Laserfiche WebLink
MECHANICAL.INSPECTOR BECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION <br />I hscby .fiim lndcr Fnolry of prj!ry thlr I m cxenfl 6om !h. ContracroF' Liccns L3w for lhc iollowin8 rc!$n (Se,7011.5 <br />Busi.c$ and Prcfc$ion Codc)r Any Cit, or Counly which rcquircs 0 ,trnil lo snsltuct. alld. impow. dcrmlish or Ep8n any <br />slod@. rsior to il3 i.su.N, ,lso EqunEs lne lpplkel aor slch Ffti lo nb ! sign.n slalcmrt rhai h. or slE b li.cnrcd purs&l <br />ro rlE pmvnhf,s of llf, Conrrmrols Lians{ L.s (Ctaflcr 9. Conftfting enh Sccion 7000 of DilGion I of fie Busincs 3nd <br />Pmf.ssn,ns Codc) or rhd hc or xhc is .xcn9l o.rcton and rhc b6h fo. lh. !lh8.d .rcmprion. Any vioblion ol S.dion 7011 5 by any <br />ortli.anl ror s pcm subjer lhc aprlic"nl lo s civil Fnoliy of nol mR ltan filc hlndted doll$ ($5m) <br />-1. <br />as owftr of Ihc pdFn, or ny cn9loyd. eirh wrgcs as lhcir slc @npc6!tion. will do tl* Pdt ond tlE indm is @r <br />ilner<Ld orotrc,cd fd sb (Se.7044. 8usiffis.d Prea.siotu Con rTn co mcrolr Licetrc Liw&B el eplylo owmrol <br />rhc FDPcrry *ln h{ilds or itrproh rlttu( ad wls dc sh s* hitucu 6r h@lf or lnmu8h hk m h.r om.n{rloFc!. <br />provi&d rh.r su.h tunprcwmnls e flor hknd.n d ofi.rcd fm s!. l( lneE dE tliultg o inlnEEnr is $ld wihin om iEa <br />dfotrplerbi, rlt Ovnc. Buildq eill trw 1lE t rd.n ofpoting dur lE or sh. dil iol buiE or inDrcw th. poFry lor dE puqnsc of <br />-1. <br />asowmrofrh€ FoFny. amcxclusirclycof,rnclins wnh [c.n$i o rrcror ro.onsh.t rlE pmid (Sc. ?044. Bu\ims <br />,rd PrDINion Codc: Th. Conmcrors Li.cn.c Law dcs nor apply ro rn own.r of prcrcny *ho blildi or imp,6ws lhc@n, <br />und who onrErs for such pmiErswirh a C.nrB.ro(s) liccn*n pusrant ro rhc Conrador's Lb.ne t w) <br />_l m.rc.rtr xods Sdion-. B &PC l'or lnn rca$n <br />Drre: oPner: <br />ttoR(ERsi ciintPEl\s^ rx )N <br />DES/AA.IIA! <br />I hcrchy fn'n uMcr p.naltyufncrruryonc olrhc n,ll,wirg d.rlumlnN <br />-l <br />hlve dd will minllin ! Ccnifrcatc 6f Co.*d ro &tt-lBue ftr *dt6 omFnslrion. 3s gDviltd lot by Setior l7m of lh. <br />r2bo. Cod.. aorltrc pdfolmrc of lt tr* forshkhlL tdn is is{ert. <br />-l <br />hcw lnd qill miil.in wo.kcrJ .on Ensalion insurarcc. ac rcquircd by Scclioi :1700 of thc Llhot Codc. lor ihc pcrformcc of <br />l,!c mrt lor ehich lhi! Fmii is issu.i. My wort6 emp.nsdion insurffie .dicr 6rd plicy nunhc, m: <br />l.cnily lh,t in Ihc perfoirrume olthc work tor uhich thn rrmit t tsuerl.l shdl n r.mphy y p.rcn in nny manncr <br />$ ns ro h(sm suhjar ro rhc wo c6 comFn\dion hwsof CalironiL dd dgN Ihar ill sholld tNom subFr lorh. <br />portss ohpcnslion rmvisions or Stlion :1700 ol rh. LaE r Codc. l shatL fonhwnh conq,ly Pith rn s Imvisioor <br />WAXNINGT Frihrc ro sur. eorkcn' .orm.trs0l ion ovcriBc is unlaqtul. and shrll slbjcct an onFi,rcr <br />'o <br />diriml Fmhics ind <br />.ivil in.\ u,, b utu hundrcd rhousand dollm (Stm.Om). nr irion lo rhc con olcoqEnsrio.. dd@gd as rrovidcd lor lh. <br />Sdlion 1076 or rhc t$or codc. inrcrcsl ed 3 o.Ey s f{s <br />I icrcbyafirnondcr pcnalry.a prrjury rhd I dn' li..nkd unJ.r pn,of Chnnrc. 9 icommE inc sirh Ssrion 70fi)) olDirision.l <br />of rhc Businc$ nnd Profc$ions Codc. dd ny liccns is in luu rorcc ar{.nc.r. <br />UeNccbls: I ie <br />I hctohy afitnrnd.r Fnnlry.lFryurylhd rhcrc h r con(rucrinn Ldios ascmt fttr rhc l( omM.c orrltr sort lo, qllich rhis Firnir i\ <br />trucJ rS( :1097 Ci! C ) <br />ATILIIANLI'ECLAE{ITN <br />I t(.by ,f@ u nd.r ,.naxy ot p.rjury om of r hc hllowirS delml ionx: <br />DcnDlit bn Pci,nib.Asbc os Nolilicdlion ltdcrol R.:3Uklion\ fri[ 40, Pxn6) <br />Rcquncd t.llcr ol Nolifi clliul <br />-l <br />ccnify th.t rhc lcdcral rcslkrions rcsardins e{lEtus remell !rc Nl ,prlh.hlc ro rhis pmirl. <br />I.dlityrhd I hdv. r.od thn npplicarion dsratcrharrh.abvcinf nrrion ii.oBr.I rerc ro mnDly wnh rll Ciry ond Coul, <br />ordin0nccs and srarc I.t{. elaring to bu <br />8bt,vc @ntiomd pop.ny ftr insF.lion <br />con(ruclion, ind hcrchy Nlhorizc rcprcsnrlrivc. .rrhil Cirymd counrr ro cnr.r utEtr thc <br />A <br />Appliances <br />Metal Fire Place <br />Evaporative Cooler <br />Furnace <br />Compressor <br />Misc. Equipment <br />Duct Work <br />Pre-lnsulation <br />Smoke Detectors lnstalled <br />Rouqh Ductwork <br />Toilet Room / Clothes Dryer <br />Residential Ranqe <br />Other <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 />Rough Mech.{,lul ht ii t"n4z 7) <br />Final Test Ul I \- <br />Meter Release <br />FINAL r/t/r6 t 'irr@)/02_- <br />Notes, Remarks, Etc. <br />lnsulation <br />Vents <br />Hood <br />l:rnnc.