br />o".S\A$\
<br />p*.ir""-'* rpl"lX-
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