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MECHANICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OIVNT:R BTJILDTT DEI,CARA'I'ION
<br />I hfichy r,ltn ! cr ptnrliy,,1Frjurr rh l dcrcnDr fr Dr ihc C{,ntrch! l-ic.nsc Lrv,nr rhc follown8.c.q'i (Scc?0.115
<br />Btrsincss rtrd I'rofc\\nr Codor Any Ciry or Coxtrry shirh r.qur.\ r |knn[ ti .onnru.l, {lrcr. nnt,mtc. d.nDli\h ,tr ,.Ft ony
<br />(rucrurc. priqr. ns nsuance. also rcquncsihc oaplicMr lnr qrh pcnnirro nb ! sisocd (arcrnrir rhrr hc or shr i\ licc {d punubr
<br />ro rhe rovni(n\ rlllf, Contri.l', r l-icctrscd Lrq (CrBrrcr e. coNncNir8 $ih Sccrio Tlxx) ol Dirision I ol rh. Btsinc* and
<br />ifllicaDr rar J p.nnir \ublccBrhc rmli.0.[o acnllNnrlryolnor nxm rhri nvc hundrcddo]lnrs (S5m).
<br />_I. d{ owftr ol rhe pol,eny. m crcluliEly .onrading wirh lien*d .otrlrur.F ro mn{ru.t tlE pmjccl (Se. 7044. Busims
<br />a Pmftssi,nCod.: Thc Conlr tol s Liccns tjv des Nl lpply ro own.r oftropcnywho builds or impots rh.rcon.
<br />and qno conrEcts for such rmFcrs wirh a conrmcro(, licorsd plnu ro rhc cooE&rd\ I-hcnsc Law),
<br />I !'ncxcnrpr undcr Scc
<br />lllaf,!8ti:coMrldtarloN
<br />IECIASAUqN
<br />I hcrcby a,firm und( pcnrlty of psiury o.c of thc following dNhrataonsi
<br />I h,ve arld aill @iniaia . Canirel. orcolenl lo Sllf-Itr{uE lor workdl on{..salion. .s lmvidcd for b, Sdlion l?00 ofllr
<br />tlbor Codc. for rlE,dfoffi ot E ett for whkh rlE p.mi b i$ucn.
<br />I hnvraidqiu nuinrsin workd{.onrp.nsarion insutunc., a\ rcquncd bysdrion 1700 of'hc Ijhor Codc. for th. r,.rlomurcc ol
<br />rhc work ror whi.h rhis Froir is is\u.d My *orkm $mp.osdtioo in\urorc.di& aJn po[cy oumhcr N:
<br />Polky Nunh.ri F\riE3:
<br />-l
<br />c.nifythoi in rhc pdlormne of lhc aorl fo. *hich
<br />'hh Fmil h hslcd. I sh.ll nol cmploy lny !'cr$n in lny Mftr
<br />s as to bcrorE subj.rr ro rtc woltsl coq,cn$ion hws of Californi4 ard agrcc rhar if I stsuld tE.orc subicr t tlE
<br />uortcn'comp.rsrionpmvnionsofSation3?00oflhcLlhrCodc.Ishlll lodhvirho,iply sirh rtneImvhions..
<br />WARNING: Ftrilur lo surc mrlcn oq,c.ssrion mvcE8c h unhwtul. and sh.ll srbirl s cmploFr lo ainiMl ltNhti dd
<br />ciil firci up ro orc huodid lholsnd dolhr ($lo().fiD). in eldnkrn lo th..osl oa.omFns.lion. d!tu8ls .s l,mdt.n for llt
<br />Selion 3016 ol rh. tjbor C.ne. i .rcn 3rd olbmy s fes.
<br />LrsliN$DraNuacrlr&
<br />DDIIAEAIIOX
<br />I h.rch] rflnn ud.r ,)..nlr, of r.rju.y thd I rm lirnan undc! roviion olChlt'lct 9(.ommo.inE *irh Ssiion 7(Il0) orDilision.l
<br />or rhc Bo\inc{ md PrDfcision\ C(xic. dd f,y lic.i{ i\ in ,ull rn.c drl cff(r
<br />COISI&UIII9NIENDIIIiIIiENCI
<br />Ihcr.hyrflinnrndci Fnalry.r rrrlury rh8r rhcr. hr.onsrucrk'n lNdiig trB.ky for rhc p6foflMrc. ol lhc *or& for*hichrih pcrm n
<br />ir\!cd lscc.3(})7. Civ. C ).
<br />IIPLIIANLIEIIABdIION
<br />I lhtydnN! d.r pdtrrlry uftrtury.n. ofrhc rolhsin! dcclurrnn'\:
<br />DcnDIiridl Pcnnir$Ash.e.s Norili.arion rcdcr{l Rc8ulInr\ (Tirlc 40. Prn6l
<br />-Rcquncd
<br />klrc! ol Nolifrrli'n
<br />-l
<br />ccnify lhd lh. fcd€nl rcBlhrhfls Essrdins .stEslos rcmval m nor applublc lo rhir ,,mj.cl
<br />-l
<br />ccrrily rhar I hav. Eed rnh applictrrion rid srare fiar rhc st rc ibformrion n colBl. I alN lo mmply *irh rll Ciry and Counry
<br />ordindft.s lnd Stsrc ljws rhra.g to brilding c.n$ru.rion. !d hcEby aurlbrirc rcilrc*nrrlivcs ol rhii Cily and Counly lo cnls uIE. !E
<br />aboE mnrioncd ph!.ny for in.p..rjon purpof'
<br />Apolicanl or Asctrr Sisnaru,e:-
<br />-
<br />-
<br />O6(cl
<br />Appliances
<br />Metal Fire Place
<br />Evaporative Cooler
<br />Furnace
<br />Compressor
<br />Ivlisc. Equipment
<br />Duct Work
<br />Pre-lnsulation
<br />lnsulation
<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 />Rough Mech.
<br />Final Test
<br />Meter Release I
<br />FINAL q/q/t6 .zilY4-v)
<br />Notes, Remarks, Etc.I tl I
<br />Smoke Detectors lnstalled
<br />-1.
<br />as owmr of lh. propcny. or my cn{,loyrs wnh waScs $ tlEn sh .ompcnetion. vitl do lhe *ort &d ltl smarm i\ mr
<br />inGided or o,Iccd for sk (SE.7O[I, Blsiftss and Prnfcsions Codq Th. Conrh.rol3 Lic..sc Lra d6es .or apl,ly t rn oamr of
<br />inc pmFny who builds or ihpmB th.mtr !n who dors such srk hinscll or hlRlfor llmu8h his or hcr oM cmrl,yccs.
<br />,bvidcd rhlr su.h inDo\tft s e mr inreid€d ororLEd fo. sL lf.lrffii rlr triltirg 6r ii{,orcmni k $H *ithD onc ,tr
<br />.,foltntrion, rh Owmr Blitbr eill hlr {E hrd.n .f lrvin8 rlEr ,E or dE did br hlld or in!ftE rrE pDtdy L. dE Ffpo$ of
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