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MECHANICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.O\']tER BUILDER DETT,ARATION <br />I hacby arnn undq pdrlly of pcjuy al I m q.nfl nDo fi. conlraclots Lic.n! k* fo, th. fouowinB t!e! (s<.7031t <br />BGinss rnd Prctsion Codc): Any Cily o. Coumy vnict rcqui,B ! p6tul ro cotr(rucl, ot6, inprov.. danofiln or tqrn ay <br />slru.n[c. prio,lo G i$xm.. also rcquim lhc spplic&r for 3uch Fmn lo filca sisn d slalool rll'ln orsn b $c.ns.d p@el <br />ro lhc !.olisioB oldE Conrncld! Lic.n*d Law (Ch!pl6 9, Comn inS wnn Salion rO00 ofDiviion I otlhc Ausind ed <br />PDf.sioB Cod.) or lh6l hc or sh. is dmpl lhd.&os &d rhc bsis lor thc cll.s.d .rdFion. Any tiolalion ofsc.lio. 701 I 5 by tDl <br />applicdl for s pcmil subjdts lh. agrli. t to . civil p.mlty of nol iorc lhe ,iv. nundr.d doll6 (S500). <br />-t. <br />s oMo of rhc FoFriy, or ny cnployG ein w{g* s lh.n $L @dpcE iio!. will do llE w* dd fic ,tudc b ml <br />intod.d o.of.Ed for stc(5*.7044, B$iIB sd Prcf*io Cod.: TncConh.loi. Licce t wdo6.olPPlvlodoudoa <br />lhe FlFly wi6 hil.b or imFov6 th.oc ad who .L€ sch *oih hins.lf or h4lf or &Fosh ht or ho o@ @91ov.6, <br />povid.d rh.r such inprcvqxiI! e 6l i.ld<Ld u otu for slc. l[ ho*d6.lh. hildiiS or itr'FsvdMl b sU sinin orc rd <br />of@rpkrio!, rh. O,.o Builds win ll,rc Llc huda olprovirg tlEl h. o, sh. did noI hiE or improE th. FlFly for tlE p4o* of <br />-1, <br />s o$M oftb. Fopqry. d q.lsiv.ly onr6cri,8 wnh licd.d cont aclou lo coilhd lh. poiel (Sc 7044, Blxind <br />sd hofstr Co&: Thc Contrrcloa s Li..ns. Law do6 nol aPply !o 6 ownq olProP.d) who blild. or imProvB lh.@!. <br />dd eho ornEcl3 lor suct proidr! wlh a Cr tt4o(, lic@.d Pdurl to lh. Conlra.lor'8 Lt@ L€w) <br />lm.rddurd6sd'on ,B&PC for ttb r.en <br />1498588!:.CqI,IfNlArlq! <br />D&CI48AUO! <br />I b@by dfm urdd p@.lly ofFjury on oflh. followi4 d..ldlioBl <br />-l <br />hrvc &td will nairtlin . C.nifical. of Co,gl lo Scll-Ltc aor Mrldt @sp.Nlion, d Fovii.d for bv Sclio! 1700 of tb. <br />Llbor codq ror rh. pafomecc oath! wolr for $,li.h rlE pqni i! isu.d. <br />Y+m*;;l:n.inlai! wd(.c compcNarion iEudme. 6 rcqwcd by Sdlion 1700 of thc tlbor Cod., fot lh. pofome.. of <br />Jhi. pdmn i. isu.d. My*ork.u compqsario n icuee.,4id 0d polic <br />6. <br />o) -Zr - 20 <br />-l <br />c.niry dral in th. psfomMcc of rhc vorl ht shich thi! Idnn is issucd. I shall oor @ploy my pcsotr in dv m@a <br />e s ro haom. sbjcd lo lh. wo 6'@mp.Miion lam ofcalilomia &d aIe rhal if I should heonc subjel lo lh. <br />worl6' conpdalion prcvisioB olsftlion 3?00 oflh. Lrbor Code I sh!r[ lonhwilh onply Eith lloe povilioN.. <br />WARNING: Failur. td srre $ork6' comp@lion ..v.ragc i. lnlawful.shall subjcl e mplo,6 lo aiEi., p€31ks dd <br />civil fr.6 up to oo. huidrcd tholMd doll6 (c@r of comFBtion. ddasd a prclid.d for thc <br />sslion 3076 of rhc L.hor Code intaBr dd <br />DEIIAEAIION <br />I hs€by smfln undd t ndl,oflcjrrylt.l I m limEd und.r rtDvisio. olclrplqI (.oh'n nci.8 wnh Seclion ?000) ofDivbion l <br />of thc Busins ed Prcf*io6 Cod., dd my lic.M is in full forcc and.fi-_r <br />lQrirBlJclrotrtldDlNc-dc[rcr <br />I hercby amnn unds rEnalryoapnturyrhar rnsc is a coNrodioo lodi.8 a8mct ior thc psronnrE oalhc sork for rhid rhG F.nnir is <br />issu.d (s( 1097. Cn C ). <br />L.nds r Addrs: <br />- <br />ITTIICANLDECI,ABAIIQX <br />t,Eur+aihn undd penalr, oapsjury ooc olrhc follo*nrg dmldtrions: <br />Dcnoliliotr Psnrils-AsbGk's Nolincarion I'€ndal Rcrulalions (rnle l0, Pan6) <br />R.qrir.d Ldrd olNotifi qtion <br />I cdlily tha the a.ddsl re8ul.tioB rcedding sbdd rmolal e. rct lppliablc lo rhir pojcd <br />abov. ihaolmrion is cotret I alre ro .o,nply wilh all Chy &d Counry <br />ordinanc6 and Star€ tlNs Elarnu lo iod h@by aurhon& ..!r6otdi6 of lhis Ciry dd Couly lo dla lpoi thc <br />abor c nBtioncd Drcpeny itr <br />Applicmt or Agml Sig,alu tr\. <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 />Rough Duchvork <br />Vents <br />Toilet Room / Clothes Dryer <br />Residential Ranqe <br />Other <br />Hood <br />Type I Hood <br />Type ll Hood <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 l IF|NAL >/16 /hh n r7?//o / <br />Notes, Remarks,'Etc. <br />COMMENTS <br />Smoke Detectors lnstalled <br />Grease Duct <br />o,r". ol-7o- 2 o <br />D^e, AI.jo- ZO <br />eY ?o-2^2 <br />I <br />= <br />t-