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MECHANICAL.INSPECTOH RECORD <br />APPBOVALS DATE tD/stG.COMMENTS oNN!]R B(III,DER Dr]l,(IARATI('N <br />I hcrchy rlili,nu cr FnulryoffrrJ!ry Ihar I mr crcnDr fror rh. Conti.r,n t-i.$\c t-!tr li,r rhc hll,'trin! r.rv'n (S.c 70.115 <br />Aonn.\s lnJ Profc\\i(r Codr): Any Cny ur Cuudy $hi.h rcqun.\ x Nrnir ni (onsn'd. rllc. inpnivc- {tcnx,li\l' ,tr rctrn r ! <br />rmli.r ln!rJ--nni \ubjccr\rhc rpniiu rt,rcirilPlnrlryormrnnn.rhx tu c hudrcd d.lldrs r Js00) <br />-1, <br />as owmr of rn prcFny, or my cnployes eilfi *ascs as th€n mb cotrWns{ion. sill do tlE wo aid lh. tulm b mr <br />inr.n(H or olIcEd for sh (Se,7U4. Businc$ and EsfesrioN Cod. Th. Co ra.rols Lis.sc bw docs ,or q,!ly lo an owB of <br />lhcpDp.dy ph.t ilrs or inrmrcs llsrn. rn who d(E sn hft tinrclf or h.elr or ihhrgh his or hd owD cn loyccs. <br />[ovidcd rhrr *h irlilorftnk m mi int nd.d oroftnd for eE. ll horcE tlE buiuin8 or nt{'rctm'n h $ld wiihi. orc ]e* <br />of.onrpleriotr rh. O,ncr Au dcr wil IEE rh. hldsn of prcling lhar hc or sh. dil ftn t{ild or irqmk lhc pmFry for ltf, purlo$ of <br />-1. <br />&s owrcr .t rhe lh$cfly. um dcluxilcly onrEcri.g pnh lkcnsdl contMror ro oBrruc' ltl proj.rl (S.c. ?044. Busits <br />and B$LsiJn Codcr Th. Conlrmtols Licc.$ L.w dcs mr opplyro !nowrcr of ,mlcrry who buildi or iolDw.lh.mn. <br />ond who .onrmcrs for slch rmjdrs *irh a Co hclo(s) ltcnsd I,!r@ ro rhc Conna.lof. Licc.s ks). <br />I om.rcmDt undcr S*lion . B. & PC tor thisRrs. <br />]IOBf,EB&I;IIMTESAIIIT! <br />DIII.AIAIION <br />I h.Eby .mro udcr Fnally of p€{ury oE of lhc follosing d!$lellions: <br />I hr\r rnd will hnnrir r Ccnilicnt. ofCorsctrrh Sclf.lr{trc Iir workcr' coflrp.!\rrid,. r\ po!idcdfurhySc.riotr:r700otrhc <br />l,'hn(odc.lqrhcprrt rnrmcof rhcwork,rtrNh'.hrhcNnnir isi{\ucd <br />_lhavcandwillmi lin workch con ie nrlrion ins!6ftc, !s eqoiEd h, sdion l?0o of rhc Libor Codc. for th. Itrforn1:m of <br />rlr *oII ior *hich rhis lcrmn i! i$cd. My workcn coqEnslrion iosummc ffi.r ed lrltynumb.r e: <br />_l anifr rtsr inrhc Frfo.Mrce of lh. worl( lor which lhh pfnit is L*ucd.l shlll mr cmrloy 0n, pcr$n in tny Mftr <br />$ as ro bc.om subjd to thc woiGr ompcnsrtu h*s of Calilonia, and agG rh.r if I should h..om subjd to llt <br />wo*c( compcnstion pmvisions olSclion lT00 ofth€ Llhor Codc.l shall. fonhwilh@oply wilh llhe pmvishfls.. <br />WARNINO: Failurc b scurc sortc^ conp.iurio Llvcnsc is unLwful, Md shnll subj$l !n cmllorr lo cnmind Fn lric$nd <br />ciril ftrs !p r0 orc hundrcd rhn!{od dollu\ (S100,00o). in duu3cs !s providud for rlr <br />Sccrbn .10?6 ot rhc lilnr c(ic- inrmn an 'o/tryZrL e-- <br />DIIIJAAIION <br />I hcrchy atnm uMer lcn0ltyoln€rjury nEl I anr licns] unrlcr pmvnbn ol'Chtrtrd 9 {.onncn.in! wirh Scdhn 7ux)) olDivnn,n.] <br />of rhc Busin.sr anl Pturclsi,ns Codc. und my li.ctrr is in tul| ln(c ud cfl'd. <br />(f <br />?o <br />CONEIBIJCIT!]NINNDINCNCEIII <br />I hcr.by dtfirm undcr tx.rlrr orr.rjuryrhar rh.rc is 0.onnrudi). th,iD[ rsc'Nt r(, ih. F-.rronhrtuc.rrlr qork for shi.n rhh rcrmil i\ <br />is\ucd rs.c :10')7. Civ C ) <br />AITL&ANI.DIiCLISAUq <br />llmhyrninnuidf ncrrhy Drp.rjury om oilhc followinB dccltrrurnnN <br />Dcmolirbn Pcnnir$Ashcsos Notilicarion l-cdcra, Rcsuldnrtrs (Tirlc to. PM6) <br />-Rcqlhn <br />krrcror Norirr ion <br />md Counryt0 cnlcr ut'on rlE <br />'d <br />Appliances <br />Metal Fire Place <br />Evaporative Cooler <br />Furnace <br />Compressor <br />l\4isc. Equipment <br />Duct Work <br />Pre-lnsulation <br />lnsulation <br />Smoke Detectors lnstalled <br />Flough 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 />Openinos <br />lnstallation <br />F.D. Drop Test <br />Above Hard Lid <br />Rough Mech.l/L/lq 5Ntq <br />Final Test <br />Meter Release <br />FINAL l/l,ul7 S\8 Y <br />Notes, Remarks, Etc <br />Above T-Bar <br />a <br />L.nd{isNam: <br />- <br />t nd.as AddEs: <br />cdily <br />'har <br />the ledcml r.8llations rcSirniu ushcsros rumv{l m. nor drpliclblc ro $n pbirr, <br />.k,vc trntiomd rop.ny aor