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MECHANICAL.INSPECTOR RECORD
<br />DATE ID/SIG.COMMENTS
<br />Appliances
<br />Metal Fire Place
<br />Evaporative Cooler
<br />Furnace
<br />Compressor
<br />Misc. Equipment
<br />Duct Work
<br />Pre-lnsulalion
<br />lnsulation
<br />Rough Ductwork
<br />Vents
<br />Toilet Room i Clothes Dryer
<br />Residential Ranqe
<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 />Final Test
<br />Meter Release I
<br />FINAL 6/27 w/1
<br />Notes, Remarks, Etc. / t I
<br />OWNER BUILDER DELCARATION
<br />I h.Eby !firn und.r Fmlry ol p.rjury lhd I m cxcnfl fmm llE Conm.r6 Lico* txs for tlE lollosing E.$o (5...7031.5
<br />aosinsr rnd Pmfssion Codc): Any Ciry or Colnry *ttn rcquircs tr rEni ro ondtuci. alrcr. iryrmvc, dcmlish or Eprt My
<br />snucruc. prhr to ns iisue., als r.q!n6 rh. .pplter lor skh pcrmn ro file ! sigmd slaleerr rh.r lE or !h. i! lkcn$d puMr
<br />ro rhe Fovisions of ihc Conrftlo Lianscn lr* (Chlplcr 9. Com@ming wnh Skrion 70OO of Division 3 of rlE Blsincs afl!
<br />PDlcssions Codc) o! rhll lE or shc h .icnlpl F.lion lnd rhr thsis aor rh. .Uescd creoprion, Any viotdio, ol S€don ?Ol1.5 by atrl
<br />rpllic. for a Fmn subjels rh. rpplicdnt io 0 civil p.mxyol.ot mn lhm lik hudrcddollr* ($5m).
<br />-1.
<br />a. owF of rhc pEltny, d ny employes snh wrgcs a lnct $h ompcB{liof,. sill d., d! sq! md rhc tu@ is mr
<br />int ndsd or ofi.rcd fm slc (Se.?044. Blsims! lnd PDfcssionr Cqj.: Thc a.nrEcrn r Li.o* Llw .t6.s .or amly lo rr oemr of
<br />rh. p|DFdy sho boildr or i,pmB tlE6G sn who d6 $.h wd( himsclf or hcN.llor l,h!8h hie o her opn.oplot6.
<br />,,mlidcd rhlr such in,'ovft sd hl inlgdcdoroffccd for sb.Ii lbft6. rh.h)ildiw o.invr)tm h sld sirhh on. jrd
<br />of6mddi6i. tlE Ow.r Built willluE tlE hrkI ofpovi,E rh8r lE n sh. did ml tdild or ilprcrc rh! lmFiy ro' tr pEFoEof
<br />-1.
<br />&sowncrof rhc pmp.'ly. merclusiv€lycontsting wnh liansd conrmcroF ro @nd cr rlr lrDjdr lS*.70,44. Blrim$
<br />anr Pm&sii.n Coilc: Th. Coflr,croas Lic.nr. be do6 nor lpnly ro e 6so( .tpr.Fny sho builds or inprorcs lhcmn.
<br />and who conh.rs fu such pmj.cls with 0 C.nrr.cio(s) liNtr*d pucus! ro th. Conrr.crols Ltctrp Lnw).
<br />l onrcrcmfl und.r Sc.r a & P.C. forlhis (ason.
<br />IQBf,EB|L.qAMIENTAIIA
<br />DECI.Af,AIIO!
<br />I hcmby {liiro undr pcn0l'y olpcriury on olthe followine del,rdrions:
<br />lhavcurd qillnrntrrir !Ccriili.rrc ol'Conrni k) S.lilnsurc litr sorkcrr $nDcnlari,,n. a\ nmviicd turbySc(i(n,.l7lx)ofihr
<br />t,rhtr Gxlr, k)r rhc Flfortun.c of rtu qork fin whi.h thr Fcnnir N i$ucd
<br />luhncc.os eqliEd hy S(lion 1700 ot rhc L{bor C.d., lor tlF l,..fomm. of
<br />conlPcn\dnn, in\urnn.ccrricr rrl Irli.t un$c. uc
<br />,ao d
<br />I eniiy rhar in rh. Frformnccolrhc ror* for whichrhii p.rhi it nsucd,I shlll not cnrr lo, any ,crv, n in anr md.cr
<br />$ oslo beq,m subjcd to lhc wortss compcnslion ld{s ofcllifomia. and aEEe lhor if I \hould ll.coft slbj{t b lh.
<br />*orkrs conf.nn ior trovisions of S.dion 3?0o of rnc bhor Code- I shlll. hnhwnh 6nply wnh th6e pevirions..
<br />WARNING: Failorc k, ecnrd workc( conn nsarn'n ovcdsc is unLrwful. aod shdll snbjcr M cnrbrr ro siminsl ocMlri.s and
<br />cilil li.cs un 16 onu hudrcd rh{sand dollm (sIOO.U)o). in addir rh. c.sr ol.omp.n*'ion, do@ecs as providcd for lhc
<br />inrcr.{ u,lrno.tuy \ 1..\
<br />e
<br />LtgNliElJru&[raa
<br />DECL EAIIUN
<br />I hcnby irlrmundd pcMlryol trrjuy rh l rN liNnan und.t tn.vnio. of Ch{lcr (, (conrmncins qilh Scc' i,n ?Om) or Divi\nD I
<br />of rh. Au\i'rcs\ rnd Px,fcsiu,\ Codc. dd nyliccnsc i\ in lull tnr Mdcffc.r.
<br />AZA b67re
<br />CAliJIB!(lIO[UiNl)lICr!1i}]NQl
<br />I hcrcby lfarm undcr lrnrltynlIErJUry lhll lhcrc isu connruclion kndins lscrcy for lhc pcraottu { oflhcw.rk for which rhis lEnni' n
<br />i\srcd (S...1097, Civ C.).
<br />a.Pfl.lcaNfl)lr!:l. a Il()l
<br />Ilmhyi0nDU cr l]cnrlry oipcrj'tr, orc oirhc t,l!,sins dcchrarion\:
<br />D.nnnirion Pcrmil\ A\h(no\ Norillcarnn, Fcdcral Rcstlrrion\ (1-irl.40. I'|r a,
<br />licquitd hrl.roi Norn. i(nr
<br />I .cdiry rh.r rh. rcdcrul rc8uhlions Eg&ding $hcstos Enxrvol u. ol aDlkablc lo lhis lnoj$t
<br />I .cd ify lhn, l hdc rcnd rhn opplicdion d s rc rhd rhr *.rc inr.mliotr h .oB.cr I r8re ro comply s irt ull Cir y Did Counry
<br />.rdinarccs and Sralc ljws Ebriia rD l,uildin8 .o.{o.rbn. Md h.rchy arrlxtrir rcprcsni,tnrs.frhis Ciry 0nd Counrylo cnls won rlE
<br />t t/>,
<br />V7.'rrD,
<br />II
<br />APPROVALS
<br />Smoke Detectors lnstalled
<br />,*,, L/l
<br />knd6! N.m.
<br />-
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