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MECHANICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Appliances
<br />Evaporative Cooler
<br />Furnace
<br />Compressor
<br />lrilisc. Equipment
<br />Duct Work
<br />Pre-lnsulation
<br />lnsulation
<br />Smoke Detectors lnstalled
<br />Rouoh Ductwork
<br />Vents
<br />Toilet Room / Clothes Dryer
<br />Residential Ranoe
<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
<br />FINAL ?-tz-fo 6eAa
<br />Notes, Remarks, E1c.
<br />OWNET EUTLDER DELCAR TTON
<br />I hcEby ,fttrn und$ pcnally of pc+ry thll I d,.x.mpt fmo lhe ContBcloF Ltense Llw for lhc follo*ing .etson (Se.70:11.5
<br />Blsine$ ad Prcfc$ion Codc): An! Cily or Griry which rcqliG a Fmn ro co.{rucl. rlre. imDrow. d.mlish or rctEn My
<br />strutue. Irior ro irs hsueq .Ls r.qun$ rhc applicer for su.h fmjl m nb , .igEd slalcmnl lhd lE or shc h lian*d pur$o
<br />b lnc tmvGions olrlE Conrrcrols LiccnEd Llw (Cnltlcr 9, Conmminr rirh Sedio.7000 6I Divhion I6ftu ausi.cs ud
<br />Pmfcsions Code) or rhlr lr or ihc h .xcr{,r rlEEfrcn and rhc hosk tor rh. 6lke.n cxcoprion. Ary viol,liocrofSclion ?01!.5 hy r'!
<br />ap!,lic.nr a6r apcrnir subjccll rhc aDli.a.r ro ocavilpcndltyotnor morc $m liv. hundrcddollas (6100).
<br />-1.
<br />&s owffi of thc pmtEfly. or ny cnployr.s wnh v!sc\ ,s rhct $k N'.pcnsri.n, wi{ &r rlE wo* .d EslEr@is ml
<br />intcoH oroflcrcn 16r sk lse IX4, Busim3s dd ProLsions C6dc Th. Conlraclols Lt.n$ t w &E noI airl,ly to u osrcr of
<br />lhc pmDdy who tdlds or n$m6 rltEtr .td *ho docs $ct hlt hims.tf or ltrsl{ 6i rhhuBh his or h.r own cmployei
<br />prcvidcd thar such irpmwEnls m mt inlen&d oroficr.t lor $L lL novcrcn rlE ll,ilding or imrEvcE ksoldwiihhoncFr
<br />oaconplcrir.! thc Owc, Buillc, will how t btlnLn of psrin8 thr tEorshcdn d bild or irymt lh.ImtEl, fn rlt txrF&of
<br />t, $own$.lrhc top.nr. ancrctusivclyconrroding wirh lic.n€d corrrucrori ro ansrdd rhc Fojecr (Ss. 70{4, Br$nc$
<br />and Eoflasion Co.lc: The Conrrucroir Liccnsc Lrw doer nor 4'rly 16 m osnu olpropcny who builds or im!rclcs rhcrcon,
<br />nnd who.o turs ror sucn F)icls with a ContB.lo( 9 li.cn*d pu^uir h rhc Cnnreror's Li.cnk tx*).
<br />_l M cr.mp' ulldm serion- B. & P.C. fo. lnis rcoson.
<br />Dxl., Own..l IOlf,EB AMIDISAITON
<br />IESAAA.IION
<br />I hcrcby alfirm uids D.Mlly of r€dury oG of rh. follo*ins d.{li!rri,ni:
<br />I rhtr (inl.. l,tr rh. l,..lonnrr( ol rhc \o lnr \lrr.[ rhe |['n r n ^{]cJ
<br />I havc snd will @inr.in vorkcrC ronlEf,sarion insum'Ec. as requted by Sslion l7m of rh. kbor Codc. for rh. ,Etformtre of
<br />lhc work for whth lhis !.rmil is isscd. My worlas' con{Ensolion insuEncc cMicr ard Iblicy nuibo m:
<br />P.lklNunl'.r EbiEi
<br />-l
<br />ccnily thal h lhc pcrfonBnce oaiLc so,k for {hi.h rhh Frni h issucd. I shnll nor lmPloy ony Pcrsn in !n} manncr
<br />$ ns b b.c.N subif,r b ih. workctr .onrl)c.ssrion laws ofc.lifornia. . Ege lhal if I sholld b.toft sxbj.d k, lhc
<br />*orkcB.ompcns,ionpovhionsofSethn3T0Oofrh.tjhoraodc.lshlll-fonh*ilhcorPlr*nh$ospmvhio$.
<br />W,iRNINC: trrih,ro rr {cur. qorkcis comp.nsarion .b ful. ntrd \hrll suhic.l r cmploycr n, lri'ninll F-nrhi\ rnd
<br />ncs un
<br />'n
<br />nnc hrrndred I
<br />rnr6 "rih" ' "(..".i.bla ltt
<br />-
<br />--t-- ---
<br />[n r h rhc co{ ofcoflrp-trsrlion, d!mr!c\ !s F)vid.d l rhc
<br />U]TI^BAIIAN
<br />I hccby .Jlrm uMcr p.nrliy of Friury lnrl I m lie.$d undcr Pllvision or CMpld 9 (c.mmmine wnh Selio. 7000) of Dirhion 3
<br />of lhc Blsine$ d P,ofc$ion\ G)dc, ,J'd ny 'r.n\.^i',hl r,r..rrkl
<br />IJ
<br />I hdEby .fatrn undcr Fnahy of p.riur, that lhcre is n
<br />iriucd (sft 1047, civ. c.).
<br />n,n bndiisagckylorrhcp.rbrnrnccolthcworkaor,hichrhi\p.rn'n h
<br />aftl,lcaNlDf(f, a]luta
<br />I lrtr$yarlirnrnndcr pcnalry.i!crjury onc oIr[c nn[ni inE d..hrari.n\:
<br />Drnnjliri,)n Pciinirs \hcno\ Norilj.aridr Fcd$rl Rctuhri(,r\ lTnlc.(). Idr)
<br />Rcqunod Lo(crol Norill. lnr
<br />nr rcg.rding e{trsros remsl @ mr cpplklbk lo lhis pmj.ll
<br />utc that rh. otnvc intbrolioo h.orel.I +re lo.omply qith 0ll Cilrllld Coum,
<br />rcbyauthornc nprcsnlarivc\ olrht C ";:/,";-*'"
<br />Metal Fire Place
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