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MECHANICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS O$TI&N BU&DET DELCAf,AIION <br />I hmby !ffum u cr pcnally of Friu.y $.1 I m cxcmpt 6Dn lhc C.nreto^ Lisr$ L!* for thc fouo{ing E!$n (Ss.70- 1.5 <br />Aulincss &d Profcssion Codc): 4., Cny or County !hi.h riliEs a IEmn ro mnsmcl alt4, ir!,rotc. demli$ or rnan ry <br />sl.Uctuc. prio, lo n3 hslu@. also rcqriB rlE,rplhsir for such Fmi lo ,ilc a iigicd .taLtrlt lhrl lr or 3h. ir lienscd puF rDl <br />to rh€ fmvisions of rhc Conrrcrols Licen*d G* (Chlpts 9. Comcming *ilt Sccrion 7000 of Division I ofrh. Busine$ i <br />Prof.srions C6<lc) or rh tE q sht i. cxcq)l rhcEfron anl fi. lssis fo. rh. ilLgcd .i.n$ion. Any violario, ol Sdbn ?ol1.5 by !.y' <br />spplka for r Fmil subjais lh. applicml lo . civil peEhy of rer mrc rhn. tive h!n&d dollas (1500) <br />-1. <br />u! owmr o, rhc proItny, {, d, cmployes pith tro8ca as rhct sh oq'.nsd ion. will do rtE wd< aid rh. {ftr@ ir m! <br />i cndcd or ofiDrcd fd sL (Se.7(x4. Busincss and Pmfci\ions Cods Thc Conhcrrk Lkcnr tjw do.s nor rptly ro on ow..r ol <br />rhc F)pcny who toilds or inlrnru rhden. uld who dms sh so* himsclfor hcrslfor lhmuSh hn or hcroqncntployccs. <br />Frovidcrt rhrr skh inptuhnEnts m to{ intend.d or otf.ad for slc la, hoqrE rhc hilding or lr+mweni is $ld wirhjn oft F, <br />ol orylerion. rhc Olicr Builds *ill harc thc t{(hn of pmvinS rho rr or stu dn ml buiE or in{m( lhc l)l),81y for lhc pqhs oa <br />I. dr owncr .f rhc pmrfiy, 3n cr.lliiv.ly conru.rins wirn lcensed conradoh ro .on{tu ! rh. pmJc.r (s6. 7044. Busims <br />ond h.Ersion Codc:'rhc Conkmlols l-iccnsc Llw dGr nor opplylo !novncr oflrcpcny who builds ot iry,roecs rheNi,,trd who om€cr3 fttr such rtu..k virn ! Conh.ro(.) li.chs.d pu*u r rorhc Conrreloas Li..n* t!w) <br />I n ,.\r r rn,l.' Sccrnl <br />IIOA6ETS:.COMIEASAIIO! <br />DEqIASAUO! <br />I hereby 8mm lndcr Dcnaly ol Dcrjury onc of rhc folloeinB d6dirio.s: <br />-l <br />hav. aid will tuintlin a Ccnifdrcof Cons b Sclf-lnsoE tor *st6 orgcnlariotr a Flvidcd for by S6rion J7O0 oallE <br />Llbor Codc. for thc !.rfollMcc of lh. wo* for which lhc pcnil is issucd. <br />_l haw ard will mainrain *o*crs compenslrn,n insumnce. !s rcquncd h! Secrio! 3?00 ofrh. lrbor Codc. for rh. FJfornmc ol <br />pcrnlir i\ issucd Mysorkcn c{npcn\ari('n iNurun.cLadcrud 8rli.ytrD $fd. <br />t/q )tq3>) <br />l.cnify lhd in rh. pcrf.rmnc. olfic wort tor whkh$is pdmit is ie.kd, I shrll not cfrrloy any'r T' <br />s' aslo tre'rc suhicd ro lhc *o*ea .r,opea{rion !a*s of(lrliaornia. nnd aEB rhrr ift shoull tE 6ft \ubirr roitr <br />workcs'conr!.nsilnrnpDrisn,nsofScdn,.ST0oolrhctih.rCode.lslEll.fonhoirh.\,dplywnhrho{pbvi\ionq.. <br />WARNINGj Fliturc lo ME wrksd onp.nsrion 6kmg. i. unhwltul. e4 d'dl subirl ai cmploF lo ainir.l FMtis ud <br />.ivil fiies up lo oE huidEd rhou$d dols (tlOO.Ooo). inlailba b F *s or otrp.n$rior. datus.s a! l'ovid.d ror thc <br />::J -'ia fi;fi ?' Tffi,I s+a*:I I ucllr,-srNrxdiras <br />DEqIdMITN <br />I lEr.$y .ffirm uider pcnalry of !.rjury [ul I an limid uldd levisbn otchrpr 9 (@nmBi!8 win Selbr 7qD) of Divislrn 3 <br />oa lh. Ausincssend PNfcsions md mrlicsns is intull rbreudcaf(t <br />n c(q <br />CONSTRUCTTON T NNNING AGENCY <br />I heeby alfirm under !,€natty of lEriury fid fidc h a connoclioi hndinS ag€ncy for rt p.rfoMe ol$. wt for which lhis Frnil is <br />tsucd (Se. 309'7. Civ. C.). <br />Arfuc rlDIlcL .E/lIlQN <br />I lEr.hyrllirn,un(lcr p.nrlry ol Icrlffr onc ol rl,c knL,rin! ncchrili,!rr <br />I)cnxrliirr Prrnrns /\\h.{o\ Norrh.rri(fl l:cdcrrlRcsohriirN (lirlc t1), Prn6) <br />-Rcqnn <br />d l.rrcrol Nolill.rri[ <br />I ccnily rhrt rhr lidcrulrcgrurn)n\ rcgudi',! o\h.\ro\ rcnn,vxl rc nnl lPrlirbl. b rhis pbid <br />]K.'":l,*r*"*';oh.ie nrfornurion hcorNr. I nsxe xr.omply*irh all Cirr,&l co,my <br />3.d hcrb, aurhrriz. Elrc*.ralivcs oilhis Cirya.d Cou <br />ahow mnrhrcd I,bp.ny for insF.lion <br />Arflicdx or Ag. SigruruE:t <br />Appliances <br />Metal Fire Place <br />Evaporative Cooler <br />Furnace <br />Compressor <br />lt4isc. Equipment <br />Duct Work <br />Pre-lnsulation <br />lnsulation <br />Smoke Detectors lnstalled <br />Rouqh Ductwork <br />Toilet Room / Clothes Dryer <br />Residential Ranqe <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 />Meter Release <br />FINAL Ll*IA Mtt.4fii ) <br />Notes, Bemarks, Etc.t <br />Vents <br />Other <br />Final Test <br />lr!d.r'i N.E <br />- <br />Lidq! Ad&* <br />- <br />l/t/ <br />lt