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MECHANICAL.INSPECTOB RECORD
<br />APPROVALS DATE tD/stG.COMMENTS OWNER BUILDER DELCAI TION
<br />I hcrby affid hdcr Fnalry ot Frjory th{r I m .km{,r 6!m the Conrmro6 Lian$ Liw for rlE folloqhs E.sr lscc.7ol l.5
<br />Busincs snd Profc.sion Codc)i Any Ciry or Cou y which rcruncs u ltmi lo .on$ruct, !lrd. inl'Jrcv.. dcmlhh or Epoar on,
<br />sldcnft. Fhr lo ils irsumc. lho r.quiB fic atplicn tor su.h lEmir ro ,ilc a sieEd s!r.@nl lhal tE or shc k li..nsd tuN.nl
<br />ro rh. pmvisions of rlE Cortrerois Licns{ U* (Charrcr 9. Commftins Birh Sccrio.7000 of Diahio.3 otrlr ausiEs lnd
<br />Prcltssions Cod.)or lh.t lE or shc is cxc"pl thcrclron{od rhc b{sis for rh. alklcd .xcnpr ion. Any violdtion of Sdion ?011.5 by an,
<br />EDlkafl for a pcmi slbjels rhc opplkanr ro 3 eiyil p.Mlry of not mE lha 6v. hudrcd dolhs (1500).
<br />-1,
<br />!s owmr of rhc I,mI*n, or ny cmtloyes wnh v(8cr a3 rhcir slc @mpcnsarion. will do tn. vot od rh. srmtlE h mt
<br />int€nded or o,tcrcd for slc (Se.?044. Busimsr and PhfclsioB Codc Tlrc ConlE lol s Liccns trw do.s nol {,plr lo an owmr of
<br />llE |'rFny wlB hil& or in!68 lh.rcn. $.t wh. .trB sn sil hituclf or hcMlf rr rnslgh hh o hd os .npLy.c..
<br />Povid.d rh,r sEh io{rcwcnk e mi irlcfthd orofi€red for sL.If. howrcr. t,E blilditrB or irFmrmnl is reld wilhin orc }.e
<br />of@npLrhfl tlr OwM BuitLr qi]l hlw [r htdd ofpoviry thar h or sn dt mr hil] or inprcE rhc pmFny lor rtr $qDs ol
<br />-1.
<br />as o*ncr ol rhc ropcny, am cxclurivcly .onlrad g uirh li.cn{d .onka.ros lo onsrdcr lt* rojd (S.c 7()44, 3u\ims
<br />a*r PiUrn\id Codc: Thc Conrturoas Liccisc l-!* dcs rer lnrly ro atr ovncr ofproFny*ho builds or imlroves rfic,co.-
<br />and qho conln.ls nr such Eojccrs *irh a Co.ln io(r) li.cn{d l,ui{unr r, rh. Co d.ktr s Liens ti*).
<br />-l
<br />en ercmfl uMcr Ser B & P.C forlhi\ rcsstr.
<br />TOf,f,DINIIjOMTEXSAIIO!
<br />DEOAAAIION
<br />I h.Eby affirm undcr prnilry of p€rllry one oiric folto*inE d(lamrions:
<br />_l h!v. and *ill minhin ! CcnifE r. of Con*nt ro Sclflnsm fd mrl6 orp.ffdion. cs Fr*ikd for by Satn,n 1700 of lhc
<br />bbor Codc. for ih. p.rao@nc. of lhc mr* lor which rh. poni is hstrcd.
<br />_l havc and *ill mialain *ortc6' compcn$lion insuBr..!s rcquircd by Sdion 3700 orllE Lrhor Cod..lorlhc Frformmc of
<br />rhe uort for whict rhii [.dil is h*d. My work s ompcnslhn insurunc cetr lnd polty numhcr m:
<br />-l
<br />Lrniti rh,r in rh. pc.fornDre of thc ao for shi.h lhis pcmil ii issucn. I shrU nol employ any llcmi in lny nanftr
<br />so N !o h.sm suhl.cr lo th. erlnc coq)cnsnrion lavr.f C!tin,mi!, nnr !FE. rh ifI should lrcom subjc.r ro rtE
<br />worksc .omFnslrion tmvisions of Scrion l70o.a lh. bb.r Cric. I dtsll, fonh*irh 6mply wirh tboe povisioB..
<br />!VARNIN(i Frilurc h {rrrc workc,i.o rp.n\ ri,r cnvcrn8. i\ unlr*li,l. xn,l \lull \rhJdri in c'npl,,ycr t, fi'nindlnctulric\ rrl
<br />.n'l lnrr\ rp kr on. hun(l'cn ihouvnd Jollrrs lSl(Xr.{xx)). in i{'n. lunbAc\ s\ pn,ridrd tu rhc
<br />Setion 1076 or rhc Lzhri,,*,-llql talr
<br />I hcrcby.fi nunrldr pcn,lry.fpcrlury rhar Idm liNn{rl rrivirioo of Chaprcr 9(@oeEins wirh Sdbn 70m) ofDivkion 3
<br />.l rhl Bu\incsud PDlc$ionsCodc. ar{i my liccn{ h in tulliorcc md cricl
<br />^.-(lq
<br />I h.dhy rft]rnr ond., Fmlly oi pcrJury rhrr rhcE t a con(rucri)n tndinr n8cncy rin rh. Fni,rmncc ol rhc $.rk r,tr whih rhis Fr lil i\
<br />i$ucn lScc. 30q7, Civ. C.)
<br />;{t,It_t( A\l t,r,( t.alt,\1'I(rN
<br />I htuh) rrlnfruDn.r Dcnxlry olpcurvomolrh.l{,ll,NIp (1..1,tr k!s
<br />Iktrtrnii(nr l)crnir\ /\\b.(o\ Norili.rri(r l.rJ.ful Rr!LLrrir)n! ll irlc,ll). I'rn6j
<br />R(tt iil l-crrcrolN,iiln of
<br />-l
<br />ccnify rhnt ll* f€dcrl N8uhlions Egarding ash.sros nmv.l aE mr spplkabh ro thn pmirr
<br />lNnllyrhrr I hrvc rcnn ihisrnt)li.rrion xl {rrc rhrr rhc aSiN intuflnalion i\cotrccr I agN rn.omnly sith all Cirya.d G,unry
<br />ivcs ofthis Ciryand Co!trry k, cnrs ul,)tr rlEordinlnNs 0nd Slntc l-.*sElrlirEro huild
<br />abovc rE nrrcd pop.ny n,
<br />Appliances
<br />Metal Fire Place
<br />Evaporative Cooler
<br />Compressor
<br />Misc. Equipment
<br />Duct Work
<br />Pre-lnsulation
<br />lnsulation
<br />Smoke Detectors lnstalled
<br />Rough Ductwork
<br />Vents
<br />Toilet Room / Clothes D ryer
<br />Residential Ranoe .aOther n/.,FZ W tt-yv.tB,,'-{4., zE t.'L",Y
<br />Hood
<br />Type I Hood
<br />Type ll Hood
<br />Grease Duct
<br />Fire Damper
<br />Openings
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Above T-Bar
<br />f,ough Mech.
<br />Final Test
<br />Meler Release 4 ,5\
<br />FINAL n-Ltl- lt /.2L,,t taa ,vl )
<br />Notes, Remarks, Etc
<br />Furnace
<br />lnstallation
<br />(1{c. inrcrcd n.d lrlorEy \ lt.s.
<br />:
<br />I
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