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MECHANICAL.INSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS Ownd-Build.r Dccln.rion I hd.by rmrn !nd.. pen.lly of p{jlry rhll I rm cx.nd aorn rh. Co.tndoa Liens.ltw lor ihe followirs ra$n Ge ?011.5 Busin6s and Prcf6sioi Cod.); tuy Ciry or Coury ehich ,.!uir6 ! pmil ro on tu(l. !hr. improvc. d.noli$ or rcFi. uy situclo... prio, t, it! is3utu.. .ho Equtd fi. .ppli.&r for such pmir lo 61. ! sistud sr!1.@nr rt.r h. or shc iJ lic.ed ,Buan ro rh. prevbioa of rhc Conllacror's Lic.ns.d L.s (Chlpid 9, Comh.nci.s wnh Setion Tool) of Divrbn I ol $. BBinds lnd ProfB,ioB Cod.) or th.l n!'or rt. ir .r.n,l rnr.6om .nd rh. bsi aor th. tll.8.d .r.mDtion any violition of Sdrion 701 L5 b, oy !ppli.&t tor ! p.mn rubj..t rhc ippli..d 10 i civil pmhy of nor nor. rha ivc hun<tr.d doll@ (1500). L c ow,r of rh. prcp.ny. or ny .mployB with wis6 ts th.t rol. comp.nsar ion. w ill do rh. worl a.d thc arruc1u. ii rot int..d.d or oller.d lor $1. ( Se 7044, BBi6! .nd prof..ro6 Cod. th. Coilncroa! Li@n.. Lrw do.r oot .pply ro rn own.r of rh. pop.ny uho build. or iinpro!6 lh.rctr rnd *ho d6 s(h wo.k hirs.lf or h6.lf or throuh hi5 or hn ow. .mploy.6. provid.d rh! 3u.h improv.ndrr &c nor i,r.nd.d or oll6.d lors.k,It hovcvd.lh. b{ildin, or im!rcwm..d ii sld wnhi. on. y.& ofcomplcrion, rh. O*n.FBuild.r will hr!. th. burd.n orprovina rhar h.o, lhc nol build or mprovc tor rh. Durpo!.or3rlc), _l, Bown6ofrh. prop.ny. ih Gx.luliv.lyconmclinB eirh li.mcd conmcroF to codrtucr rn. proj<r ( se. 70,14. Bdnci! Md Prof6non Cod.r Th. Conl6clois Lic.N tr* do6 nor apply ro m owF ol p.op.ny who blild3 or imprcvcs th6.on . .nd who conrrlds lor such proJdB w h r conl,!cro(, I'c.n!.d puaunr lo lh. conrrctoa! L'eme llw ) _l.m.x.npiud.rS..rion .lt.&PC for thie r.ason IAruiIALC9MIEISAIIAN.AECLAAAIIQN I h.!.by alfim und6 p.nrhy otr.rjury onc otthc follosins d6ldtio6: I hNc.nd sill m.i.[in r Ccnif'. . of Cou.nt ro S.lf.lcur. for @rk.B coop.nsrion..r provi,.d for by Sdlion ]?00 ofrh. Llbor Cod.. forlh. Frtomtu oftn wo* for qhich rhc,.mit i! i$u.d. I hav. lld wrll ma'nrlin *ork.rs romp.nsalon insunnce.ns r.qutr.d byS.cl'on ]700oflh.hborCod., forrh.p..lormnc.oflh. worl aorlhrchthu p.rmr t '$uâ‚¬d My work.rs cohpâ‚¬nshon 'nsurdh..a('d ind pol'cynumb.!.8: _________Exptcs: lThB r.crion rccd .or b. coopld.d ifth. pmil is fol Onc hundrcd dollm ($1001 or lc$) I cenify rhi' in rh. p.rfomrnc. ofd. worl for whkh $is pcmn is isu.d.l shrll ml mploy rny p6otr in My m.nnd!o 6 to b6@. subFct ro rhc *orI.B comp.n$r io. hwr ol Calrfor.ia. !.d lsrfr lh rf l sholld bâ‚¬om. subjd to the worr.B co,npctrarion provisions of S.clio, 1700 of th. L,sh.ll. foahenh conply rvirh rhosc wAmiING F.rlurlro se!r. workds compef,s..o!.rrs.6unla*ful.andshlllsltrecl.n.hploy.rtocrim'@lpe@llr6rhdc'vrl 6.8 up ro on. hudrcd rhousd doll.rs (1100.000),in additionro rh. cdr ofconp.ns ion. drMs6 a prolid.d ro, th. Sdion 1076 of lh. trbor Cod., inl.rd lnd anorn.y 3 fd ucElslDsqNraAcraE!2lcta8aI&N I h6.by .mm und6 p.mlty oatc.jul rl[l I m lieB.d n d6 provkion of Chlplr9 (omn.ncins wilh Sdlion 7000) oa Divirion I of rhc Bdin s.nd Pmf6sioN Cod.. md oy lic.6. t in tull forc. rnd.fcl, tic.N.Clui:-?I ?oiqtl 5/rl ta,c,* ?rof.r{i<'-.. co!Erauer!9!lE!!t!9-aEENt! I hcrchy r(id und.r p.nalr, oipcrjrr rh rhcr. is r cosro.rion l.ndiry ucocy ior rh. p.rlomanc. ofrh. rork aor which fiis pcrmil is issu.d(se. 10e7, civ. c.) APlllgANrs-0Egdaduq! D.mlnio. P.dil!-&b. os Norifi.ltion Fcddl Rceul.lio (Tiil. 10, Pln 6) _ R.quh.d krrd ofNodicdion I c.nify fiar Ih. r.dc6l BaulrtioB r*ardinr dbcsros rcmo!01 ar. nor appliceblc lo rhis prcj.cl I c.niry th.t I h!v. rqd ltus lpplicalion.nd sral.rhat rh. abo!. intormation is cor.c1 I asr.loconplysirhrllCiry&d Counly ordinan.G ind Sul. lrw3 in8 ro buildio! cocirucrio.. a.d hd.by aurho' iz. r.pr!s.ntrtiv.s ofrhis Ciry lnd County ro enlcr upon rlr .bov. m.nlioncd plopcny s/t )ra Appliances Ivletal Fire Place Evap Cooler Furnace Compressor Misc. Equipment Duct Work Pre-lnsulation lnsulation Smoke Detectors lnstalled Rough Ductwork Vents Toilet Room / Clothes Dryer c..L\.rB -))oe*q u0 Residential Range Other Hood Type I Hood Type ll Hood Grease Duct Fire Damper Openings lnstallation F.D. Drop Test Above Hard Lid Above T-Bar Rough Mech.(:.2't-ts llaraP (,19 Final Test Meter Release FINAL /--ttl - /4 .DoJ"+-rvr) 03 31 06