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MECHANICAL-INSPECTOR RECORO <br />DATE COMMENTS OllNEB BUILDER DELCARAIION <br />I lErcby d,Irn u..Lr F.rliy oa pcrjury fill I m er.mtl fDn llt Conlra.lm Lt$sc Llr for llE following Ea$n (Sec.ro3l5 <br />Busi.6s and Prolcrsion Codc): Any Cny 6r Cou y *hi.h rcqui$ ! Fnil lo.on( cr. tlt$. inptov., dcdrish or rcpon any <br />srruclrrc. Fk r ro nr iss!d., {lso rquiB lhc ',plicr for such lcmi lo lilc a .igmd trer.m rhal h. or sh€ i5 laencd purqa <br />lo rhe pEvisions orfi. Conlrrclols Liensd Llw (Chlpld 9, C.nNBi,g vnh SNlio.7000 of Divhion I ofllr Blsincss and <br />Prcfcssions Codc) or rhar hc or sh. B.xcnpl lh.r.ftom ed lhc b&sh for lhc alls.d cxen{,rio.. AnyvioldionolS..fionT0ll.5bya.y <br />,Dplicrm for r Fmi subjers rhc appli.!fl ro , .ivil pcMlry of nor mE rh& lilc hondtd dollds ($500). <br />-1. <br />as owE ofttr. IxDItny. or ny .q)loFcs slh qaecs s lh.ir slc @npcnsarion. piu do lh. ool dd dE nB1r h ml <br />inrutu orolI.nd for sL (56.7044.8lrircs ed ltDf.sioB Cod.: Thc Cn tucld\ Lkt!* Lw &t$ mt ryPly lo d ownct ol <br />rh.IhFny *L lnikh o irpFB r!@i. .,n wh d(E trh tu* hi@lf or lEBlf d lhreu8i his or her oqn cn9loyees. <br />previ.tcd tn{ sh inplmEnls m ml inrcdH or oficEd for sh la. hoabq. tE t ining or inprowmnt sld withh ok }w <br />of conphrb( rlE Oem, Buih( {iU hlw llE t !d.n oflovir8 lhd lE or dr <liil rcl boild 6, iqrcw nE FoFly for tlE Ftpd* of <br />-1, <br />ds own.r ofrlE prcpcrry. sm cxchsiv.ly co !&ing snh liccnscd conlrsclc lo cohsltucl llE r.eiEl (Se. 7044. Businc$ <br />ad Pmftssi{ Codc: Thc Conr@rois Lt.nsc ljw dcs nol lpply lo !n owmr o, t'oFny who builds or imimtr $c.6!. <br />a.d who conrEcls lor sh proixrs eirh a C.mturdrt3) liered I'ununl lo lhc Cor rsclit\ Lkfl* llw). <br />LDcxc'npr uMcr Scc <br />1lITBtrDINlaufEIl,:/UraNDl:ct xaurlti <br />I hc,rby rlitnru dcr pc.rlr) of p.rFry otu ol rlf tulkr{ing dc.l.rititnrt <br />I luvc xlwillnri {irrCcnilicdcofCotrs.trrhscllln\urc{otwotkcs conrp.o\dn'n, * F)vidcnlorhySccri(n,:170{rolrh. <br />Irhr 9J.. ir rh. F'nr Lnrrrr'[. trrrlr,tr ql-ich,h. r, 'irr i+u.d <br />!(h.trc J.,l willn'., J'tr B"rkc^ rcmpcn\Juri '.!unurc. as rcqunc{ty Sccr i,,n .r?m or rhc Lthor Gde. ti)r rhc PclfonE i.c of <br />hnmmi isn cJ Mv wor*cBllE L,i k-a <br />conp.nsrion i.suErc fftr <br />z /d./i-Lo2) <br />-l <br />cenify thar in rhc pcrformnc. orlic work tu which rhis lcrmil is hsucd. I shallnor cnPloy lny Pcson in 4., nr.n$ <br />h ,s b h..ohE subicl t, rhc lorkrl comr.nsar ion laws of Califonia. rd treN lhll if I slnuld tf,cotu subJ..r b rlt <br />eo*cn'@mp.nsrionpmvnionsofSction1700ofln Lihor Codc. I shall. lonhwilh coq,ly wilh iho$ lmvisions. <br />WAININC Fliturc ro *uc workcB comFtrslh. svcmgc is u shall subj..r ,n clnploycr lo dmi'hl Fn0kici ond <br />civil fincs up lo orc fiudrd rh.uend dollns ($l{xJ,(x)o), in addil co$ ofcoqEnsllion. domtgcs !s lrovt.d ror lh. <br />S(..n 1016 or rhc lltrr Cd.. inrcE{ and <br />D.r.: l- /l -zu+,-r-;, X <br />Ih.(hyrfln$rndcrFtralryorr^_rjuryrhirIrmli.cnslu.rn'ovi\6n.rchqrcre(.onnrEocins*irhs.cii( 7(x$)olDi\iion l <br />ol rhc l!u\ims\aBl Ptr,h\nna Codc, d my licctrrc <br />^ <br />if lullhr.clRtc,l.ri <br />(-r o c'4 ? =ntfilox" 7 - i 6. 2 z -s-i*r.""" <br />I hcrcby.lllrmundcr Fnah) oipcrjuryrhrr rhtd h n.o {flcriD lcndirB 4cncy lbr rhc Pcrformtrn.. oirhc "!rt for whict rht Fmir ir <br />isslcd lScc.l0i)7, Civ C.) <br />^I&IIINLD}:CIAtsTIIONIh.nby llnnundcrp.rrlryolt,crjuryomolrhcfolhwingdccl rJrrnrs: <br />Dc Nlirnnr Pcrnrir\ AshL{o\ N.nh. nr Ircdcril RcEulurions ( lill.40. Prn6) <br />Rcquncd ti(crol Norilicarion <br />l.cnily'hrIlhc {cdcml rceuht ng .slEsos r.mval m ml arulklbh io lhn t,mls. <br />landfy th^t t tnr. rctrd this !rhrr rh. !h)rc intuinrn.f ir.un(r. llgre r(' cotr,ply snh rllCiryrnd Counr, <br />odinrnes lnd Sllrc ti*\ ehr ond hcrcby aurhornc rcrcsnroriws ollhis Cilyand Colnrr ro.nro uPon rhc <br />/6 z.>z-o <br />e <br />Appliances <br />l/etal 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 />Rouqh Ductwork <br />Toilet Room / Clothes Dryer <br />Residential Ranoe <br />Other <br />Hood <br />Type I Hood <br />Type ll Hood <br />Grease Ducl <br />Fire Damper <br />Openings <br />lnstaliation <br />F.D. Drop Test <br />Above Hard Lid <br />Above T-Bar <br />Bough Mech. <br />Final Test <br />Meter Releasg iFINAL 2 //Y/ Aplb ?)-da/oLl <br />Notes, Remarks, Etc. <br />APPROVALS ID/SIG. <br />Vents <br />-<-------" <br />f-------T------