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MECHANICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER I]UII-DEN DELCARAAION
<br />I hcrchy rnir undcr pctrrlry or pcrj!.v rhnr lun cxctrU t'rom rhc Ci, ruclor! Liccnsc Liw aor rhe rbllowin8 rcrur (S..?011.5.
<br />aurnc\s rM Phfc$i(n C.dc) Atry Ciry oi Coutrry whi.h rcquircs a t6m[ h .oniturr. ]lr.r, impnM. d.ntrnh ,tr ruFtr rtr)
<br />dncrurc. pri,rro ir{ nsu cc. aho r.quncs rhc {tli..d ltr \u.h Fiinir b lilc, si8Rd nrrcrftnr rlr ltor shc i! lic(n\.d NFutrtrr
<br />k, rhe p('visnnN ol rh. cotrrn (tr\ l-i.cn*d trw (chnptr 9, colnnrncine wnh sccrhn 7fifl of Divki.n .] ot rh. Brsiic\\ rnd r
<br />Pnnrr\i{,ns('o'lc)orlhrrhcor\heiscrcmflrhcrclior.trdrhcl)Nnrorrhcrllc8l{cxcnuitnr.AtrylnnnhnofSccrirT0.llShyrtry
<br />,ppli.lrrurpcnil\uhrccl\rhtamlicrtrrn,ucivilltnrllyoinolntrclhrtrlivchutrdEddol[rs(t500)
<br />-1.
<br />$ oPncr oa lhc lmFny, or my .mplorr.s *ilh w!8cs ns rhcir $k .$mp.nsrio.. will do tf, wt and dE nrul@ is mt
<br />intndcd or offcrcd ror slc (se.7(x4, ausin sr rd Profc$ions Codc: Thc C,nnador's LtcnE Liw do.s Fr alply ro u oeno o,
<br />'h. F,Fdy vh. brikL( ., in!ft8 rhe@n. a]d *ln dc un mn hins.lf or hcNlf o! thmu8h his ff h.r ovn cmployNs.
<br />prcvidcn tul such impmkmnls N mr i crt d r offcR{ for slc. ll lf,'*wr. df, buillinA or in{nwtunr is $H wilhin onc Fd
<br />of.onphrtun. ltE ownfi Buildcr will h.w rlE bldcn otpoli.g lhar hc or dE dij hr hliu o! inFtuE $c I,DrEry for 0t p!,I$* of
<br />-l.,so{n$olrhc
<br />ImFny, ancrlusiv.lyco'ur&rins *nh liccn\cd conrEcror roonntur rlE rroj.rr lscc. ?0a4. Businc$
<br />o'd Ptuftsim Codc: Thc Contaclols Liccnsc Law do.s ml atplylo r.owncr olpmt ny who huilds or nnprovcs ficr.on.rnd *ho Lnnldsfor such pmjer wirh ! Conhcrods) licc.scd ruroan! ro rhcC6nt6.roli Liccnsc Las).
<br />-l
<br />omcrcmfl undcr Sccri.
<br />EIIBKEX$JAMTENIiAIION
<br />DECIABA]IITN
<br />I lErchy .Irtrm u.d.r !.nrliy ofFiury oic of lhe fouowing deldadois:
<br />lrhtr (itrlc.lnr rh. JicniirrRn.c olrltr tr.rk l,tr !hr[ rhc Fnnir I ns!(d
<br />I h,vc rnd will n8inhin w.rkcrq .of,p.ns ion in\umrcc. ri ruquncd h, Sccrin 3?OO or tne bhir a)dc, tu, rhc FrfomGc ol
<br />F9l|! iercd My soii(6 @nip.n$tion lffi di, dn Flky nunb6 e.
<br />7 <. 'r-e+
<br />X.cn,llrh, ,,rhct" ryNnll.rrhc tr.rk r'tr {hrl' rhisr--!nir n i\\kd.l lhrllnorc'ntrk,, rny pc's inrny rr cr'a trroh.d m {,|'i^r rot\r trnrlc'('.nr,t(r\Jrrn l.'tr\of r'.'lh1n'r {ndJrRrh. l.h^nld l{.nim.uh,t.rr rorhc
<br />u.rkes c.nrpcn\llion pmvi\ion\ ofScdn,n l7(xrollhc l.uhn C.dc.l \hill. fonhwiln conrply wirh lhos Irfi,vht,ns..
<br />WARNIN(;F,ilrrc ro $curc sorkcs mfrpcnsri'n ..vcr!Bc n unhsful. and shall \ubicr an coploy., b mhino! Fiahix,nd
<br />ro otrc hndrcd thousaid dollr\ lSlU).in addnioi tr rhc co( .rco rp.nslrtun. drnDCG ds flovid.d lnr rhc
<br />olrhc Lnhr (i c, rictunrkl
<br />6
<br />DEELASAIION
<br />I hcrchyrflir undorFidryofpdrjuryrhj I rn li..n*lr drrl$ri\nnrofChrfl.r9(.oinMi.ingwnhSd.rki7(xx)).lI)]vi{iotr:l
<br />.I rhr Busincs\rnd [,rorr\\i{rn\ coJD. MJ my liccn\c i\ in llllnx.! ud c0irr
<br />Iq \41
<br />o < l',r
<br />CONEIAUI:IIIINITNDINC.dGEICI
<br />I hcrchy om.nuMcr I'cmltyofFrjurylhol rhsc h 0 cotr(rxdion LMirS lgcncy tu rhc psfornrmc ofihc work Ior {hicn lhis,,crrril k
<br />tsucd iScc. :1097. Civ C.r.
<br />AITI.I(;ANfDEITAAAI&N
<br />l lxrbyt limru.,l$ Ntrihy ualcrjury otrc of rlrc foll,,wirt ddcld,rionsl
<br />Dr'n,lirn,n Pcrmils Ashcnos Nolifidion rcdcrul ltcaulations (Iirlc.l0, Pan6r
<br />-Rcquicd
<br />L.n.r of Norifrdi,n
<br />-l
<br />rcnify r har th€ fedcral .c8lltrtions rcEadinS lslrslos .crmval m ml 0pllic$lc ro rhG Imrccr.
<br />I..dilyrh! lluv.rd rhisrnpli.arionri $trrrrhrrrhu rtx'vc irli,rnurion i\ c.iic.r IigrL{hcomtlysirhallCnyandCounry
<br />odinrm$ und Strrc tiws rch'inBto huilding hcrcby0urho.izcrclr.*nroriv.sofrhhCn,a Counr,locnlfqe.$c
<br />*ovc rtunrn,md ln,pcny nn
<br />Af,pli.dr or Ascnr Si8ndu,€; V/u/ta
<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 />Rough Ductwork
<br />Vents /)
<br />Toilet Boom / Clothes D rye(7-25"1{x.%d
<br />Residential Range
<br />Hood
<br />Type I Hood
<br />Type ll Hood
<br />Grease Duct
<br />Fire Damper
<br />Openings
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Above T-Bar
<br />Rough Mech.
<br />Final Test
<br />Meter Release /-..\
<br />FINAL V-15-lK h"\IL1LI
<br />Notes, Remarks, Etc.
<br />Other
<br />lnstallation
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