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MECHANICAL.INSPECTOR RECORD
<br />APPROVALS DATE COMMENTS OWNER BUILDER DELCARATION
<br />I lErcby ltfrn u.dr !.Mlry of pc.jury that I d.rcflpr fiom rh. Contrsrou Lt.n* Llp aor rhe folo*ing @€n (Se.7031 5
<br />Busincse 0,t Pmfcssio. Codc): Any Chy 01 C.uiry which rcqliEs ! Fni b 6n$tu1 drd. inprow, dcmlLh or Grci, 6y
<br />silctuE, Ftu lo ils t$Me. lls rcquiF3lh. ,pplk&r for 3eh Fmi ro liL a sigftn 3l.lcmt |t.r lE o. sh. b liansrt pu^u
<br />lo lhc pmvisio6 ot ttE Contm.iofr Lk..Ed tlw (Chaprd 9. Comfttuin! airl S.dion ?000 ot Divisk'n 3 of rhc Busincs. 6nd
<br />Prelcasions Cod.) orlnll tu cslE t.rcmpl llErcnDmdd ir. h&ri! 16r rn dh8.d cxenplion. Ary vi.blion of Scctbn 7011.5 by ony
<br />ipplicd fo, d pcmit lubi(B rtE .plrlica & a civil ,€nrh, ol mr mr€ rhan filc nudrt dousrs (3500),
<br />-l.
<br />rs osr.r.l rh.|ro!.ny. (trnrycnrf]ovccs qirha !.\r\ rhrn {,lcro pcnlrri(n,. uillrlo rhc\olk rh.qnrrurc$n
<br />IhD^{.ny sh. htriu\ or i'n[ovcs rhmrnr, a trh.d.c\\uch*or[hi'!\.ll.rtuR]lorrhnn,lhhi\orhrowf.ffoydc\.
<br />_1. N oqncr of rh. I'mFny. d crclusiwly mah.'iog *arh ltc.ed c6nrn loB ro ornier rli lt6ir (56. 7O14. Burnc$
<br />tui Anfis.bn Coder Th. Conrdhas Li.cn{ ljw docs ml.pplylo anowmroir,mFny who builds or improrcs lhtun.
<br />lid qho o.uds for such Fojccts siin . cofiscto(9 lte.Ed tll!!1@r t6 rlE colld.roii Lt.ns t s).
<br />-l
<br />dcEmpt uds Serioi . B. & P.C. for lhis rce.,
<br />I).I€ ()rn..
<br />woRxuRs; aoNtPaNs?\iioN
<br />DECT,AATIIIN
<br />I hcrchr rlllrDr trtrd.r |.ntrkyolrc{uryonc ofth. hlk,wing dcclrrltiflr
<br />lhaveand*illnuinrainaCcnific cotConscnrtoSclf.lnsur.lbrsorkcis.onl,tnsarion.0s providcdhrbyScdion.lTfirolrhc
<br />litxtr Cdc- li)r rhc pcrfnrmrcc ol rhc $oA for whiclr r hc Frnrir i\ i\sucd
<br />-l
<br />h!$!ft1!ill n[inr{ir wolkcNi comtcn\arion nNur,rcc.,1 ruquircd hys..rnn:l7u)orrh. trho. Cod.. tor lhc lnlinn rc or
<br />rhr "qk,n, whth rhn Frn'ir i. nsucd Mt n rlo. !r,mn.n\d'un 'n.u'rn!c,Jrh1 rrl Fntr'y humbfl s
<br />.."". Sb"L<- Q-.",-
<br />Ac-.v SZattqxc2t-'l 1
<br />I..dify
<br />'hal
<br />in rhc pcrformtu..f rhc work li)r which Ihk pcirnil is hsucd. I sh0llnot cry1loy ony t son in on, hann.r
<br />s us lo tE..m snbjcd to rlrc workcrJ .onDrnsdlion l0sr or Calirnmia. r.d .gm rh ir I should tt@m strbi.t lo rh.
<br />wnrkus ompctrsalh lrorisio.s olScclio" l70oollhc hhn Codq I qhrll. ronhwirh.omply wi'h lhos. ptuvisions
<br />WARNING: raibn h Ecuie *ortcn conrpcnslriotr covcmSc is utrl0etul. oid shall subicl !n cmFlorr lo siminal lEmlti* lnd
<br />.i!il fi.c\ W ro oft hundrcd rholsand dolltrs ($loo.Otro), in addnion ro rhc co{ of cotr{,.nsalio.. daeScs as prcvidcn lbr lhc
<br />s(lt,n:1076of rhc Latn codc. inrcrcn and Dllomy s
<br />,,,.,1'\( \n
<br />DEqJAAIION
<br />I rlr llu\i'r.$rnd Ptufc\li,m\Codc rd iiylircn\c is ir hll turcu trlc,lc.r
<br />c-C !6-z \tol
<br />,"r", -'1 '\!' \x Xi,,uSZ-U
<br />C(T STNTICTI(IN I FNDIN(I A(:NNCY
<br />I h.rcb, lmrm uodc, lcnahy ot lcrjlry lnal thcrc n a .onstrudnn hdin8 oScmy lor lh. pcrformN of lhc srk tor snich fin rEmir is
<br />issuc{ (S( 109r. Civ. C.).
<br />AITLICANLIECbAAII!'N
<br />I Lr$, !fim undcr pcnlll, ol tE.jury .rc ol lhr n k,wing dc.lmr n,s
<br />Dcnxriri( Pfnrir\ Aih.sr.s N.rillcirion Fd .rnl Rcsulxrions ('litlc4lr. PrlO
<br />-Rcquircd
<br />I.ncr of Norifi crion
<br />-l
<br />ccnifylhd I n w rc.d lht trlrli.olion.nd srar.
<br />'hd
<br />rh. abovc inaomrion h comr.I l8e rooq,lyvilh.0 Cnyand Colnly
<br />.,dtr,rN.! rnl sr.r. I r(\ r.ro blildi.s conntucrion. and h.rchy aurhnze EpreEnllrivcs olrhh Cnyad Cornrr ro cnrB uFn rhc
<br />abor mnriomd prcpeny for
<br />Applionr tr Ag.nr Signalurc:,"," t \( (8
<br />1r\
<br />Appliances
<br />Ivletal Fire Place
<br />Evaporative Cooler
<br />Furnace
<br />Compressor
<br />It/isc. Equipment
<br />Duct Work
<br />Pre-lnsulation
<br />lnsulation
<br />Smoke Detectors lnstalled
<br />Rouoh Ductwork
<br />Vents z-<\
<br />Toilet Room / Clothes Dryer 7-174k \.vhu)
<br />Residential Range
<br />Other
<br />Hood
<br />fype I Hood
<br />Type ll Hood
<br />Grease Duct
<br />Fire Damper
<br />o penings
<br />lnstallation
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Above T-Bar
<br />Rough Mech.
<br />Final Test
<br />Meter Release
<br />FINAL 74)-lll iVitr*-et,,/."-Z/r)
<br />Notes, Remarks, Etc.Ir
<br />ID/SIG.
<br />-l
<br />ccdity lnal 0E lcdco! rc8nhlions ESardin8 asbcslos rcmval ,rc ml {llictrblc lo lhn poi{
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