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APPROVALS DATE ID/SIG.COMMENTS <br />Appliances <br />It/etal Fire Place <br />Evaporalive Cooler <br />Furnace <br />Compressor <br />Misc. Equipment <br />Duct Work <br />Pre-lnsulalion <br />lnsulation <br />Smoke Detectors lnstalled <br />Rouoh Ductwork <br />Vents <br />Toilet Room / Clothes Dryer <br />Residential Range <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 />n*,od-aRough Mech.tlttlt4G .) <br />Final Test trrt )t/ <br />.h'wo\laFINAL?hr10 .ra,,) <br />Notes, Remarks, Etc.) <br />OWNER AUILDER DELCARATION <br />I hdcby arfm undq poully of p.rju.y lhal I dn .xm non lhe conlraclos Lic.@ L.w ior lh. followin8 ra&i {s.c.?o:l I .t <br />Bcin6s md Proasio. Codc): Any Cily or Counly which r€quir6 . looir lo conslxci. tlt6. inprcve ddolbh o. Ep.n'any <br />srruciw. Fior ro ils isuMco dso rquirG rh. appli.ot lor such F mil ro lilc ! sisncd (oltul lhEl h. or shc n ltds.d PuNtrl <br />lo rhc g,ovi5io6 oftfi. Conlradois Lic.ns.d Law (Chlprd 9. Conomcirg wnh Sdlion ?000 of Division I oflh. B6i.* and <br />Prof.$iof,s Cod.) or liar h. or she is €x.mo lh6€tio,n dd the b*ir to. th. llleSed exnplion AnyliolalaonolSdtion?01l.5by.ny <br />spplicdl for s psmit subj..r! th. rprliclot lo a cilil plBlrt of ior morc lhn fiv. hundrdi dolld3 (t500), <br />l e os,r olthe FoFny. or my .dtlo)B wnh w!g6 & lhct eL @sFssrio., wiu do lh. wolt ed lh. !fii.lG i nol <br />inr6d.d orofcrcd forsd. (sc.?04.r. Busi.6 &d PoG.sioB coda Th.conko.toi! Licmc Las &6.o1tpply to oMdol <br />th. pmldly who h .Lu s imprcvB lhqor! od who dG such B!.t hitu.ror fi@laor thmu3n his or hd om .nDlott6. <br />ptuvid.d rhd such inprovomt! & ml t ad.d oroftoEd aor sL. l[ tDw.lh. hrBing or inFrl€lrd is sE wnhin onc )@ <br />ofompldion, rlE olms Boitjd will h!v. iE h!d., ofpiovilg rhd h. or $. did @l hild or inFov. fi. PoFty for [E PltPoF oa <br />l. s om6 ofllE FoFaly, m q.lusiv.ly contd.lins $ith licas.d conthcloB lo conslrucl lh. projd (Sc, 7044. ABinB <br />ed Aoistr codc: Th. ConrBror! tic@ Law doe .ol alply lo & owtrd of prop.n, who builds o. nnprovd ln66n. <br />.nd *ho conrmts ror sucn projds haco d.ro(s) lic6a.d puBuafl rorh.Contradoa! Lic6e Law). <br />I hd.by afliro und6 poally of <br />I ha!. ad will @inrrin s Catilicst. ofaoMl to SdHBurc lor rvo*6 onpaB.rion, u Fovid.d for by S..iio. 3700 ofln <br />Labor C.d.. lor lnc polomMe oflh. $o for which lhc pqinil is iarued. <br />I nrtc and will mai.tain work6 conp.@tion i6urucc. s .t<lut d by Serion 1700 of thc Labor Cod.. aor rn p€fom&.. of <br />lh. wo* aor shich Ihis Dqri i3 is.{ M} trortd @nposarion iBurecc cni6 sDd policy nunbd ec <br />Icdirylfistinlh.pdforekcof$.$orttdwhkhUispcnilisi$u.d,Isfi.llnoldnpLydyptMnineym.s <br />so B ro b€en subriEr ro lh. wort6' onp.Mtiof, l.ws of arlifomis. dd lse lhd ifl lholld bdon. ,ubjdt lo th€ <br />work6' @EFn$lion pmlkioB oas..lion 3700 of thc Llhor CodG. I st ll. lonh*r$ conpl, wilh ltoF Prcvisions.. <br />fARNING: F ilor.lo sE wo 6' o'npsN'lion covsagc is uilavfirl, dd shdl 3ubjer e olployd lo dif,jnal paalriB dd <br />cilil lioB !p lo o.e hundr.d ltonsand dollm 100.000). in additior lo thc co oa <br />oIlt !t!lu] <br />I h.abyatfmundd Fulyofpqjlrythat I u li€o!.d un<lcr Fovbionotor a 9 (co@.i!g win sdiot 7000) otDivisio.l <br />of the BuilB and RofBioB Codc ad oy lic.B i. b tul fot.6d.Itc.r. <br />LitM cls:-Licdc N@bal <br />CONSTRUCTION LENDI{C AGENCY <br />t bcrby dfim ud6 FEliy ofFjury tlld $@ is . @dEcrio. lodi.s asdcy for rhc P6fol!1rc olllE mtr ftr *ltth $is pdmi n <br />eu.d (Se. 1097, Civ. C.). <br />ATTIIIANLDECIA&IIION <br />I hq.by amm undcr pmtlty ofrsjury onc.flhc followi.S ddlarerions <br />Dinrlirtrn Psnirs-Asbdor Notilicarion feJ.r.l RcSulat ions ( rnlc 40, Pan6) <br />R.!utcd tnrs of Norilicalion <br />I califylhrt tb. f.ddal rcgulations Esodin8 6b6ros rdovalo..or aDlicabl. to thjs prcjel. <br />sral. thar rh. dboE infomdion i. coo.d. I arre lo conply *ilfi 3ll Cny and Counl, <br />airy ed cou,ry lo .nl6 upotr lhc <br />Applicot or ABot S,Enat <br />"*,,-XV6 <br />t( <br />MECHANICAL.INSPECTOR RECORD <br />Meter Release <br />*",J <br />l)rrr <br />----+--- <br />=