|
MECHANICAL-INSPECTOR RECORD
<br />APPROVALS DATE tD/stG.COMMENTS
<br />Appliances
<br />Ir,4etal Fire Place
<br />Evap Cooler
<br />Furnace
<br />Compressor
<br />Misc. Equipment
<br />Duct Work
<br />lnsulation
<br />Smoke Detectors lnstalled
<br />Rough Ductwork
<br />Vents
<br />Toilet Room / Clothes Dryer
<br />Residential Range
<br />Other
<br />Hood
<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.
<br />Final Test
<br />Meter Release
<br />.{/.4q0 9)FINAL -il1{1t9.
<br />r h.r.by .m,h und.r ,.,rr,y or *r*, *., , ,. *".rlJ'"1',unl'i*,Hlli'il** ,- ., r" .r.i., ,**" ,*. ,0, , ., ul
<br />and Proassion Cod.): Any Cily orCounly which r.qut.s r pcmn lo omlrucl, rlt.r. impror.. d..olirrr o...p"i. "ny.,-.,*..6n,!i$ue., rllo rcqutB lnc lppli.rm fo, su.h pmn ro (1. ! iigNd 3tlr@fl rh.r h. or rh. ! li..B.d p6uml ro rh. pror R,oN oi rh!'
<br />Contldoas Lrc.N.d l-.w (Cll.pl6 e, Comn.rcins wtrh S..lro.7ooo oaDrvBion I oalh.8$rn6s a.d Proa6sioB Cod.) or lhst h.',
<br />rhc i3.r.hpr rhfto'oa.nd rh. bat fo.rhc al Le.d .x.mpr ion . A.y violdion ofSction 701L5 by My.ppli.! for. p.mn subjccr3 t..
<br />eplionr lo r civil p...ly of nor oor.lhrn fiv. hrdr.d doll6 (1t00).
<br />.._1,c own.r o f lh. lr.pcrly. or my .nploycB vilh wtrg6 as tt.n sol. conp.nsrlion, will do th. wort and ln smdur. is not inl.nn.d
<br />or of.r.d aor sl. ( se 7044, BBin63 in! ProLslions Cod. Th. Co.h.roa. L'eN La* do6 nor .pply ro in o*n.r ol rh. prop.n,
<br />*ho buildr or inprovd rha.o., .nd *h. do6 ruch work hilNllor h.Mlf or rhrourh hi! or ho own .mpLy.B. polidcd rh.r trr.h
<br />inplo\th.nr! ac nor inr..d.d or ofi.r.d foi $lc. lt how.ts. rh. buildnt or impro!.dc n sE sirhin otu y@r ol coopl.rion. r,!c.
<br />Ow.a.Build.r*iu h!\c rh. bu.d.noaprovi.B lhrr h.or !h. nor build or impoG ror rhc puQo!. ol$1.).
<br />l, s ow.c, of rh. prop.nr, !n dclusivcl, .onrr.clins wirh liccB.d conr.crou ro coBrtucl lh. Irojcd ( S(. 7Cs. Bciin! ed
<br />Prof.lson Cod. Tr. Conrncloas L'c..$ tlw do6 nor lpply ro u ow6 ol prcpdl, *ho boil& o. inp,6!6 rh.r.on . &d eho
<br />contr.t3 for 3uch proJ(ri * h a Contrcto(3)l(.n!.d puAum lo rh. Cont.dor'3 L'c.N. tr* )
<br />I M.rcnfl uddsccrion .8. & P.C. aor rhi! r.aon.
<br />Dal.: Oerq:
<br />uaatsEalcaltsEls4louEcl4S r!a.N
<br />I hcr.b, ifiinn undd p.nah, otp.rjury on. olrh. aollouin! d.cldmrionsl
<br />I hrv. md *,ll,n.ini8in i Ccniil.arc ol('otuqm io S.lilnsurc fdr worl.rs conlpen$rbn. ii provded lbr hySecr6n 3700 ofrhe
<br />ljbor Cod.. l,(lrlh. p.rfomncc oflh. wo for rvhich lhc p.mil ir issu.d
<br />|Z/.*,. -o *,,' -" -,. *rr e, a onDcn$r 'on ,nsurrncc. ss rcqurcd hy sccr,on I7oo !i rhe Iibor cod.. ror rh. p€,ronnatrc. or rhc
<br />nr6'k fo, $l',chrhi>p€ m trsu.dVyqu,t.'rcomp.nei'.n'n.u'r,.\a',r'rndpolhlnuhb.rd.
<br />,P*u,{t c-/-
<br />n^*, /<-tAo.oOACZef 5 l-=
<br />(Thissdionn..d nol b. conpl.lcd iarh. p.mil is aor (h. hondrcd dollm ltloolorle,
<br />_l c.nify lhlr in thc pcraom.m.oarh. work aor anich rhis p.rmil is issu.d. I shlll nor.oploy rny r.6on in any nann.r so 6 ro
<br />b...n. subJ.cr lo th. srkcu omFnsrion L*oac.liaornii. ind.BrFtlEl f l should h.@m.rubJdl toth. mrtdt
<br />f Sdtion l?00 ot rhc kbor Cod.. I 3hall. ronhwnh comrly s irh rhos. po!i!ios..
<br />--I --:i rc- ---
<br />WARNING r.i&. to aur. woll.rs @hp.nsarion @v.tus. B urbvful. lnd 3h!ll rubjer e .mploy.r ro c.iniMl p.MltG rnd ciril
<br />fin6 up ro oft hundr.d rho@d dolla (1100.000).in rddnioi ro lh. cdr ol.omp.Eriotr .t!ru96 6 providcd fo. lh. Scrion 1076 of
<br />rhc L.bor Cod.. '.tcr6t.nn.no@y r ad
<br />UCEISEDII)XIBAqIOBIUEELAAIIO!
<br />I h.r.by aflim undq p.rollyofpcrjury thlr I m liccoscd undd pm\hion ofChrprq 9lconmcncils *irh scclion 7000) oroirilion I of
<br />thc B6in.ssrnd Proa6sions Cod., and my li..nr is in tull forcc ond.flal z??tzo"r*"*r'B c
<br />cg}!tS!JEfl9}-!!!!AgiCElCv
<br />I h.r.by amfln undd p.mhyofpdjuryltul rh.rc is a coGrruction lcndins u.trcy ao! lh. p.rfomlnc. oathc {ork ao. !hi.h rhis ptdn is
<br />issucd (S( 1097. Civ C.)
<br />ACSUC NTsDECIAaAIOX
<br />D.oolirion PmnlAlbclrN Notili.arion F.d.6l Rcgul6rioru (Tirl.40. Pd 6)
<br />R.quir.d Ln6 olNolifi .rlion
<br />I c.nifyrhrt lh. a.ddslr.sublions Eslrdins sb. or rmoval aE nol applicrblc kr lht projccl
<br />_ I c.nit rhar I hav. rcad lht rppli.arion Md srar. rhrt fic !bor. infomarion i. cor.cl. I agr.. to compl, u ilh rll Cny lnd Counly
<br />ordinrnc.s rfld Slalc trv3 r.lsrinslo buildins construcrion. and hd.by iulfioriz. t.pr6cnt.ri!.s ofrhb Cit, lnd Counry ro.n.r lpon rh.
<br />.bo!. o.otioo.d propcny
<br />Z*r z-z*-z'-z ,'i,.-S
<br />Mr\wP51\Pemlt-lnspection Fonns\M€chanlcal-lnsp€ctor R€.orddoc 03 31.06
<br />Pre-lnsulation
<br />I
|