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APPROVALS DATE ID/SIG.COMMENTS OWNER BUIII'ER DEI,CARATION
<br />I h@ry lfrrd undd pae!, of Fiu.y rhd I d aoIF nln !h. Codr*r@ LkG@ Li* fo. rlE aotlowiis lasn (Sd 701t.5
<br />Butitlg !n Ph&.ion Codc)r 4,, Ciry o. Colrr, shth Equn6 . poiir ro oitntEr. $a. iftFov.. &mli.h !r, ,rp.i ey,
<br />inaruc. Fir io ir. bu.E. .ho r.qui6 d. tdi.d tu *lt Fhi' ro 6L . tir..d rr.Er rhr lt q lE i [cd.d lied
<br />b 0E FDriiiB ol ttE Co r-rdi Liu*d L.e lcll+tc 9, Con1,t@iog *nt Serior 70@ of Divlbr ! of iE ArirE rd
<br />P,lfcai.u Co<L) c rha lE d.lE i aanfl lt6drd -d rlr t-ir 6r rh. rlb.d dordbn
<br />^ry
<br />violrim ols<rbn 70tl t ry rny
<br />rpf lioir for . Fhii ubjeri rh. lrpliclx lo a civil p.uly of Nl m,. tm li!. hurdcd dollr! (t500).
<br />l. - dE of llE FlIEry. c ., apbrc $ih *t6 . d6 hb Nqa!.ir'. sil & {r Nt .d dE ftlEe a or
<br />inq'd.d ( o&rd ft. t L (Sc.?Oa4. &!nE rd ED&'*E Codc TIE Conr-rn,! li* l3 &6 Dr Al, io - orG of
<br />EFDFTy s,lD t{ib irryD6 thca! ed *lb &Ert uit ti'elf or n6df d ftrqitir c lE .M clrpbtd..
<br />poid6d lhd $ch idrr.mlt G rFl hloi.d orolE !d tr d. lf. ho*tc. E hlildiS o, tiFreEGr it eld wihin 6. t6ofcdglai,\ th. o$c Brl& will hG [E hlddr ofFot 0'r li d !,| did m bild or inttrE dE FtFry br iL F,F.. or
<br />Ls.\n6.lrh.liot61\.rr.(1"{1.1!.onh,rrtr'!\ h h..n(l ..nti.nr \ rr .fN' u.r rh t,,,Bt ISR rrirl. BunnG\
<br />rn nnt\sm(inl( lhc(.nharnnsl'(.n\.lrs(n,6n.rrml\n,nno*n6orInntd)\h.hu'l$ortrnfro\r(hs6)n.
<br />,nd rho Nnrc.lJ tu ech rnjatr $ irn a ( odr.tu(s) It6r.rt puRd b rh. (bdr
<br />r;-7
<br />I lE*'y .rm ur& Frry of ryoEot !c tollor.€ ddL.rio6:
<br />lh{rcdi*nln nrr$a('dr'lir.rcof(i,BorrtSclf-lnsur.|nr$orkscovEnsrnn.sFo\dqjnnhtS(K.17(xr lrh.
<br />l.alrn (id., rff rh. rEfonunrc o l rh. \f* fitr qhi(hrhcpdnrt * ilsu.n
<br />-l lrE dd wil, Bi'ntb srt?t .or4@.b! tDnrc r tlqoid bt Sdir lr00 ofilE Lto. Cod.. 6r {E Fh.ffi otl|! *ul foi *tit ttir Fri i in d. My *dt6 omF!.ih iE|tr. 6b -d poticy nudt G
<br />Ildrlrh ri rh. l.inrh.R.orrh.+orl ror \hf,h rhsInm 'r trstral. Iihnllnor.nplt)\ r
<br />r, iLi t, It{oDc iubl(t r,r rhc r 0r[6r' (nnFnrnr klr ltr$ s . f (-rli tur nii. ind iB,e rlh r r I shtrlJ h..o,E ruhldr k, nr
<br />\drt.\'.omrsshrnl]l.lisroBolS(ionr7(xr.rrh.lahr(i{l..l.lull,nrhrrn..nll\$irhrk,EF\htr,tr3
<br />rh {..r11 Ll.l.tr\ 1r 1' r,r r
<br />r r( r \n r)(,i\rr!! !!fr!
<br />I lflUt ilIrn und.r F.ly of ,aju.y lhd I e li.a..d u.L. Fovirhn ofct.Ia I (@irt snh S6rio. 7000) of Dtihr I
<br />or llE &uiE .d ,rokiE codc rn rr fi<dE ir i tuU loe rn.,t t
<br />talila!]clla!.rIaptltiltillcr
<br />I hd.ht_ lmm ututo FnahyorFrur] thlt rhq. ir ! mNrtudnrn bndins trsocy tn rhc p6tonn!.c. olrh.Mrk tor qhichthn FDir ii
<br />isu.d lsc l(})7,(n ( l
<br />R(ttrtr.\l I .rr.' .r \.r'l'.rrnr
<br />I 16rr[ rhd rl! fo:L..|q rtuB qsdin3 6tBrB rm\tr|(. m' q"nk!bl. lo lnb FoF
<br />.b.\ r nE iond p.lrFnr r#v
<br />Appliances
<br />Metal Fire Place
<br />Evaporative Cooler
<br />Furnace
<br />Compressor
<br />Misc. Equipment
<br />Duct Work
<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 />Grease Duct
<br />Fire Dam per
<br />Openings
<br />lnstallation
<br />F.D. Dro p Test
<br />Above Hard Lid
<br />Above T-Bar
<br />Rough Mech.
<br />Final Test
<br />Meter Release tt I tl
<br />FINAL
<br />rc /lbtw
<br />5o gr,*t
<br />MECHANICAL.INSPECTOR RECORD
<br />Pre-lnsulation
<br />Type ll Hood
<br />7\r{7[y{1Y01 \rVzt1
<br />Notes, Remarks, Etc.
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