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MECHANICAL-INSPECTOR RECORD <br />OWNTJR BUILDER DELOIIATION <br />I h.Ehy .rrn undcr F.llly of Frjury th.l I m .x.d{ll fmm lh. Conrraclm Liens L.* for ltc folloei.g rca$n (S& m31.5 <br />Busiess ud Pmfcssion Codc): A.y Ciry or Cou y which rcquircs a leml lo 6ine[ alro, in'rrcw. d.mlhh.r Epat ry <br />slrocne, prior ro tu irsuae, aho EquiEr lhc arpltsr for sh Fmn ro ,ilc a sigmrl st.l tr.l lhal tr or 8hc i! lkcn*d pursel <br />ro thc pmvisions of rtF Cotrr.!.rols Lic.nsd tiw (CnlpE 9. Cnnwmin8 wnh Se.tio. 7000 6r Oivision I of thc Businc$ .nd <br />Pmfcssiotrs Co.lc) or rhsr h. or sh. h cr€opr rh€Efilm a.d lh. lbrh ro, rh. llh8cd cxcnlPlion. Any viobtion of Selion 7031.5 by mt <br />amlic!fl for a ,cmi subjccrs ihe atpliqnl ro 0 civil p.Dllt of nol mrc than fiv. hundrcn dollss {$500). <br />-1. <br />ar oqNr of lhs ptul.ny. or n,.fploles wirh e!8cs s rlEir $h ompcnsrion. *ill do rlr srt. ilE cEt@ is ml <br />imcirlctt or otr rcrl fo slc (S*.7Ol!. Busimss snd Profc$iotu tu : Th. Crnlmlols LiNrs Lsw &,.s ml arPly lo u oerc. ol <br />rh. nmr.ny qho boil& or iri{'oE llE6n sid who docs *n md( hin*lf or hc&llor lhmugh his o! trr ow. .mployes. <br />p.ovid.d rhrr such irymm' s @ mr inrctd.n oroficEd for sb. lf.lD*cs. tlr hildh8 d inv@m h$6wi6hom,Mr <br />of.oaDhrhn. dE OM6 Blillr wil hlr dE bordo otpetng tlur lr d !h. did mt budd or inplm th. pmFnt for tlt Pulos of <br />_t. ns oen$ of th. ,)mFyry. m crclusively.o.rractinS wilh liccn*d conrracloB lo onrlfu.t rhe l,nlrl (Ss, 7044. Bu\ir$ <br />! Prof$bn Codc Thc Conrrsctois Liccnrc Law does mr lpply ro !n os.cr ofprcpcaywh. buildi or imprcrcs thcr.on. <br />and who entEds for skh Imirrs wnh a Conr@ro(O lirnrcd 0!h@ ro th. Conrtrrtr s Li..nsc L.w). <br />DECIASATAN <br />I lrreby dlfirft lndcr F.ohy of lqjury oft of thc folk {ins deldar,oml <br />Ih!v. rl will Ninr(nr a atn ifcrrc o{ Ci'n$nl ro Scll ln$c tur sork.s co r!.n\dr t,n. rc lmviturl lor hy Ssrion .l?(x) ol lhc <br />Lrhn c.dc. ror rh. !.rrornuncc ofrhc*ork n, rhthtlt ncrn l is issucd <br />-l <br />hlvc and *ill noinllin lorkeB .omFnsution inslram.. ui Eqlir.d by S.dhn 3700 of thc t bor Codc, for tlE l!.taortucc ol <br />rhc work for which this lEmir is istun. My *0r&6 on{Ensarioo in$@c c.nc. !d policy nunbcr m: <br />I am acmDr undcr Sffrio. . B, & P,C, fo, rhi! Erron. <br />Lic.nr. Clns:-Lien* Nuflbr| <br />D.r.: CoDlEctor <br />tlc}:ltlllcaNr&tclaa <br />!EC!A.EAuON <br />I hcdby rflirn undcr Fnrlry ofr.rluryrhd I rm lir.\cd u.d$ rn,vnion olChapts, (<nnflEEiog wirh Sccri,,. 70([) .1 Divismn :1 <br />ol lhu BulilEs md Prnt\sion\(idc, o ,! liccn\c is h rtlllilr.c nnl.flNr <br />WARNINC: Flitue to sw wrk6' @npmlrlion .ovcegc h lobwtul. ond .hrll subic.l ai n{,lor!r lo dinimt FEhici {rd <br />.ivil fincs !n b oft h!ndr.{ rholsnd d.ll6 (S100.000). in .ddition ro 0E cosl of cotrp.rslion, dlmgcs !s fovilcd for llr <br />S6rhn 1076 of rh€ Libor Codc, i.rm$ ad aoomy\ fc.s.4 <br />CIISIXICIIAXIENDINGTIGINII <br />I hcrcby rfltor ondcr pcnalry of Frjury rhd rh.r. is a.onsfl.ri,n k.dinB !8cN, fd Ihc pcrlormancc ol rhc lort rar whi.h rhh Fnnir h <br />i\sucd (S.d.:11197. Civ C.r. <br />-t <br />ccnifylhur rhc fcdcrll r.Elhrn,ns rcg,rdins Nh.nosrc $vrl*c n.rnPplic$h brhisI$F.-.r. <br />_lccnirirhar I nivc rcad rhi\trppli.arioiurd {urc rhlrih.abrc iironBr n k.onc.r lrBret'co rflywilhlllCiryrndC.u ry <br />odi,aN.s ard Slflc tjws rchrinS ro buildinB <br />at E mnlioNd pmFny for i <br />Aprlicnnr or Agcnr Silnrrxrc: <br />u!rlxtri/. el,.\.trrdrivcs dfrhn Ciryand Counrylo cnrer !F,nrh. <br />APPROVALS DATE ID/SIG.COMMENTS <br />Appliances <br />Metal Fire Place <br />Evaporative Cooler <br />Furnace <br />Compressor <br />l\4isc. Equipment <br />Duct Work <br />Pre-lnsulation <br />lnsulation <br />Smoke Detectors lnstalled <br />Rouoh Ductwork <br />Toilet Room / Clothes Dryer <br />Residential Ranqe <br />Other <br />Hood <br />Type I Hood <br />Type ll Hood <br />Grease Duct <br />Fire Damper <br />Openings <br />lnstallation <br />F.D. Drop Test <br />Above Hard Lid <br />Above T-Bar <br />Rouqh Mech. <br />Final Test <br />Meter Release <br />FINAL v-77-8,./y'a{o*(e <br />Notes, Remarks, Etc <br />Vents <br />Poli.y Nu.$cr:-Errn sr <br />- <br />_l c.riiiy rhar nr rhc nslonrlr..frhc w..k ttr *lri:h rhi\ r.nnir h issucd.l shnll mr cmploFny pcFon in uy 6d(r <br />v, * r, h.coft sxhFr r. rhc workcn'.onDcnsd ion hws of Crlibnrin. rnd l8e ind ir I should fttonr h].drorh. <br />workc^.oipcnsdioop$vi{iotr*ofscriotrl7mofrhctihorcMc.Ish{ll.fonhwilhconplysilhrhosr)viriotrs.. <br />t ddd'r N@:- <br />NIILICANIDECLABAIIQ! <br />ll.rut'yimnnutrdcr prtrlhy oiprrjury oru orrh[ aollowinE dNlrDrnris: <br />Dc'n.lirn'n Prrniis Ash.no( Nohlrcntiotr lrcdcr.l Rcsuhrnnrs (lirl.4r). Prn6) <br />-Rcqut <br />d trlrcr ol Noli,icirn,n <br />tt <br />tt <br />f-------T------ <br />tt