40111088 - Permit - Laserfiche WebLink

Home Browse Search

MECHANICAL-INSPECTOR RECORD DATE ID/SIG.Own.rBrildd Delrarid I bftby .lfim undcr Frdty of pcrjur, ln.l I h dmpr fdm ir!. C6rrrd.rs' Li@. bw fs lt. foll@in8 lt&n Gd.?031 .5 BBinqr dd Profsior Cod.)i Any Ciry d Couly which rcqliB r pmi b @Btrucl. Bllq, improv.. d.molirh tr Eplir ey ilrlclur., prid l., iti isuecc. also rcqut6 lnc alpli@r ld !!ch parn lo fih t sitr.d lld.tMr lh.r hc o, !h. k li@is.d puBu&r to thc Provtid! of rh6 Conr'c'o* Lien&d L:w (Ch+16 9, Cml@cing wiin Seti@ 7000 of Divirim 3 of lhc Buin6 .nd P.ol6ic Cod.) 6 lh.l hc o, sh. i5 .x.mfl d'q.fron ud $. b6ir fo 0'. .llc8.d .xnplid .Any violatio of S@tim 70r l 5 by dy rpplimt fq . ,.mit loblec d'c applicar to a civil F .tt, of not n@ tnu ,lv. hu&cd dollu (1500). _1, s own.r of tn. Fopcny. tr my .mploy.6 gidr wrg6 d tt.ir tol. .omp.nrarion, will & lllc work dd 0E suucrur. is not i .ndcd or oll6.d fq s.lc ( 5&.704., Bsin6 e.l Proa6.i@r Cod. Th. Cont&tor's Li.ai. L.* d&s nol .pply to d oyn.r oa ln. ,ror.ny who buil& or improve th.ffi, ud *ho do.' luch wqt hiftcll or fi6d4 a $roo8h his tr hd own .mtloy€i prorid.d thor suct ihprov.tu.t dc nol inlddcd u off.Bd fortal..I( horcva. th. blildinSor improvmnr is rold within om y@ of @mphtion. fic owi.GBuild., will havc th. budc, of povin8 thd h. q sh. nor build d ioprovc for thc prrros. of !alc) 1.6 oM.rof dr rrcp.ny, d dclaiyrly olBtin8 with lims.d @n!'etoE to coGhd rh. prj.d ( S.c. 7044. B6i.6s sd Prol6io. Co<L Thc Cdlr&lort Lica* Lrw dc nol +dy ro owrd of prcp.ny who b!il& s iBFov6 thdm , 4d yho conk4ts ror such prcj*Lt witt . Co.r&to(, limr.d plFuut ro tt. Coil'&lors Li..ni. L.* ). I M aopt undd Sdioo ,1. & P.C fd $i5 ,!.m. WORI<ERS COMPf, NSATION DECLARATION , ha.by .tfm undn pcn.lry of pejury @c ot lhc follwirg rlccl6r.lin: _l hav. dd will mainllin r Cdrificr. of Conrc.r lo S.lf.lnr@ fd w(t6 compd..rio, a provid.d fr by Seion 3700 oarh. !.bd Codc, lo ln. p6fd1Me of 6. wo.t fn which ln. Fhit is ii5u.rl. _l hav. ad willm.inlrin w6k6 compoB.tid insuMcc, a rqund by Sccion 1700 of lh. Labd Codq for tn. ,.rfomoc. ol $. wor* for which thit p@it is is@d My wcl?R' cmpc.s.rion dorue cdir ed policy .umb., e. Policy Nmb6:_ElpiBl (ThL @rie r*n .o! b. @plac.l if $. ,mn ir fd Oi. lM.lrcd dolle {l l0o} 6 la) _l c.niiylhat in (h. pafomMe of $. wort for ehich tlis p.dith issuc4 l ihsll nor mploy 4y p6on in dym n.r so s to K-^\t wARitING Failurc ro wurc sort6 Mpcmario fin€s up to on. huidrcd $out&d doll6 (l100.000),ii th. Labo, Codc. intddr sd du6cy i ac6 - @vfi.sc I ohwful. hd rhdl iubJ*lh mdor/b ohr.l F.lr6 sd.'v,l lldino to $. c6t of @mFrdrm, dm.s6 $ !'i!ri&d fd $. S*tin 1076 of LICENSEO CONTRACTORS OECLARATION I hr.by ailim u.d.r pd.lty olprjury tlat I d lic.n*d undd rrcvilio oaCh.9lr 9 (.mm!n.io8 wilh Scction 7000) olDvision I of rh. Bu5in6 Dd Prcfsioni Codc. od my liee is in full fre Md.,Lcr ,"" \-\3O4 I nd.b, linm und.r p.ahy of p..Jrry lnat lha. h d conn,uclid tcnding agmcy fs ttq p.rfomrcc I *ort for which rhE p.mir it isslcd (S@ 1097, Civ. C) A?PLICA]IT'S DECLAR.ATION D.molnion PmiB'Aibdos Nodfication F.d.6l RcSrl io.r (Till. 40, Pin 6) _ R.qutcd Lar6 of Nodfi qrio _l erdfy rhlr rh. f.dcr.l r.Suldohs rcSdding sb6t6 rmoval &. nor.r9lietl. ro lhis projer _ I drfy that I h.vc r..d $t appli.rj@ md $ar. tlEr rh. !!ov. infomarion is c(m.r l.8re ro.omply wrrl ali Ci ordin-6 od Star. L.es cl.ri.s 10 buildin8.orstrucrion, Md rcprcscnl ivd oa rhE Cny ed Coonly ro.ntd upon rhc .boe. mcnrion.d prcpary o Appliances Metal Fire Place Evap Cooler Furnace Compressor Misc. Equipment Duct Work Pre-lnsulation lnsulation Smoke Detectors lnstalled Rough Ductwork Vents Toilet Room / Clothes Dryer Residential Range Other Hood Type I Hood Type ll Hood Grease Duct Fire Damper Openings F.D. Drop Test Above Hard Lid Above T-Bar Rough Mech.l-11 ,rtlt A4-,,?- Final Test Meter Release FINAL 1.-,f=t q .*t- An- APPROVALS COMMENTS lnstallation I =