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MECHANICAL-INSPECTOR RECORD
<br />DATE COMMENTSAPPROVALS
<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 />Smoke Detectors lnstalled
<br />Rouqh Duclwork
<br />Vents
<br />Toilet Room / Clothes Dryer
<br />Flesidential Ranoe
<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 />Rouqh Mech.
<br />Final Test
<br />Meter Release
<br />FINAL 6 1)t,l l *tQ lo\
<br />Notes, Remarks, Etc.
<br />oTINI]T BUTLDER t'EI,CARATION
<br />I hcrcby nmrn undcr ranalry (,fprrury th{l I m.xcnDl amd ihc Cont&nrs l,i!Tn\e l-!w fd rhc finlo*in! rcuv,i (Sdc70.ll.5
<br />Btrsincss lnd Pro&r\n cnh) Atry Cn, or Counry whi.h rcqurcs i Pcnnir k .ondru.r' llrcr- imPolc. &'n,ish or rcPatr ,
<br />{tu.rurc, rir ro ns Lssurmc. {{, r.qrircs rhc it diclnr lhr such llcnir b lilc a \i8trcd nalcmtrl rhrr hc or \h. i\ licc.scd Pu.uMr
<br />ro rhc ,mvi\nnr\ ol lh. Conrmbls Liccnsd tnw (ChaPr.i 9. CdnxNrcirs wilh Sc.rion 7fix) ol Division .l orrlt! Rtrsin'ss 8trd
<br />Poltsions Cdc) nr rhar hj or {hc hcxcmpr lnerctron aitl rhc b[sN turltulllcscd cxc rflnrn. ny viohrionofsc.rio.?0]l 5 hv anv
<br />amlicrnr n,nF-rnrir suhlccls rfic lpplica r. a.i!ilPc.,lryoinor rrurc rhrn filc hutrdrcn dollm (3500)
<br />l, !\ owncrolrhclDrtny,orm,cnrfloyLts wirn*?gc!3s rh.trv,rccoDPcns ion. *ill do rh. sort ud ltt {dur' n 'brinrc d or olitrdd Ii* slc (Se.7n l,l. Busim\s rhd Pnnalsions ('ode: Itu G,ntn l$ s Lien* lis doN ndr sDPlv ro !n o*ncr ol
<br />thc lln)Nny who huilds or i'nprovcs rhcNn, !'d who doc\ru.h w'tk hims.llo' hc^clfor rhrough h( or hcr o*n cnrlovccs.
<br />pi(,!nkdrlrr such irnpmEnrnrm n imc cd ot oftrcd tu eL ll, h,scrs. thc huiklinE or nrgrcvcmnl is g,U $irhi'r 'nc )tir
<br />o, coqrlelio!, rlt owmi aui cr *ill havc lhc hunl.n or l)n,ing th h. or shc did n.r build or nl{mE lnc pnFnv for llE Otqr$ of
<br />l.r\owicrolrh.prololy-r'ncr.lu\ivclycotrtrcrin!*ithliccn\c .ontn.r.r h.onnrud rlt lmlccr lscc. ?(l14 Autilc*
<br />d l Pn'lLisbn Codc ]'hcc.nrnctolsLiccnseL N doc\ .or rPfly h an ownct 6r nr.lxny Bho l'u ild\ or imp tsrhcr$n.
<br />lni whu .otrtr.rslbrsuch prn ccG *irh r Cdntrio(\) li.en{cd PuBuMr n)th.Conkrcrois Lic.ne t-rq)
<br />-l
<br />mcxcnp unda S(tion- B & P.c. for Uir E&sn.
<br />jlaBrliBs:-cllllrEBsarloN
<br />DECI.ASEION
<br />I hccb, rflirn undcr !.nrllyolFrjuryo.c orrhc rolloqinS dcchrarn,nl
<br />-l
<br />hrtr ud w ill n!,ihi. r C.n ificarc of Coi{ ro sclf lnsurc iot wo.kc.r coqrnution. as Pnvidcd In bv Sccriotr :17(x) oi rh'
<br />tihrr Conc.lnr rhc Frfonrufuc dllhc wolk n, shich r,t renir h issucd
<br />I h,rc.nd *illnoilrlrin q.rkcrs ..nDcnsntion in\ut!trcc. rs tcquird h) SLrlio.:17{D.rrhc lihot Cod.- tor thc Nrronnrmc or
<br />rh. *orklhr*hicn'hn rcnnir is i*ucd. Myqorkcn clmprn\rri.n insurancc coricr !.d loli.y flumbc, E:
<br />-l
<br />€crrif, rhlr i. thc p$forromc of lhc qo& tor uhich rhis Frmit is isslcd. I rhlll ml cnPlov mv lENn in lny Mftr
<br />$ &r ro b..om subFl lo lhc *ort6 conp..stion lsws of Cslitomi,. tnd l8r lhal if I lhotrld hcom subiel lo trE
<br />sorlc @n{Ensslion Fmlnions of Ssaon 3?OO of the Lrhor Co<tc. I st ll foflhvnh @nDlv wilh th)s Pmvishnr..
<br />WAR\INC aailurc lo sm work s comlEnsri.i .o\rrasc is lnlaw shau subirl an ctr{rloy.r lo diniEl ,'.ultix ald
<br />.ivil finca up lo oe hundrcd thouend dollan (5100.000). io add cu{ or mnF}solion. datu8.s 0s prcvilcd tnr rlEL-L--l0?, of lhc Llbq @.. i.rcEslh. L?-r6
<br />DLCI.ABAIIAN
<br />I h!r6y rfltm !ndc, Fhalr! oi I'crjury rhar I d liccn$d uMcr Prcvist'..aChxfld 9(.omNnci'rg *irh s{lirn 70(U) ofDivi\n'r 1
<br />or rhc Bnsi.css lnd Prcfisst,ns Codc. dd nry liccn\c n in futl tur.c,nd cilccr
<br />c>4 L ) a'l f/
<br />L_=
<br />I hcrcby !flirn u.lcr Fn,htolpcrj!ry rh rhcs isa coNrrullhn hnding rlcRy f.r lh. Pcr,ornuftc oflhc wotk aor shi.h rhis Fnnit is
<br />i$ucd (Scc 3097. Civ C )
<br />Lrrd.lr Addrrc.
<br />-
<br />A.ETI]CANLDECIIIB{ITON
<br />I lm-$yafiinn! cr lcn,xy oltErjury otu ol rhc lolk,sin8 dc.lffilion\
<br />Dcnr'lni.n P.nnii$Ash$t.\ Nolificarn,n r{dcrrl RcSuLlion\ (Tirlc 40, I'.d6)
<br />Rcquncd bllcrof Noria,.jrr,n
<br />I ccn iry rhll rhc fedcEl B8rrlalions cssdinr aslBror rcmval m mr aPPlkabL b lhh Poj<r
<br />-l
<br />ccnily ihor I hovc rcid rhk ,ppliolbn .d sldlc rhal lhc lbow infomElion
<br />nrdirufrcrdJ sr.rc bw! rcldin! rn buildine cpn<lrclior d hc,cby aurhorir
<br />abovc mnrioncdl'mFnyfor in.n.,i",n,.p"\. )
<br />k comr. I !8re lo collll y wirh Nll cny a.d coul,
<br />rcprc*ntariwr ollhis Ciryand Couryro cntd upon lhe
<br />L,D&Y 27-H
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