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MECHANICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Appliances
<br />Ivletal 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 />Bouqh Ductwork
<br />Vents
<br />Toilet Room / Clothes Dryer
<br />Residential Ranoe
<br />Other
<br />Hood
<br />Type I Hood
<br />Type ll Hood
<br />Grease Duct
<br />Fire Damper
<br />Openinos
<br />lnstallation
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Rouqh Mech.;,Lq--A .//tlN,,.0
<br />Final Test
<br />FINAL ,-/3"/B Q.t (4 ep
<br />Notes, Remarks, Etc.
<br />OWNET BUII,DER DET,CARATION
<br />I h.rcby nfintr und.r Fnrhy (if Frjrtry lhll I afl qcnu ln,n l hc Coord.s Liccnsc ljw lor rhe ftnl(,win8 t.r$n ( Sa.7l)J l 5
<br />auntrct{ ni PknissnD Cod.): An, Ciry or Counry whkh rcAuncs 0 lcrnrir ro tod(rucr. !lr.r, inrFovc. dcnnlirh or toprn an,
<br />soctr'ru. pritrr,, irs isur(.'..,1$ rcqutcs rhc qr c0nr r.rnrch rEnnir ro,llc a riln.d sdrcnrd thol hcor \hc i\ li.c0sd pusurnr
<br />ro rhc pmrnnrn\ ol rhc Conrrartr\ Li.c.*d ti* (chnptcr q. ComnEncing *irh sc.rion 7(xx) or Division 3 .flhc Brsincs\ and
<br />Pn,tc\\i,'n\ Cdc) or rlur lf,or \hc i\cxcnDl lhcrch ondlk+bn\i\ntrrhcdlkBcdcxcarPri.n. An,viollliooorS..lidr701l.5byuny
<br />,prli.rnr fd rp.nnirsuhl..rsrhc !pplicinr io rcivilprnrlrt.fnor mrc lhan fivc hundr.d dolla6 ($50O).
<br />-1.
<br />os own.r of rh! ttuFnr. or sy enq,loyds wilh wags as lhcn $b conEns.tion. wil do llt *ort !d lhc $ridw b ml
<br />inr.fldsl or offcEd lor sh (Se.?044. Blsims md Profcr.io.s Codc: TIE Conlrelol s Lians tt* d*s nor q,ply ro !n ovtut oa
<br />rtc lorE ry who ltuitis or ir{r@ ttE@tr lrd wh. d{Er Mh w* hiRsclf or hcelf or ihrcu8} his m h.r o*n.tr{,ldy€ci
<br />p.oti<tcd rhur sncn in{i6wr.ls N ml hlcdcd orotu l'or sle. ll tFeE, th. i[ildine or inpbtmnt ksU wihin nm Fs
<br />ofo'ri,l{ioG rhe OwM Builtr will hav. th. hftr.n ot pmving ll[t h. or sh dil ml ldild or irioolc !E t oFty for thc plIpo* oa
<br />-1.,\
<br />osrcrorrhc Imtlrly, !mcrclusivclycoilractinS silh liccnsed conrmloB locon(tu.Ilhc Eoi.( (S*.'7044, Burincr\
<br />ond Pmtsshn Codc: Thc ConlBcrors Li.crsc Ltw d..s nor tpplyro Mouncr orprcpcny who builds or imprcvcs lhctcon.
<br />and sho conrturl i6r snch poi.ls {ilh n Conlncto(s) lt.nsd puA@r lo rh. Cdntacrols Liccnrc L.w)
<br />-l
<br />rn.tcDrfl untur Sccrtru .ll & l'( li,I rl,,\ 'cn\nr
<br />IOXf,E8S:.COMEEMAIII')N
<br />DECI.AAATJI]N
<br />I h.Eby .mrh !trd$ lcMlry of pqjury om of rh. rollowing delearioff:
<br />I rhr(i c.larrkjrrlan[Nc.llic tr.rk,nrshich l[c |tflnir i\ i\\!cd
<br />-l h.vc 0d will
<br />'Eintoin
<br />worteB onpctr{dion iosrraR., N rstuiE{ bt Sccli.n l?00 of rlE tibor C..L. for tht p.rfomm. of
<br />d. work for whth lhn Fmil ir hsuc.t My *ork6s onlp..sdion insmna fficr !d lolty numh.r e:
<br />Policy Numb.r:-srp
<br />-l
<br />cenili rhnr inrrE nc.rormrc.f $c wort for which lhis Frmil n ({,cd.l shall nol.mPloy otryPcron in an, tunner
<br />$ .s ld lE o,m subjcd k, rhc vo*qs'comrcnrrrion hws otculif.mie..nd l8N rhal iaI slhuld bc.om lubicd lo rlrc
<br />wolk6{ snF.raiion ,mvisions of S.clion 3'7tlo of rhc Llhn Cod., I shnll, fonhwilh corq,ly wiln lho* pFvisio.s
<br />WARNINC: Faihrc ro $dE *ortcu omFnelion srcs8c is unlawtul, ond shall subj.ct o.q,lorq lo dihitul PcBhics d
<br />ctuil fincs !p ro oe h!.d.ed tnousdnd dolls (llOO.o0O). in sddnion lo $. .osl of coqrmalion. d.tu8er !s Prcvtdcd fo. tlE
<br />Sccrion :t076 of rnc Lrb.r tuc. inicEsr and allomy s fes.
<br />LLAEIIEDI;OtrIEAIIqA
<br />DII('I {RATION
<br />I hcr6y afinnr und.r |)cnJlry ol !.rjuy thd I rm li.cnk.d udcr pmvisnr.rChlt)rd 9lconnmncins wirh s..rhn 7fiD) olOivisn,n:l
<br />of rhc Bu\nrs d Pror'.ssions Codc. md my licctrsc n in tull Lr.c 4d cff..r
<br />B: I ieN Numt r:
<br />C!]IEIBI]qUQNTEIDIIC.&GEN(I
<br />I h.Eby rnnn undcr ricnrlry of l.rjury I hm lh.E t a Lu(ddion lcndins uscicy for rhc Pcrrbrnsrcc oa lh. *ork ftt whi.h rhis Fmil is
<br />issucn (ss. ltr97, civ. c.)
<br />A.ttj.t( NLDr(I,laalIar
<br />ll+!*hyrnnr ndcr pctrilry,'rt)c'j'try onc or r[c nn[Nirs d{lmri{n,\
<br />l)cm'lIirtr Pcr rir{ \tii.\Nor]li.rrtrtr, FcdeBl RcguLr(,Nlli(lc+o l']Jrl6)
<br />.- -R.qut.n lrrr.roiNoriliii(nr
<br />Alplta or Aacnr si8turur.
<br />PqrnirN tunE([irl)
<br />IIII
<br />I
<br />Above T-Bar
<br />Meter Helease
<br />-l
<br />ccniryrhar lhc liderd r.lrlnrion\ elu'linE $bcsos runmvnl R nor appli.abh ro lht pmrc.t.
<br />l.crtifyrhnr I h.rc rcrd thh lptlicarion and rr{c rharth.dhot itrfonMln,n is torcd l,siLtro.onflywi'h.llCilrlndCou.ry
<br />ordinrn..r and Star.lrws rcl,ring Io buildins con(rudion. ud h6ehynurk,izc r.trcscnl,tivcs oflti\ Ciry d Counryto cnlc! ulon Ihc
<br />nhov. nrnrn,n.d pr,Fnynn irsFttiotr pu('osci
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