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APPROVALS DATE ID/SIG.COMMENTS <br />Appliances <br />l/etal Fire Place <br />Evaporative 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 />Openinos <br />lnstallation <br />F.D. Drop Test <br />Above Hard Lid <br />Above T-Bar <br />Hough Mech.?/dt? Ti t^u*uJl rt) <br />Final Test I J\ \ <br />t -t^--*4-17ldi,t"lmT >b\ <br />Notes, Remarks, Etc ui <br />MECHANICAL.INSPECTOR RECORD <br />OWNER BUILDER DELCARAIION <br />I herby .flirm undcr pcmlry of pcriury thl I @ .rcopr fDr tc Co.lrsloB Ltcns L3w for lhe fouoqing rc(en (S( 70l l.t <br />Busings &d Pbfessio. Cod.): Any Cily or Counly which EquiEs a Fmh lo olslod. all.r, impmt, d.mlth or Ep&r ty <br />slru.th, priu ro its Gsuuc.. rl$ rcgutcs rh. lpplicad for slch rErmil ro lih a.igncd {aicmnl thrl lE or sh. n lienscd l)ur$ut <br />ro th. Imvisions ol llE Cofu0crols Lk.nsd t * (Chlprs 9, Conmctuing wirh Sccrion 7000 of Divi.ion 3 ol lh. Brsir.$ ord <br />Profc$ions Codc) or rhat lE or *lE h cxcmfl OcrcfNn and lhc hecis tbr rhc lllcgcd d.nprion. Any viohtion of Sation 703 I 5 hy ory <br />qpltr fo, . p.m[ subjNc rhc 4pli.!nr to a civil p..!lry of ldr ee lho fivc nundEn dolrs ($500). <br />--I, &\ ownr of rh. popcny, G my crploFs wilh *sgcs I tEt $h ompc.slrbn. pi[ do ll8 s* ald !E srtrdE is ml <br />inrdd.n or olYercd for slc (5(.7044. Ausie$ and Ptufcssions Cods The Conrrcrolr Li..nk Lls dGs ml !p!ly to d oqnd of <br />lhepmFny wi. hlil& i!p6B llEon. ud wno do6 sh eort him€lfor hcrslfor llftugh his or nd own cn[lolcca. <br />ptueidcd rhsr s!.t inpNrGnr! e m ink'idcd ororcad aor sh. lf. ho$w.0E tlildin8 or hpmwGnl b sH wilnin om rqt <br />of omphti,n. rhc Orrcr Blillr *iU hlw d* hhh. ofFovins rhd lE 6r ihc did mt hild or inpmw $€ ImFly for dE ltrrpos of <br />-1, <br />as oqnr of rhc pnpcnr. 0a crclusi!.ly .o.reling {irh lien$d contrcroE lo construcr llE Imic{l (SN. 7044. BNirca\ <br />und PmrGshnCodc: Thc Conirsclols Liccnse Ltrv docs nol altly ro .vncr oflnrpcrry*ho builds or irpmrcs rh&con. <br />and who s mcts for su.h ,&j€d. wnh ! Contux)(.) lien<d pursuld to rhc Conh.ror's Lkcns L!w). <br />I m.rcmd unds Serio. . B & PC forrhr mMn. <br />Drl.: Ov..E <br />:uaaf,[Bs:l:0ltPiNtAr'laN <br />DECLAMIAN <br />I h.rchy amrn utulcr pctulr, of Iojury o.c of lhc rollowmg d.chrnri.ns <br />-l <br />h.vc &ld siu tuinrab !C.,rifi.arc olcoM to Sclf-ltri@ lor mrl6 .onrF.slion. !s prDvij.{ aor b,Selion 1700 olrlE <br />Labor Codc. for lnc p.rfomNc of lhc sort for whth llt plmil Lr issued, <br />_l h!!c ann will rainrsin woikc^ .onrn ncdion ii\udtu., d1 rcqunud hysrcrionlTu)olric L.hor (-odc. rbr rhc Frf{,nlncc.f <br />rhc so* li)Ishich thnFnnir i\ h\ucd My*ort.B comFnsario. inrotu.c.rfti,jr ut ll)licrnuDbcr m <br />tdicy Nunrhcr:-Exptcs <br />I..(ily rhri io rhc pc.formN. of tl'c work for vtich lhn I.rnil k hsusd. I shrll ior cfrrlo, any p.Mn in rny nDtrrcr <br />$ rs ro tf,.om srbFcr x,lhe *orkcs compcnerion la{s of Califonil lnd lgE rhd if| rhonld b.co.r subjat lo tlt <br />wo.tc^' omp.nsor ion prcvkions of Setion 3?0O of lh€ l-lbor Codc. I .Jlall, fonh*irh snply wnh lhos Iovnions.. <br />WARNINC Failurc to *orc *orkc.J.onrrcnsirtr r utrirstul. ind shrll suhJccr rn.nrpk'ycr h ainnnrlFrt,lri\ rnd <br />.ivil ,lics u! ro oe h!.dred rh.$a.d dollrs ($l <br />Sr.ri,n.1076 ofrh. ubr Codc. inrcrcs ld itronry's iccs. <br />Drler- Appudnt <br />I h.rcby rfirn uo&r FEhy of p.rjury lhll I !m licnsd nr otChrrrrer gtconrEnci.s wirh s..rbn 7{D0) ofDivisiotr 3 <br />D.lc: Corlmclo <br />I n Eby olirm undd FMlty of p.rJury rhar rntr is ! <br />hsucd (s(, 109?. ci!. c.) <br />as.ncy fo. rh. Frformn.c of rhc *ort lor *hich rhh I'cmh s <br />AIIII( .ILl2IClr'LBtrIl0N <br />Ilrd)trllir run(ldlEtrJliy.l trrluryomof rhcli)lL'{ nrn..]ffiri,nN <br />l)cnrn,i,,f l'$nlr\ A\h!{o\Norific ri,n, f{dcrnl Rcg!hrnn,sil |c.11). I)J$} <br />Lrqotrcd l-rrrcrol Norili.nr on <br />-l <br />ceaify rhat rhc fcdc.rl Egrrhlioo. Egsrding asb.d.s Ercvrl . nor lptlicablc to lhir !rej*r <br />-l <br />ccnilyrhll I hak rcsd <br />'hn {'plk&r <br />ordinrnccs and Slatc tiws mldirE lo bui <br />,d irar. rhnr rht nh.vc jnfdmrio. is.old l.8E ro orr,y wirn all Ciry lnd G,unry <br />abovc nEnriomd pmlcn, for **(h.rchy a noir. rqdsdnl0tivcs ofrhis City ind Counryro cnlc! unonthc <br />Meter Release <br />FINAL <br />of rhc A!\iics rnd PDrc$n s Codc. ml nyli.cnrc is in flll laftt uxi cffccr. <br />tt <br />I