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MECHANICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS <br />Appliances <br />Evaporative Cooler <br />Furnace <br />Compressor <br />Misc. Equipment <br />Duct Work <br />Pre-lnsulation <br />lnsulation <br />Smoke Detectors lnstalled <br />Rough Ductwork <br />Vents <br />Toilel Room / Clothes Dryer <br />Residential Ranoe <br />Other <br />Hood <br />Type I Hood <br />Ty ll Hood <br />Grease Duct <br />Fire Damper <br />Openinos <br />lnstallation <br />F.D. Drop Test <br />Above Hard Lid <br />Above T-Bar <br />Rough Mech. <br />Final Test <br />Meter Release I t 2]l <br />FINAL 0 I <br />Notes, Remarks, Etc. <br />{)WNBR DT'TLDF-R DT:I,CARATioN <br />t t Ehl .m n unls lcMlty ,,, pcrFry ih,r I n crmfl rt'm thc Conkkt,^ Licne 1," nn rlE follorins ..N,n rS..70ll I <br />lruiirc\s ! l ltofcsi'n Cixlc) ny Cir, dr Cdnry *hkn rcquiEr ! Fnnil ro oNrucl- !lr(, ii{'rnvc, d.mrlnh ot qf,r any <br />,tudud, ,ritr r,, ik FruM., !lv' rcqunus lhc qTli.unr r'r such lrnnn lr' fi|. ! sistud enrc'rnl rhd lI or shc n liucnerl Nru0nl <br />ro rh. Enviii.n. ol rlE Conrr*ttr s l-i.n<d trq lchafl$ q, cd'nnrNin8 *ilh Scclion ,ur) or DiltiDn .1 oI rh. Burirc\( ind <br />Phr.*hnr ( dr ) d rhir rE or ilE n .r.npl rlEcfior lui rl* t'!<ir t, rh. rlkscd ct,ry htr An! vr,Lrhnofsdion 7l)ll 5 hr_.ny <br />lFtlic! nn! Frn'n n,hFlsrlr rpdiu ro !cirilI'cnrlryofLn dn(rhrn fi!. hunl,.J ir,ll,r I llu)r <br />,_l. r' trs mr nr tlr I'n'FdJ-, ,r nrt rtrrflo)rc( udh <br />" <br />rtr\ r\ rh(n aJt . n,|tn! knr. sill do rt ${(k lri rh. {n(r! i\ ri <br />irfmldl or.rfcrd nr sb(SN 7(!4.llu\irc$ !ft1h'ncsDn{(dlc l'i. (nntn.ktr \ l.tcn'c li" lnc\nd lPtlyl.rno*mrof <br />rhcpolrny sk) hrikh nr iq8tr\ r,*G,n- u wlx,d({t\och*1 hnn\.ll(h.rscllurrhrnr8hii\,trh.rowicn'tl{,y.c., <br />prrvncd rhar such inF.\cnrnhuc rn N.nLrl uorTm\lrfi \,lc ll ll)*(\u. ihchiHinEor n{notr'ftnr i" all sihnoN r!' <br />nfdr$Lrr)n,rh.(hftrAli .r rillthrrlr'h{n!ool flurtn[ rld,r.r\tu dil 'r ttu'ld or tr!+nl. dt fnlxn] tr rh. t'uqn{ol <br />l r\'N'krolrh |m)l{n). rrr(1tr!,ul).rnki(rt'S tdh lNrt{J..nni.nt\n,((trlr!(lr tr"F.i rS( 7(i!r. }lu!nf$ <br />rxi lhnfs (inle lhr(in fld,tr\l'..tr\rlx*lnr\rcrrfnlJr,,rt!Nn(',,lfr"tc ! qh" hurld'"' uPn,r.\rh.'.ot. <br />rtr,l $h' r,d'n.r\tur\u.htnr.r\\rhi(-(r'r.nrr\rh.r"qllf0'{r,rnt,rltr(irnrdtr\li.rn.el.r{) <br />l)al. <br />I|t.8li.txl_lunlll tr!a!l,I(t rf,ruut <br />Ih.'.1,y,lrr'n' trrlr' t).trJlrv !,ltu rtrri o0. orrhr I'i I'i\trrs rlrl( t(N <br />-l <br />n E d will nilnr.h. Csrlftn. of Co4nr lo S.ll{ E fd qxtd orpcrudirr. B FaiLd ld by Selin.l7fi) otUE <br />LIbrC..t . fordrFfre of llr rqt l, rtah llE Fnn a !qad. <br />xlrw..d *ill mifl.j! Mrl6'.onp.tr.ri,n iNnr. .r EquiEd h, SBlhtr l'rln otllE Ubo.Co&.lor th. Frll,llrE ol <br />*ork lu *h(h rhnFrnrn iJ Its M, *,"rc. $ryr"dk,n insunm oni td r.li., nunlE, d.: <br />Arz f4 <br />Tbto-oowTTzal 1[ tlz.ozt <br />_lrtn'ryrhlr iortx Frfortuft.trlrh. *ork ftrrh.hrhil Fmnr n N\u{.1$.ll.or ctqrl'ymy ltr$. inn.ymnftr <br />$ ns lo tEom rulrr{r k, rh. ui,k(r, lotrqE.eri'n L*!ol('{linmi!. nfrl lsNc rhni irl rh,uld lE{om rlbFr ro r,r <br />Nolt.F Nnlltnqri('n pmvnirn{ olSern,n l?(x) Dlrli ljhn Cftlc- I shlll nrnhsirh.\,n{ly silh !h,{ p$tishn\ <br />$ \R\t\r,$bFr a diploFr 1o dlnBl Fflli.,.,n <br />.Ml firl on lo G lEid!.d rhouqtn &[,8 ltlq).G),. i. .ruil of @trF s.rih. .Lnq.* e povil.d ad th. <br />sdln 1076 0l rlE l,id c0&. idcrd .r!d .'arev'r <br />-*.2122-( I zaZb ^*-,.- <br />I.II:EISED.GOMIAGIIElg:utAllqu <br />I i.cby .nm !i&r F.ry d F jury dn I u Uccd utr F.vtbo o(O!FE I (6dtnthr eht s..rbn ?lID) ol Divilir ! <br />of dE Ad!6.d Eot ibB Co.L..n ny lile b h tul torc.il.,bct.i8 <br />*", al?4 lzot-o"-.** <br />(-oNirDllcTro LE{ntrG acI'N(Y <br />I h.rd,yrf,ir!'nd FdXyofFriu.ythn rlE b. oinnrior hdi!.rtry lor llE Fforttre of rlt kI tot r|l!h fi& p6nn i! <br />h"Ed (s€ 3097. civ. c.). <br />APPLICANT DECI--/\IATION <br />I hdtt!' ,flinn xnd( Fn,lty ol Fllry or ol rlE follN '.t dc(b.d io.\ <br />D.mlirn lcrnilrArtE{G NdirE ion lcdcill Rcsubli,fi (1ib{,, Pud6) <br />-Rcqunct <br />lrllcr ol Mr ifi.drn <br />o\rc rtrrl3r norrlttilf,xhLrr rh6 pnr(r <br />-l <br />ftnif, fid I h.E E d rhn lfpla.rbn th.r rlE stbt. infomra.. ir (*r.r I alE l. s'rt,ly s'ilt !{ Cn, !'d Or y <br />.rli"x .c\,rkl \r.i.l ,'s!rl.itrr! !,lii l(l i{i trl ltr'rntrtrrh,rvr 11!.\roltrtr(\ or rhr\ (irr rn (i,! rY ro.inr ur)n ilr' <br />rh^r nrtrrkn'.(l |'.1{n\ 1,tr \t11f,tr' <br />,\rr kJrr ,f \rL d \, nn <br />Qeu ,-^.,€[u4$ zo <br />,ELUK4lUKit <br />II <br />! <br />Metal Fire Place <br />I <br />"**"r.t e? <br /><1.14 <br />r