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MECHANICAL.INSPECTOB RECORD
<br />olvNuR t UI-DDR lrr:r,(ARATX)N
<br />I hcr.by rrllr r undcr pctr.lry ol |{qury rhrr I u cxcmpr from rh. (innrdcltrJ Li.cns. ti{ l'or lhc ti,lk,sin8 r.Nh lsq.70tl 5
<br />Btrsnrsl rnd l,rott$]fl Cmlcrr Any Cn, or coumy shirh r.quncs r Ernril 1,, on(tucr- alrcr- nnF)r., dcnnish or El]atr m!
<br />srru(urc,Irior k) ii\ issuancc. rl$ rquncs rhc.tfli.rtrr li)r \uc[ ]^-.flnir ki fi|.3 sig dd {ircmnl rhd h.or shc is li..n\cd lurtrmr
<br />n, rhc nmvisn)ns ol rlE Conr'r.tr'r l-iccis.J l-nw (( h,[cr 9. (-omnrncirs rirh Sccrt,n 7fin ur Divnn r ] oi rhc Btr{inr( itril
<br />Pofc\si,)nsCodc)o!rhar h.or\hc 's.rcnrB rhcr.ti.mrM thc h$is I lhc!llcrcdric'n!rn,n Anyvioi{i(rolSccli,,nTl)ll5hy{!,
<br />rrpliLrd turapcn subjc.r\rlr rpplicrtrr ro icivilpcnnllyolnor nnnd rirn llvt hr drcd d.llrh (S5{)(l)
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<br />rs o{r.!olrhc pron nr.(, nryo'nrk,rtcs Ni(hsrA.\ r\ rlEr "'lc t,;r' vr ', $'lld,' rhcs.{l ird rht {rudurc i\ nor
<br />imNrlL{ orolnrcdtu\Jc(S.!7(!J.llu\i'{$atrdrtol.s\n,n\CrxlcThcConrrrtr'sl,kcn\cL,*dot\iorutllyt)anouN'ol
<br />rhc lx'Fnt sho hilds.r in{(,vN rhcNnr ind sho dfts {rh *or* hin$clr.r hcsrlfot rhmugh his or htr.{ncNPloyccs.
<br />p'ovidcd thtrrnrh iDl,rornr.rs at nor inrrRld orolf.r ktr srlc Il, kNc\rr. rhe t{ikli',! or nnfi.knrtrr is n,ld *irhi'r ,,nu J"n
<br />olcotrDlcltir. rla O*ncr Drildf sillluvc Ih. hurdcn rfr)rir8lld hcor$c Jil rxn triu oi i'r]4,o\t rhc PoPcnt tur rhc I]!,F,ror
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<br />dl h.f.sirrG)d.:licCo.rrr(xtr\l,ic.n\rt-rsdor\iorrt)Plytotno*.crollroPcnyqh.huikl\urimlovc\ih.rcon.
<br />l8l who.onh.r\lai{khtr)judswnhaOrnrncro(nll.cnsdpur\unrr,rhc(i)nrnclffsl,iccNcltrs)
<br />I adcxctrrfr uMf Sc.rio B & PC rrnrhn rc!n,6
<br />I iE cby,mrnundcr Fn!
<br />uaErEEi:couSENsaf:loN
<br />PT.qLAMIIi'N
<br />onc otrhc nnn'win8 dccl&B'ions:
<br />ri'na r (-cdiricircol(lnr\cnr ro Scll:lfsrrc fn {ork.r\mmpcnstion, as pDvilcd for by selion 1r0o of lhc
<br />ror rhe pdrrommcc ofltu mrt for whkh $c pcrmir is isrtcd.
<br />havc and will moinrain -olkcn conpc.qrio. insurdmc. "s rcquiBd hy Sdion l70o otrh. tihor Codc. for lhc Frfomn.c ol
<br />th. Nork for *ni.h rhis Fmit is hs.n. My mrtss ompcns,lhn insmrcc orir .od policy ,unbcr 6c:
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<br />ccnifr rhar io rhc F for@m. of d. sork for phth this !,crmil h hrurd.l.hrll not cnlloy !try IEMi in any 6d'8.
<br />$ {s ro b.sm subjd ro th. *orkc6' cotrq..sarion hws of Cslifomi., Md !8N lhal if I slDuld b.com lubjecl lo lnc
<br />qot*cB L$nFnstion povisions of Selion 1700 ol ilE tibor C.dc. I shall. fontwilt soPly wirh rlb* Pbvisions.
<br />WARNINCT Fdlurc ro suc qorkcc'comncn\arion covcmar is unldwrul..nd shall suhjcr un cmpl6y$ ro aiDinrl tEMlries ond
<br />.ivil ,lne. ulr ro on. hundrcd thousond dollds (ll ii ddiri{'n ro rh. cosr oa coMp.n n,n, drm8.s .s [ovidcd nx lhc
<br />Sccrn'n 1076 oirhc ti&rr Codc, intcrcst B.d b.{\^-J
<br />D[!!r&ul()r
<br />I h.rchy offinnlndcr FnrlryorFrjur! rhdr I m lic.,rtd uftlcr,,x,ri\n,n orChi|,8 9 (L$mtncin8 qirh S(ri.n 7fiD) oroivisi(nr.]
<br />ol rhc Businc$und Prorc\liorN Cod.,,nd nrr li.cnr is i,r lilli,tra ul cfli{r
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<br />,.,., l/iq/ .lopr)
<br />I h@by alrrm !nd.r Fndry of pcrj!ry rhar lhft is r
<br />isslcd {S.c. 1097. Civ. C.).
<br />i.n hndin8 0gcncy for lhc pcr{ordEc ollh. work aor sfi thlhis r6nit i\
<br />t ndcr's Nrnr
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<br />APPLICAITT IIf, CI,ARAIION
<br />I hoEh, afiim undcr !.n.lty of Frp.y o* of llE foUo*ing dNl,orions:
<br />D.mliriotr Ps'trih'Asb.dos Noriicition tucnl R.SuLtir.s [rnb 40. Pan6)
<br />rnc fcdcrd rcgrlalio.s Eg,rding lsbcsos rcmvol mc nol arplicdble to rhir pmhd
<br />buildinpsnnoction. dd hcrby axrhori2c rcorcscnlolivcs ofrhis Cny and Cou.lylo cnrcr ulsn llt
<br />ID/SIG.COMMENTS
<br />Appliances
<br />It/etal Fire Place
<br />Evaporative Cooler
<br />Furnace
<br />Compressor
<br />lVlisc. Equipment
<br />Duct Work
<br />Pre-lnsulation
<br />lnsulation
<br />Smoke Detectors lnstalled
<br />Rouqh Ductwork
<br />Vents
<br />Toilet Room / Clothes Dryer
<br />Residential Ranqe
<br />Other
<br />Hood
<br />Type I Hood
<br />Type ll Hood
<br />Grease Duct
<br />Fire Damper
<br />Openinqs
<br />lnstallation
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Above T-Bar
<br />Rough Mech.
<br />Final Test
<br />Meler Release l_ tTlunJt DIhl\r7;L WYLIFINAL
<br />Notes, Remarks, Etc.|,r t
<br />vt-
<br />APPROVALS DATE
<br />l) lr
<br />u )5 p..{5__-)
<br />riis {'plkarnrn ad rarc rhnr rh..horc infonerion t cotrrcr. I aBrcc b.omply wilh lllCir, trtrd Counry
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