|
APPROVALS DATE tD/stG.COMMENTS
<br />Appliances
<br />Metal Fire Place
<br />Evap 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 />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 />Openings
<br />lnstallation
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Above T-Bar
<br />Rough Mech.ll,['rtrt-,hr
<br />Final Test
<br />FINAL Q-/?a//r/.)4r, ltta/
<br />MECHANICAL.INSPECTOR RECORD
<br />Ownd-Build.r D.ctor.rid
<br />I hdby .ffim Dda padty of p6jqry$n I ir .xdpt fm iI. CdE&tm' Licd. Lav fd rhc followinS Ea6 (r. 703 , 5 Bainar
<br />ed lrofcliod c.d.): Any Cit, or CNty flri.h rcquir., ! pmn io cMFuc! ahr. imprcv., danolish or rcpah Dy !rr!c$!c, prior ro irs
<br />i!rue, rllo cqdB $c lppli@l f6 N! Fail to filc i ti8rcd 3tlrdrat thd h. q rtc it lico!.d p$u ro $. Fovkionr of0E
<br />C@h.r@! Licen*d lr* (Ch4r.. 9, ColEI.ncin8 wirh SEtiod 7000 ofD:v8on I ol rn. Bsin4! cnd Prof6lio,u Cod.) or dl.l hr u
<br />,h. is d.npl &ftfim Ed lh. bat fd rt dcgd GmtPdm.Aiy,iohti@ of Seti6 7031J by ey lpplicsl fa. Fmi! lsbj6tl d.
<br />.pplicllt to a civil pqdty ofnd tnoE tba fE !u(i.d &llu (tJ00).
<br />_1,6 omd of thc FoFrty, d trry dPloyc wirh wl8B a rhcir sol..mpae ion,willdoth.wo ed $c trucr@ ir nd inhdql
<br />or ofd.d fd !al. ( S.c 7044, Blsina! &d Prof.irioG Cod.: nr. CmE&rd's Lictu. kw dN nol 6pply !o d o*n.r of th. prcp.ny
<br />who buil& dinFDvd th6!on, ddwhodo€ iuqh wort hi@.lf orhd.lfdlnrolgh hi! d hd own cnployd, Fovid.d th su.h
<br />impmvd6$ u. nol inr.nd.d or ofiacd fd !.1.. lf, lDv.v.r, tn. hilding q inprovdol is sold wi$in on. yce of cmplaion, ih.
<br />Own.FBuil.Lr will hav. th. bud.n ofproving $al h. o ih. nol build mihprov. ld !h. purpo* of salc)
<br />_I, a oMd of t. p@Fny, d oGlBiv.l, @tr.tirg *idr licd.d @r&t@ b @nstud rh. pbjcct ( Scc. 70a4, SBind ed
<br />Pref6rio. Cod.r Tlc C@B&!o.! Licalc Lrw rbd nor eply to e oMd of FoFrty who builde s idprovd lh.@n , ud *ho
<br />.@h.r lu iuch Fojen wilh . C@tt rot(r) li65.rl p@usr to $. CoDrdtr\ Licd. L!v.)
<br />_l m q6!F u&, S*1i6
<br />-A
<br />& ?.C. fd thn E !6
<br />WORKERS COMPENSATION DECLARATION
<br />I hfrby af,im ud6 p.nalry of Fj!ry d. of rh. followirs .L.l@iiol:
<br />-t
<br />h!v. 6d eill rui.itin . Cdti6.ri. of C...6t io S.lflN@ fd vdtd' compqsdid, s Fovid.d fd by Sdjd 3700 of,h.
<br />rrbt Cgd., f6 dE p.rfolruc! of tG wt fq *hi.h Ih. Fnir i! ie.d.
<br />21h.v. &d willmirl8tr wdtd' cdlatrid ill.lm4, d rcquircd by S*d@ l?00 of th. L.bo Cod., ror $. p..fomDc. old.
<br />wot fd xhict t[ir FDit is ir$.4 M, qdt6' 6,D.r4dd i '@e @i6 od policy nmb6 e:
<br />(Thit sctjd n..d .ot b. corplct d jf t,!G paDft i! fd Orc h@&!d dollG lt l00l B 16)
<br />_l cddf, $.r in thc F{()ll 6 of $c wat fn wiich Oi! Fmit i3 i!.u.4 I ih.ll nor oploy ey !d!oo in ey ,@n6 F a ro
<br />bc.e. subjd ro dE rc*m ' c6rFri.ti6 l.wr of Cdifmi." ed $e thd if I lho{ld
<br />olSdion 3?0o ofth. t boCod..I
<br />WARNING: F.ilE lo i6u. rc!t6' cmFrs!6 cova.3. ir ul.vfd, srl rubj.d u @ploy.r ro cimin.l pa.ldq Dd civil
<br />6n6 up ro @. [or&.d thMd dolle (t100,000),i. addiri@ lo th. @r of .6porsti@, &au8B 6 provid.d f6 thc Scti6 3016 of
<br />6c L!b6 C.d., intcr &d .dmcy! f€.
<br />LTCENSED CONTXACIONS DECLAf, TTON
<br />I hdhy rf,im und.r p6.lly of Fjuy tt.t I @ lico!.d u.Lr rrcvitid of ChapE 9 Gffimcing *ith S.crion 7000) of Divbion I of
<br />th. BBii{ ed Prof6!i@ Cod., ed n, liccE. ir ir tull tdrc {d .fidt
<br />4
<br />I h.Eb, afiim u.Lr pnalry of pdjury lhal th@ is . coNddio. lddin8 r8.ncy re
<br />is$.d (Sft. 309?, Cir. C.)
<br />p.raomM.. of rh. eork aor which $is pcmil is
<br />APPLICANT'S DECI.ARATION
<br />Dmdid@ P@iB-Arh.nc Notifqlon l.dlrBl R.guladoi! (TirL a0, P!.t 6)
<br />R.qui.cd Ldd ol Norifiqti@
<br />_l ccniry t'r!t 6. f.ddtl rcgul4ions rcgar.ling 6b6rs rcnolal s. nol .rplicabl. ro rhi. proj.c(
<br />'_ I @ftiry tnol I havc Ed die spplicadoo &d !r. tl:rr lt. a!ov. infm.tid is cor.ci I agr.c ro ..hply wnh dl City ud Couty
<br />ordiiecB ed Slal. Laws r.l6tiig |obuilding @nrEucdon, dd hd.b, auth orizc ,cpr6d tari v.3 oflht City d County to dh ulon i1r.
<br />!bov. mdddcd prop.ny ld
<br />sis \-z-o(Meter Release
<br />L ---T----
<br />f T------
<br />H-
<br />--T------
<br />I
|