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MECHANICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.' COM,MENTS OWNER EUILDER DET,cARATION
<br />I h6.!, rmnn uidq p@ht of lsjliy lhar I d dcmfl tD6 rhc ConldcloB Lk.e L.w tor th. foltowiry rcen (Se. rO l .5
<br />Busin* ard Prclsion CodG): Any Cily or Coudy wnich rcqoir6 a p6mn ro @nsrtuc1. all6. ioprclc daioltt or i.pM my .
<br />sldcluq piior ro ils iss@cc, als. ,cqut6 lhc .pplicdl for such p.mn h fi|. a siancd statonc lnd hc or sh. b lic6s.d Ns.nr
<br />lo rhc rrovisiotu ot lh. Co"rraclois Licms.d t w ((18 t6 9. Comnd.ing wirh S..tio! 7000 ol Divilio. I of ftG Buinar aid
<br />PrclBioc Co&) or rhal lt o. sh. h ddpl rhd.Eon ud rb. bsi! lor th. rllcgcd qoptio.. Aly violition of S*tion 7Ol l.J try'e,
<br />applicanl for . pmit subjets th. appli€ni io ! civil p.n.hy o t rct hor. ltd liv€ hoo&.d doll&s ($500).
<br />I, a omo ollhc proDdry. or n, mplor6 eirh vosd s rh.ir $lG @op6sdion. will do rh. Bdt &d lh. slErE k tur
<br />ifldr&d oroftacd aor el. (se.?044, Bqin* ed PrcfBioB Codo Thcc; r*rols Lic.* Law do6 iot spply lo doMd ol
<br />li. pmpqly who builds or tnp@6 thGsll. ind who do6 Mt wrt him.laor hwlf or lhEl8h his or ho om oploy.B.
<br />proli<Ld Oar such inFl\EEl!cmthtad.doroftoldlbrsk.Itho{e6.rlEtrildin8oriopio@lbsU*nhiion,@
<br />of@opkrio( tlE ol*c Buiils vilt hsv. lh. hrd.. oaFlvirB rh.r hc or 3hc dt 6l hiild or i,rFlc $c Fopoty h. tlE ,lrpo$ of
<br />I, I ow6 oflhc popciy. 6 qclBivcly .oulracrirS w n fi.d!.d com.rou ro @ldncr llE Fpje.t (Sc. 70a4, EEins
<br />d P,oftseih Cod.r Th. Co.tncroa. Lics. Lrw do6 nor apply lo d ownd of propsry who builds or imptuvq rt6mn.and who .ofldcls for ch p6jdswith i ConrEdo(, lic@5.d pmudt lo tt.Conr.ctol3 Li.@ t w).
<br />lu!3f,l8ucourEltarlo!
<br />DICIAAAIqB
<br />I hacby 6mrm und6 poahyofpEj!ryon ofth. following deloatios:
<br />I h.vc dd will mrinrai. . C.nifi.rt. oacongr lo Scll-l6m for sort6 odDdsarion, 6 l,lvid.d for by Sclior 3700 oflh.
<br />Labor Cod., for th. p(aomec. o f rh. @lt lor which lhc pmil is issu€d.
<br />mainlain woI*d conp.salion iEm,c., a rcqoted b, Sarion 1700 oalh. trbo. Cod.. aor lh. pqfo,l@c. of
<br />il, w
<br />\rort6 conrpdario. iGor cc ceid md Irolic,
<br />K.-.
<br />K"-
<br />ol *u-Etv ?f5
<br />3
<br />I c.niq lhat ii rhe pdlolr@c. of lh. Nork tor which lhis pcnnil t isuel. I shall nol dtrploy ey ps$n in ..y f,und
<br />e ab b.<an subjel lo lh. vo*6' omp.Nalion l.wr of Calilomi.. Mdrgelhatif I rlbuld b..o@ 3ubjct to th.
<br />rvoddc comrdstion prcvisioa of S.clion 1700 of lh. l-sbor Cod., I stsll. fonhwnh comply wnh ihoe provi.ioB .
<br />W R\INC Iailu(ro{rd.$" 6 compqsd inn ."' orS.A ui la{ lu l, r.i shdll tu hlrr M anplo}<' ro @'rl F{lr'6 Jnd
<br />:]-:11,"'i;;1fi:1"*t*:Ji:ysj1ff:iY:fl1 /rdjr i'i\'s{ fame'4s'nn J'm36a\prc\d'Jl.r'ihc
<br />7., )lL1 1,6 ^,,,*.,,,
<br />(!(tJ (,, (/z(---a
<br />, lj(lTsEDjalIMCIaa
<br />DECI.AEAIIQI
<br />I lErcb) lmirn undd n.Mlr! ofpn urr rh0r l on lic.trkl undd ptuvision olChlprd 9 (cooidcinn rirh scction 7000) ofDirisiun:l
<br />of rh. aunnsMd rroler'oG c.d..ddn! l'.nk h
<br />'n
<br />lull ln(cadcn(r
<br />K"*""4Sqs8K"
<br />ca!sra!Jc[Q!.r!!Dt!ru8
<br />I h@by ,ffim undn p€.ahy of pqjury lhd lh@ is a coNrrucrbr ladin8 ,gdcy for rh. Fl6M.. ontu wo* lor slict this Fnil h
<br />ssued (56. 1097. Ci!. 4.).
<br />I crdd ' d.n6"
<br />APPLI('ANT DECLA&A IION
<br />I hcany ojrm uid6 p.nalr, ol p6jury one dl lhr rolbwins drbmr ions:
<br />Dcnolition Pmrns-Asbsros Noliiicolion rcdcml Rcguldions (Tnl. 40. Pd16)
<br />R.quir.n &te olNdincdion
<br />I cclify lhal I ha\. @d rhi! app rhar rhr ahv. intomarioi is.or-r I rsrdlocomplyrvirh lllCir!and
<br />ordinecB md Smr. L!$ r.l6ting ro
<br />lboE no'ioD.d propdy 6r
<br />App[cer or Aso! siBidu...ta
<br />0A/
<br />*"J )
<br />Appliances
<br />Ivletal Fire Place
<br />Evaporative Cooler
<br />Furnace
<br />Co mpressor
<br />Misc. Equipment
<br />Duct Work
<br />Pre-lnsulation
<br />lnsulation
<br />Smoke Detectors lnstalled
<br />Rough Ductwork
<br />Vents
<br />Toilet Room / Clothes D ryer
<br />Residential Ra e \
<br />Other
<br />Hood
<br />Type I Hood
<br />Iype ll Hood
<br />Grease Duct
<br />Fire Dam per
<br />Openings
<br />lnstallation
<br />F.D. Drop Test
<br />Above Hard Lid tt rlt.,
<br />Above T-Bar qlL,rx MVlilfl4 -q
<br />I )
<br />Rough Mech.
<br />Final Test
<br />Meter Release tt
<br />FINAL bt<tv.4Ic{rq
<br />Notes, Remarks , Etc I
<br />."",."","., U W L LqrI4".S
<br />_l .6ri8 thrr rh. f.dcral rcguLtioE Egqding abetos rdolal e not applkabtc lo thb pojccl.
<br />6SX
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