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MECHANIGAL.!NSPECTOR RECORD <br />APPROVALS DATE ID/S!G.COMMENTS Oru-Builds Dclratba <br />I horry lmm ulda palty of pqjEy rhd I E @pt foE tbe ColtrEtoE' Li(rc kw for thc folloviog run (8.703 I .5 BdiD6 <br />ud Prcftssioo Codc): Any City or Couty which rcquim a pcait to @Drtrd, Elts, iEFovc, <Lmlirh or rqah ay rtrurtur, Fior to iaiswc, rlso roquiE thc ap,plicsd for such Fmit !o filc r rigrod d!t@t thst hc or stc b ficocd prga o thc povisbu of tbc <br />Coorncror's Licancd LEw (Cbrptq 9, Co@@irg witi SE{io! 7000 of Divicba 3 of th. hEiB aod Profasiou Co&) or rhlt h. 6 <br />rhc is ao;l thac&on ud tbc basir for thc allqcd aogbn.Aay vblrbn of Scrion 7031.5 by my rpplicut for 8pm[ sbj6t th. <br />rpplic4prto a civil pcaa&y of rct mrc tha 6vc huldrcd dolba ($m). <br />lZ, s ow ot tdFopaty, or Ey oployc with waga s thct rch oryoraio4 will do tbc wort ad tbc srrurtre ig rct iaradcd <br />or offacd for srlc ( Sc.7044, BuiB tDd Proftrsbs Co&: Th. CoDtstor'r Licc Irw do€ Dt qply to E ow of th. FoFty <br />who buil& or imFos &@q ed u/bo do6 nrc.h wort hirelf or ha*lf or thrcugh his or hc om opbyrcs, fovi{tod thrr $r.b <br />imprcv@@t! e mt imodcd or offaod for ulc. I{, howm, ttc hildiag or impovaat i! sld whhio oE yw of ooplctio4 thc <br />Orc-Bui.ldq will havc thc hrda of pmving thd bc or rhG Dt build or impow for thc prpos of sb). <br />_I, u ow of tlc Fopqty, u qclwivcly onmaiag with licanod @ltrrton to oDltrEt thc polrt ( Se. 70aa, BuliDd Ed <br />Proft$ba Co&; Th. Corrcor'r Lirrc Iry do€ rct lpply to e ow of !:otEty who builds q iEFovs thsaa , aod who <br />oofrt3 for $ch Fojcls with r Coffiq(r) Iicalcd Fnurd to thE Coelcbr's Lic@E Iry.). <br />-IE <br />udq for this reo. <br />DEtc: <br />(t 2!.DO <br />I hq$y sffim ulda poaly of pcjury oa of thc following <br />I havc od will uiaain r Cstifqtr of Co@r to Sdf-lDsw for wrl6' @Epa&tioo, I providcd for by Sccbn 3700 of thc <br />Labor Codc br th. pcrfow ofthc wort for which thc paail is isrod <br />J havc sl will nrirrh rcrtc' oqosdi@ iqraocc, a <br />rcrt for which this pqmh is isrod My wortc' @Ep@srtio! <br />rcquircd by Sdbn 3700 of thc tabor Codc, for th€ pqforue of thcime miaud policy !ub6 rc; <br />PolicyNuba: Expiu: <br />(Ihis ryior accd rct bc @Eplltcd if thc FEit is for Ooc hundrcd dollm {St00} or lcs) <br />,y'*tfyldutAr}rFforrcofthrrc*forwhi:bthispqnitisisr4Ish8llDtcqbyuylmninuyresstorfccuc nbjat o tlc wrt6 ' orpasrioa lry: of C:lifom4 od rgr thd if I rhould be.rc $bjcct !o rbr worto' <br />fovilbu ofsrtb! 3700 ofthc labor CodC I lhslt fonh\dth with thos provisiou.. <br />6 .E-oo 6 <br />WARNING: Failw ro w worhc' omposation ir ufEwftl ed sbrll nbjcr u oplolu o qiniul paahic and civil <br />fiac up o orc huo&cd thouad &lL6 (S100,000Xn "idirin! to rb. coa of oopanrtio4 dugc u povilod for tbc Soctioa 3076 of <br />thc Labor Codc, id6€{ md rtorDcy's fc. <br />LICENSED CONTNACTONA DECI,/\NATION <br />I ha$y rtrrE uods poaty of pcjury tlat I m licancd udapovitio! of Chrytq 9 (om@i!g with Scdiol 7000) of Divisbn 3 of <br />thc &siru aod Proft$bs Co&, ad my liw B ir full fore od cffcct <br />LimClrs:_ Li.rcNEbq_ <br />Dale: <br />CONSTN,UCTION LEIYDING AGUICY <br />I hscby rtrrE ulds panty of pcjury tha rhsr i3 r so*Iuctio! ladiag !g@y for th. pqfotDre of tb. wo* 6r which tbis psnir ir <br />irncd (Sc. 3097, Civ. C.). <br />lada'sNe: <br />Iada'rAd&u: <br />Doolitioa PmitgAsbcstos *o*o r* rffiffi <br />_ Rcquircd Lata of Notificdbr <br />I qnfr.b fu.lrcgubti@ re[diDg ubcdw rovrl re ut sDplicabtc to this po]rt. <br />_yf,etity ttat I trvc rad thir ppticaba od *rtc tha tbc rbovc iDforutbn is @m.t t lgre to oEply yitb <br />&di@ ud SttG Is rcJrtiag to hildiDg oDfiitctbq ed bfrby rutborizc rcpratdic of thb City rDd r <br />all City and Couty <br />Couty to @tq upot ihc <br />lbow EldioDcd prcFty <br />Appticrrt fi rgai <br />Pminc."a(Fiat): <br />Pupos.6/q o6 <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. <br />FinalTest <br />Meter Release <br />FINAL