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MECHANICAL.INSPECTOR RECORD <br />APPROVALS ID/SIG.COMMENTSDATE <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 <br />Rouqh Ductwork <br />Toilet Room / Clothes Dryer <br />Residential Range <br />Other <br />Hood <br />Type I Hood <br />Type ll Hood <br />Fire Damper <br />Openinos <br />F.D. Drop Test <br />Above Hard Lid <br />Above T-Bar <br />Rough Mech. <br />Meter Release <br />FINAL <br />Notes, Remarks, Etc. <br />otvNFiR BUn-Dlti lllil-clRA'lloN <br />I h.[b]_ nlri'nr undcr Nnrlrt (,r pcrjrry rh,r I m cx.trU rion thc Conrrncnt\ t-i.r \. Lrs lar rh. ir)lhwi.! t <br />lJu\ircss md Prolcsi,u (inlc): Any Cir, or Conoly *hi.h rcquir.\ r F ir k' coniru.t. ilrcr, n lx,rc. dctrFlish or rcFt nny <br />nnrhrc. rrnrb irs issunn.c.0l\o r.qutc\ lh. rpplirn r f(n \u.hFnnir r.ljlc a \i8ncd narcnrni rhlr hor shc is licctr*d nor\or r <br />I. ihc nmvi\nnr\ ot rhc Cotrkr.ktr \ I-i.cn\cd lj* (Chrprc! 9. Cornnrici',9 sirh Sc.lion 70(X) of Oivision .l ol rhc Busirr.r{ nnd <br />Pnr'csrion\Co(lc).rrhnr hcoi\hc i\cxcm rhurclronr nd r1[ brsis lirlhu rllrs.dcxcn{rion Anyriol0lionofsccrionT0rl5byrny <br />appliunllnrrr.rmir\!hJccr{rlknfflicrtrrbrcivilp.nrlryolDornxrcrrtMrlvclrfttcddoll!!s(S500). <br />-1, <br />us owtur of rh. ,bncny. o, my .mplorecs wilh wls6 ds llEn $lc @nrpcnsaiion. wil do llE wlk !d tlE srurw is ml <br />inlcdcn 6, otrcr.d for sh (SN.?044. BusiElt sd Ptof€.htri C.dc: Th. Conlt!.ror'3 Litns l-rs dG3 ml ryPly lo u owE ot <br />rtr pmFny *ho toikt dr inprcE ttr€r {n uho drs sh mrl hirellor lEmlf or ll@!!h hir or lEr own.nplovcci, <br />tDvidcd rhlr su.h ihpotft s @ ml i4Brcd orolimd lor $L. li ho*rM. dt boiuing or isp,owm issldwilhinomrd <br />oaonplcriotr rlr OwGr Blild.r sill hrk llr bE&n of FDvinS ihd tp or sl* dil mr hild or itrprow dE p|Dpdly fq th F4.E of <br />-1. <br />$ owmr of rh. I!()pcdy. ad .r.lusitclt co.tr.clin8 qith liefl*d .om6do6 to mn(rucr lhc pn,jer (s*. Tol4 Busm$ <br />lnd ADrsrirn Codc: Thc Conrr&tols Liccns Lr* d@s nor lptly to otr owncrofpbp.nywho boilds or impmrcs rh.r.on. <br />a d sho .o.rnck for su.h proFck wnh o Conlruclo,(s) liccned pnFu{nr h' I hc Conrr.clol s Liccn€ tf,*) <br />-l <br />sn crcmfl undcr Selkh-, B- & P,C, fo. ttir @sn. <br />WORXT'RS''OMPF\SATIoN <br />DES.AEAIION <br />I hcrcbyatfi rmhdd p.nalryotFrjuryoncof lh. followirg dshr idns: <br />-l <br />h.vc {t willminllin & ccaaficirc of Conmr io S.lI.lnsw aor wo 6 otrrrcrs.lion. s Fovidcd for bysc.tho ]700 oflh. <br />kbor Codc. l{ thc Frfo.nlm. of lh. e for *hi.h lhc pemil i. irsu.d. <br />-l <br />hatr and will minrain wortc* .onF.sllion i.$mBc.as Etlncd b, S6riod lrm of rtc L3bor Codc. fo, th. Ffolrwc of <br />rhc {o ror which rhis rcmil is irMd. My workdl comrcnslion i.sudcc .odtr atd polky nlmb.r a.i <br />P,ni.y Nui$cr <br />-f:inircs: <br />-l <br />ccnily rhar in rhc p.rformn.c of lhc *ork for whicn this ncrnrir i, issued.l shullflol cnDloy unyF^oh in any ronrcr <br />s ns b bcsm suhixt k,lhc so s\'.ont*nsdio. laus ofcalifomi!. lnd ose lhar ill should b..om sut'j.tl to rh. <br />wo.lcN' loqEnsstion lmvisions of Sdrion l7m of ihc kbor Codc. I shlll. tonhwiln con ly wiln lh.$ ntovisio.s <br />WARNINO: Fiil!rc ro scurc mrte.s' comlcnsrlion colcn8c is lolawtuL lnd shtrll subject d .n{lo}e! ro eininal Fmllts aod <br />civil fiics !p to oE h!ftlrcd lhousa.d don&s (1100.(x)0), in oddnion lo lhc .osl of comrErelion. d!e8p3 a Provad r.r rtE <br />S<tion 3076 of thc Libor C6dc. i.lcrc( 3nd lllorrcy's fes. <br />LlllilJl:9_cl)xISacloa <br />DticlllB^uar <br />Ihrr.hyrfln'nundcrlttilyolt{rjurlilHrItrlicoi*duiJcrtt.\1\i()n iChlplcr9(connrfnc ! airhScdi'n?(x[))orr)'!ni(r' I <br />oi rhc ll'trim$ ond l}orr\\i(u\ Chlc, Jmyliccn$i\i'rtulllaEcxRltlfu.l <br />coNsl !lU(:r'l(lN I trrtDlN(; A(;ENCY <br />IhrEhy.ltirmu.rFntllyofpcrjdryrhxrrhcthr.onifl.rktrlcndirA!8cm,fitrrhcl.rfffmkcoirhcsorkitr*hichrhir,snri!is <br />is\ucd(Sc. l097.Civ C ) <br />APPLICANT NF(II {RATI(TN <br />I hcd,y ifiim undcr pctrrhy ot pcrJury onc oarhc r.llowingdccld nnN: <br />Dcnmlirion PcmnlAsl,esros Norifi. ion F.d.rdlRcSul ions(Tillc 40. ta,r6r <br />_Rcquncd ktr.i ot Norilic.lion <br />l ..d ity rhd rh. fdlcral rcsulili()n{ Esddins s\h.$o\ rcm)vnl arc not opdicar'b ro thi\ nmj.ct. <br />-l <br />cedif, rhd I ltav. E.d lhi rprlkalion sd $arc lhal rhc lhow inforNiion k .ml. I ae@ ro @nply sith lll Citv a.d Courlv <br />odinan(.s Md Srorc L!s! rclaring lo hnildin8 consnudion. ed hcrchy authotiz. rcpr.$ntalivcs of lhis Cny ud Counly lo cnl6 q,o. rhc <br />ahok m ion.{ noFny for ins}*tion purrrss. <br />,\l)t)li.rir,tr Au. rsrlfrnrr l)rc <br />r <br />Vents <br />Grease Duct <br />lnstallation <br />Final Test <br />t-iccn{ ch$:-Li.cns. Nuntur <br />trndclr Nrm:- <br />PomitN nam rn nl, <br />- <br />ffi <br />tt <br />I <br />llt---f-- <br />I <br />t--