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MECHANICAL.INSPECTOR RECOHD
<br />APPROVALS DATE ID/SIG.
<br />Appliances
<br />Metal Fire Place
<br />Evaporative Cooler
<br />Fu rnace
<br />Compressor
<br />l\,4isc. Equipment
<br />Duct Work
<br />Pre-lnsulation
<br />lnsulation
<br />Smoke Detectors lnstalled
<br />Rough Ductwork
<br />Toilet Room / Clothes Dryer
<br />Residential Ranqe
<br />Other
<br />Type I Hood
<br />Type ll Hood
<br />Grease Duct
<br />Fire Damper
<br />Openings
<br />lnstallation
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Above T-Bar
<br />Rough Mech.1/<//tt :*>ffr
<br />Meter Release
<br />FINAL 1/tt/tv y>q-6
<br />Notes, Remarks, Etc.
<br />o\VNI]R BUII,DI.:R DEI-CARAl-IoN
<br />I hrrch! riftr oid.r Irixry,rrlf,rpry rhrr ldr crcnDr lion, rhc (_r,nr&rr{ t-iccn{ tn$ tur rhc li)lt,)wirA r.rer 1S0.70.115
<br />Br\inc\s rM Prolcs\i, (i cr Atry Ciry or Cuunry rhi(h r.qurc\ r Fnnir !i con(r.|- rll.r. irpr\.. d.ttnnh,r rrtrn rnj
<br />rn!1i.rd t{n a p.nnil uhjc.l\ihc apDlicrnr l{, rcivilt.nrlryolnor nxnc rh$ n\c ht nrd Jollr\13500)
<br />-1.
<br />as ovncr of th. I,mFny. or my cmplotss pilh we8s as tbcn ot smpcnsalion. vill (l. lhc wdt ldl dr ntre ii rc!
<br />i erncd or or.rcd for *lc lS(.7044. Busift$ ,nd PDtessions Codq Tlc Conradoii Lhcnf tiw dEs ml q,ply lo e owncr of
<br />rhc pDIErty who btrilds or iq,mws tlEmn, srxt wh dc trn wd{ himrclf or hcmlf or lnrcu8h nis or hs o*tr cmlloyccs,
<br />,mlidcd lh.t such imrmtmnls @ ml hlcrH or otu for sL. lt no*cwi llE huildin8 or iryoemnt i sld wilhin oE ]td
<br />ofotrphnD. rlE owNr Bui06 *iI t,h 0r hnbn oll,trti.g rhd hc or sn dd d hliU or inpmw de pmFly lor thc purpos oa
<br />,1, s o*nc. of rlF prcFdy. m cx.lusirely mnr,clin8 wirh liccnEd .onl,lcloB lo onsrtucr lhc prcjcd (Se. '7044, Bulitu$
<br />ard EDErsi{Codc: Tlrc Co turol s Lic..s Law docs mt ltply to an o,nc. of nrolcny who hlilds or iofiovcr rhcEon.
<br />and who o.rrek fd .Eh p6j.!ls wirh r Coorero(s) lic.nscd puBumr ro rhc Conractors Lkc.* t2v).
<br />-l
<br />sm .rcmpl und.r S€ction- A. & P.C. for thn Erson.
<br />ltoll(nRs' coltlPErlsarl(lN
<br />DECI.AIAIIO!
<br />I herct y lmnn undcr DcMlty of Dsiury om of lhc fouo*infi delurlhns:
<br />-l
<br />lurc atn will tuinhin a Ccnifr.r. orcon*.t ro Sclllnslrc fo, workcs compcn$lhn, !{ Frvi{ted fo, by S.crion 37m of th.
<br />L.bor tuc. fr ltf, Frfoimme of lhe e for,hich thc pcmil is L$ucd.
<br />I h!v. a.d will tui.tain work6 comp.nsarion iBuramc. ac rcqutcd by Sd ion 1700 of lhc Llbor Codc, lor rhc lcrfo.rrec of
<br />ll'. eort lor which this pcrnnl is ksued. My vorkds $npcn$lion insur cc coid ud polty nunlxr @:
<br />e,\r\tc tl-rnc,
<br />z\t ,, Azb/tb
<br />l.cniryrhar in rhc l.rrormrncc ofthc w.rk for which rhh p.rmr h nsu.d. I shlllnot cmployrny pcron h any nruncr
<br />so a\ lo hem E subicl ro lhc wo*sl conpcnsalion lles oacaliaonio- and lsN rhlr if I shilld bc.om slbj.d
<br />'d
<br />rlt
<br />norkcH compcnselion tmvisionsofSslion lT0Ooflhc Lntnr Code.l shall. fonhsirhconfly wirh rho$ ptuvi{ions..
<br />WAnNINCT Failu,. ro sue workc* snpcns|rion ..v.ragc ir unlrwtuL , sholl subj.rt !n .n{)lorr lo aiminol lEm]lts rnd
<br />.iv nnN ut ro oe hundrcd thoustrnd dolln (slmJno). in addirion to lhc cosl of comrcNdion, danascs !s P,otiled foi lhc
<br />Sclion 30?6 ofthc bt r Codc. inler.sl ond allormy's fc.s.
<br />o*.. 7ll'illR
<br />LICIINSELCANI&TCIAf,
<br />DECU&III()!
<br />I hcr.b! rrrrnrundcr Fnrhyol p.'jrrt rhrrI rn lt{i{d undcr !n,ri\n ofChrDr$ 9(connRn(irg $ilhSccrion TlXx)) ofl)ilni,r.l
<br />ol rhc lnAir.$ rnd tnncssi,rx Co,lc. rBlnryli..n{ i\ ir tu ll lnid rtrd .frirr
<br />'7t26ll9 .*,*n*,
<br />COISBI]CUIIITIENDIIiGITiEII
<br />I h*by !frim u.<tc. Fnrlty of p.dury rhlt thd n ! onsrru.rion hnding sgdy for thc pdfomN of ihc ert fo. srrich !hj. psnil i!
<br />isso.d (Sd- 1097. Cie C.).
<br />_l Lrdiryrh,r rhc r.d(rl rcgularionr rcgtrdire a$.sror rc'mvalrrc nol rflrlic.hlc io rhis pmjccl.
<br />-/4cc(i{rrhlrIhols,cadrhislnpliqriondl{trr.rh3irhcltx,vcintrnurionkcotrc.l.Irgrerocomply*irh!llCilylndCounly
<br />odinomc( aftj Shre ljqs rclarins ro buildins con(rucrion. md hcrchy aurhonrx rcr.cicnurivcs ,,rrhi\ Ci'y and cou.lyro cnls ulnn lhc
<br />0&,!c mnliomd Im|xny rd ins pccl ion p!,!o\c s
<br />Applico or ASc SiEMlurc
<br />-7t2 5/18
<br />i
<br />2
<br />I
<br />COMMENTS
<br />Vents
<br />Hood
<br />Final Test
<br />*,.*, lo(7? 3{
<br />lrndcis Addrc$:
<br />-
<br />apu rr:,lr,ri orii*r,lixx=
<br />l liftty lnjm und.r Fn0lry olF.jury om olrhc foln'eir8 dc.lmlions
<br />D.nmlilior Pcrmils Asbc{os Nolificarion Fcdcral Rcxuhrn,ns (Tirlc.{1, PM6)
<br />Rcqxir.d bn$.f Norifi .arh.
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