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MECHANICAL-INSPECTOR RECORD
<br />APPROVALS DATE tD/stG.
<br />Appliances
<br />Ivletal Fire Place
<br />Evaporative Cooler
<br />Furnace
<br />Compressor
<br />Misc. Equipment
<br />Pre-lnsulation
<br />lnsulation
<br />Smoke Detectors lnstalled
<br />Rouqh Ductwork
<br />Vents
<br />Toilet Room / Clothes Dryer
<br />Residential Bange
<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.fUll-ts 5\(<
<br />Final Test
<br />Meter Release
<br />FINAL \L/ 14Au 5t(&
<br />Notes, Remarks, Etc.
<br />OWNFJR BTJII-DDR DE!-CAII/T'IION
<br />I hcrchy alfin un cr lcnrlry {)f lrrjxry rh r I d.x.n[r r'on rhc A tu.loN l,iccn\c l!* nt rhc folk,*in! r.r$n (S!t7('.rl5'
<br />llusn(\\ rrl Pmlc$i,,n (i c): ny Ciry or C trnrj- shi.h rcqun.\ a |Ernir b con{fld. ,lr$, i'nlrovc. Ltrmli$ or EpJn I'iy
<br />iturtrrc. I,n{tr r) i( i\Nrir.c. rlso rcqutcs lhc npplicin h, {rh|cnnirt' lilcr\igncd {dcnf,tr rhd ltor shc i\ lircnscd fursuanr
<br />ro rhc provi{ioN ol rhcConrBcktr\Licr\rdl-rtr(Chlllrrr9.cohnutrcirtsilhSc.lirD71Ix)oll)niso.1.irhcBusn.\\lnd
<br />ftoli$ ion! Ontc ) .r thar h. or sht iscrcnrpr thcrclioo d rlr lBri\ Ior rh. trllcS.d dcryr i i nyvt,ldionolScclion70.ll5613iy
<br />rrtlicrnlr{,rtf,nnnsubjc.rrrl[npllicntrlroa.ivilncntrlryoJmlnmrurhr rivc hurdrcd d.rlrF lS5l})r
<br />-1.
<br />as osnf of rhc pmpcny. or my cmplorrcs wiln wagcs ds ln.n mb cory'.n*lion. will do tlE wodr oid d. slnrrw Ls nol
<br />idcnd.d or od.Ed for eh (S8.r044. Blsircss ed PEf.$iotrs Cod.: Thc Coor&rols Liens La* drcs nor sptrly lo 3n owmr of
<br />thc l,or*ny wh. huilds or itr!ftEs rh.6n. r.d who .!o.: sh @* nins.lf or lERlf or rnousn his ot hd osn .n{,loyccs-
<br />pioddcd rh4r iuch inpmkmnls m ml i c(H or oficBd ftr sh. lt tn@@,llE bliUine or in9rcrcmnl is s]d wnhin nrc Fu
<br />ofmnpk.lior rl* Oqrcr Blittr vill how llE h,n n oapmvine lhd lE or rh. dn hl hlild or inpEr lnc FoFry for llE l{rlo{ 6r
<br />-1.
<br />arowrc.ofrh. pmFry.6 crclusiv.ly conlBclin8 wilh lic.nsd m retoF ro.onntrd dE pmi4l (Sd. 7044. 8usi6i
<br />ond t'hErsiotr Codc: Thc Conreroi. Li.cnsc Lj* docs.or lpplyro m o*ncr oiprop.rty who buildi 6r improvcs lhcrcon,
<br />aid pho @irr.r$ to, su.h pr.Flr wilh ! Conlmio(s) li.rnsn pusla'n lo lhc C.nltetoCs Lien€ t:w).
<br />Iamcr.mnr ndcrSdt
<br />,{pplienl:
<br />UCENIEILCI'NIBACIAA
<br />DEgT,Af,AIION
<br />I hcrcby affrnlndcr pcnal(yolpcrjuryrhar I n lian$d undn lmvnion of Choprcr 9 (.onmking wirh Sd ion 70(x)) oa Divi\ion .l
<br />of rhc Busircs,trd Prcic$ionsCodc, anl nt li.cns. is h rull ri,ra .nd cfic.l
<br />COISIBICIION.LENDIdCJgENCI
<br />I hcEby !fiirm under Fnalry of lEr,trry rhd rh.re h , mn(rudion hnding !8ctuy tor lhe !€rfomm of rhc wotk aor which lht lEmi ii
<br />issucd (scc..1097, Civ. C.).
<br />AIfIICANLIIDS.AAd.IIUN
<br />lhNhyr0nnrundcr Fnrlry oi l}-rjuy onc ot rhr lallosin! dccln'nrnnr:
<br />I)cnFlnion tcrmils shcdos Norilicrrion Ircdcfll RcBUluri(ins(lirlc 40,l'!n()
<br />Rcquncd Lcnuol Norill.di)n
<br />I ccdiay fid $c r.d$al rcellil ions Es6dins astrsrosrcm'ulsE nor,p/t,bE ro lhis lmjcl
<br />I (nily rhJr! hrlciadrhi\ arplnrrionrklsldclhai rhc rtntc itrirnuri{r, i\ orfrr. I 08te ro.onrlly wirh al Cir}andCoLnll
<br />ordiutrc.s ud Srarc li(\ ruliinE r. h,ildnr! .onsrud n,.. and hcrchy orhoriTc ruprc*.rrrivcs otrhir cirllnd Counry k, cor.r uFr rlt
<br />iborc nrctrlioncd po!.ny rin irl\t cri,)nl)urll)\cs.
<br />A[,licdnr or A8c.l S iSnrlurc:
<br />-
<br />I
<br />COMMENTS
<br />Duct Work
<br />tvanKEBlrouflllArloN
<br />DEIIAIAII!]N
<br />I hcrchy lllinnu dcr pcntrllyorp.rjuryoft oflhc lnllowire d(l!r!lions
<br />lhrrc rxlwillnrn rrCcnificrrcofG,n{ r x, Scll l n{t Lr workcs' .orlpcnsll ion- us pmvidcdaorhysccln'n37(x).frtc
<br />titr, (.dc, Lr rhc ptrlorlmrcc ol rh. \'ork lbr whti ric pcrni i\ n\ucd
<br />-l
<br />hrlc!trd *ill nuinraih workcr. conDctrsarnr irsur0nce. a\ rcquircd htSccri.n 1700ofrhc khor Codc. lor rhc I,.rf.mn.c ol
<br />rhc *r n, *ni.h rhis Fr.rn a\ h{uLn. My wodcrs ompcnsalion insurlncc crri.r ind Fli.y nun$d m:
<br />crn k1
<br />-
<br />PolicyNuDrncr-E"Pn$
<br />-
<br />I.cdilyrh nrrhc lErlorm{nccofrhc RUrk nn shichrhis p.rmir h irnrcd.l sholl nor cmployunyp{rs,n in rnynrnocr
<br />v' N t' hc.o'r \rhjtrr h rhc wtr*.rs smFns i0 Lws of crlirornii. aid aarcc rhar ir I shrxld tro:E subi.rl ro
<br />'hcworks\' codpcn\ riinr Foritmns ol Sd ion l7(xr of thc t1hor Oxlc, I shall. fi]nh*irh d,dpl! wnh rbt pmvi\k,ns
<br />WARNINGT Frilurc ro wurc *orlc^' conrpc.slion covc(gc i\ tnlawlul, .trd shrll subrrl m cmfk,rr b si.n.rl Fmlrics 3trd
<br />.i!il fin.s u! b onc hutrdrcd rhousond dollas l$100.000). in uddiln,. ft,lh..ost olconrr.nslrion. d.'tusc\ x\ pmvid.d ri.lh.
<br />Ser ion 1076 .f rhc bb.r Codc. inrcrcsr and oltormy\ l'e\
<br />CoDlmclorl
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