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MECHANICAL.INSPEGTOR RECORD <br />APPROVALS DATE rD/srG.COMMENTS <br />Appliances <br />Metal Fire Place <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 />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 />Final Test <br />Meter Release I .::) <br />FINAL rl J? <br />Notes, Remarks, Etc.\J\ <br />q-L8-+4 ?1,4,t2- 9 7.-et tbo€et/-- t-Ila*reu$l <br />!I vt <br />OWNER BUILDER DELCARATION <br />I hmry.rm undd pd.ty of pdjuty $a I m ciopt to6 rhc cof,rffroB Lic@ L5w for rh. foltoeins ,@tr (se.?011.5 <br />Bsin63 .!d Problion Cod.)r Ary Ciy or Coudy sttt ..qut6 ! Fni lo otsttud. .ltq, impove &holah or i.r.n dy <br />ntuclc. Fb. lo il! isue...to 4qui6 th. lpplic&l for such pctrn lo fib t 3ign d dmt th.d lE or sh. is lica!.d P@ad . <br />ro rhc Frvisiod of rh. Conn.cldt LicnFd kw (Cb!pl6 9. Comcing w h Scrios ?OO0 of Divnion 3 of lhc Bu'ds ed <br />ProfBioN Codc) or tur h. d 3h. i! q@pr ths.fron @d thq b05i. for lh. dl.gcd croplion. Aly rilbrior ofsdlion 703 L5 by dy <br />applicdl ror a pmil sbjc.r3 rt 'pplh&t lo acivilp@lyofnor 6oElne fiv.lundr.d doud ($J00). <br />-1. <br />s oM6 ofth. FoFny, or my .dptore wilh wagd s lh.ir elc .onp@stliotr will d. dE *o* dd $c !EuG@ h rcl <br />intdd.d oroGcd for $lc(Sc,7044, Bsir6 ed ProftlliocCod.: Tn. Conmctol! LiccMt wdo6@lgPlylomoMdol <br />$.pmFty who hoild! or itoFoB rlEet! ed who do6 Mh elt hi@lf or 6sstf or lhrcush hb or ha oM mployc, <br />pblid.d lh.r sch mFD!86! @ mt inlatkd or or..!d 6r sL.Ii lhwd6.lh. t{idin8 or itprDvffil b sld widrin on. }d <br />ofempkrior rhc olrrn Blildq will halc $. bu&r ofFovirg lh, h. or !$. did mt hrild or imFoE lllc FDFty for dE pillo* of <br />-1. <br />soM6of th.propdrr. m.x.lsir.lycontmcling wilh lictucd.o rado6to @.nod thcFojdl (Se 704-{. 8Bl!6 <br />snd hofrsion Cod.: Tnc ConkGtoa! l"icc@ Lrw do6 nor ,pply to sD om.r o lpropsly who b.ilds or inproc lh6oo. <br />ad vho @.uacls lor luch Foj.ctr with s Conrr.cto(s) lics.d puu@r lo Oc conrr.cror's Licd. L!w). <br />-l <br />m ex.mpl undd sarion , B. & P.C. forlhh rB).. <br />lt.rq Orne.:g!85E8!:CAM8!N!AION <br />DECIAEAIIA! <br />I hacbr srnm uod6 F.6ty orFjury otu olth. fouowi.g d.dardoc: <br />-l <br />hsc ald till roi rin a CdifiqG olcoMr lo S.lf-lNr. fo, wrk6a onlp.Nlion. s pDvid.d for by Sdd@ 3700 of ft! <br />Llbor Codc for ftc Ffor@c. of lh. erk for whib th. pqsil i ksu.d. <br />-l h.v. .nd will mai ail work.B .of,pcMdon iauu.q d r.quircd by Selion 3700 of th. t bor Codc. fot thc psfotrec. ol <br />lor {li.h lhis Ftf,nir is ilsuol yy wolksi corposation insumrcc.diq md policy um6ro.: <br />9l'.+- r".rl <br />1€q1 1-zz*rl <br />-l <br />cqlit rhd in lhc paromanc. of rt No* lor *hich lhis ,.mi is ku.d- I lhdl rol dploy ey pdsn i. &, @E <br />$ s ro t€o'rc subjer to $. wod(6' coep.reaion lr8 or Califoni4 md $E thar if I slbuld b..om. iobjer ro rh€ <br />*0*6' amp€oetion povi3io6 of Sdion 1700 offi. tihn C.&. I nu . tonhrilh comply witt $o* pr.rilioB . <br />WARNINGT Faillr. lo Ku. uorl6' mmpdsatio. covras. i! u.lawiul, od slBll subjd an dployd lo ciminal p.o!hi6 ud <br />civil lircs up lo on. nundred thousnd doll6 ($100.000). ii addition ro th. cost olcompc6.lion. dmag.s 6 providcd for ihc <br />Sdion 1076 oathe t*or Cod., n{cc( ed llrotuy'! fc Rr*-/tlztrt-20'tq <br />IIffXSED-QtrlTAclA& <br />DliclalduaN <br />I h6by a0'@ undd pemht of lojury th,l I m liceis€d unds I,o\ ision orchrprd 9 (com,ffiitrs silh Sdlion 7000) of Dirision l <br />of rfi. Bsin6s ud Prca6sioN Cod., dd ,ny lic.6. is in full torcc a.d .Od. <br />^14 <br />A sfi'l3z <br />3.2"- @ <br />colsrtrlcuolJ,lNlac-dclxcr <br />I hRby .mm undd Fmlry o f pcjury Oal rhd i. a conslo.rioo kndinS osdcy lor l!. pefotl@.c oa$c lvorl for *fii.h lhi! Fni' b <br />issu.d (Sec. 3097. Civ C ). <br />aEEUCAAf![lLI8Ar]Atr <br />I hset, at'm undd dalryof pdior. o.c olthc louoNin8 d.cltroltuns: <br />D.,nohio6 PmneAshstN Nolific nnr F€dtral Rclulalions (rillcir0, Pan6) <br />-Rqun.d <br />Ldl( olNotifi calion <br />-l <br />c.niry Od rh. aeddrl r.gublioN Eseding 6b6los rdoval e 661 alpli.ablc to lhis prole.l <br />-l.ditthar <br />I hav.@dlnisapplic6tionadstal.thol lh..hov. inronnalion b conal, I.EElo onply wih allcn, d county <br />ordinancd md Slotc Lows rhtiis lo blildii! coisltuclio[ ad hq.by aull[rtc rcrre alilc oflhis City .!d Counry lo alc lron ttt <br />attrre nEnrioned prop€ny for insper <br />Applicmt or A8ctrl Sbnalu -4- <br />MEriV^dA <br />I <br />: <br />=