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MECHANICAL-INSPECTOR RECOBD <br />DATE ID/SIG.COMMENTS <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 />Bouqh 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 />Rough Mech. <br />Final Test <br />Meter Release <br />FINAL ?E//L sL6 <br />Notes, Remarks, Etc. <br />oWNER ItUI LDT]R DEI,CAIIATION <br />tlu\inc\\ rnd hor.$i{nr Codr) Ai, ( ir, or C,rtrry Nlrich rrqut.\ r I'.nnn ro .onrn,d. rllcr. imnmve. dcmoli\h o' rcnrn rtry <br />ro rM I'nrvi\i N ofrhc Cort.r.ld\ Liccnscd llq (Chrptcr 9. Connn.ming sirh S..rn,n 70{x) of Dnirnrn I oilh. Bu\nr\l3trd <br />Prnt$ion\CodcrorrhJrtrorshri\crcDprrhcrc,ionra rhchr!\ntrrhcrllcScdcxcnrtri.n.Anyvi.ltni,)nolSccri{,n70:ll5h}dny <br />rppli.ntrrntrnpcnniisobjN(rlrapli'.atrrk,r.ivilncalryolrornnncllMfivchundrcddollrF(S5u)) <br />-1. <br />&s owmr of lhc pmpcny. or hy cnplo)tca *irh wascs ss rhct eb .on{EosaIio.. pil do lrE k,t dn dE strEte ii ml <br />i cndc<! or oltcEd fn sb (5€.7044, Busircss .rd PreLsiaons Cod.: Thc Co.rsdor's Ltenk tr* d@3 Fr apply lo a 6vEr of <br />llE FDpcn, *ln hildl or ihprDB drmn. aid sno docs sh h* hins.lf 6r lErell o. lhmu8h hn or fi.r own cmployccs, <br />p.ovi!.d rh.t Nch iiprlwmdse d htcri.d orotu fd s!.1( hoeq. th. bildi.g or i,pmEnd i! sld wnhin ox )st <br />ofotriphrir. rh Oqn.r Bui!:Lr sill ltsw rlE h(hI of treving Urr h. or shc dn ml boild d in rot lh.,rorEly fotllr Fl4bEol <br />_1, rs owNr of thc ,rolEnx am.x.lusircly co tu]rins wnh [ensn contncron ro ensttucr rlr l'oj6i (S(.1!U. ausim$ <br />md ftoftsrir Codc: Thc Conrkrols Liccnsc L.* dms mr sprlr ro d o*rci ot I'hFny who builds or imprercs lhfton. <br />itrd *ho oiln.ti for such ,misl, *Ih a Co.rer6(rl li6.i.rl puA@r lo tlE Conrralols LLtn$ Li*), <br />-l <br />ucxcru u!d6 Setbn-" l. & P.C. fq tn! l@tr <br />IITBIDIILC(UIIdSAIION <br />DECIABAIION <br />I lEr.by 30ir6 und.r D.nrlry of D€hry oE of th. followi.E d(lmlioN: <br />-l <br />h.E en *ill mintlin . Crnif&r. of CoMrr ro Sclt-lnffi fo. s,ks' onp€Nlion. !s FDvitd for by Scrion 3700 of thc <br />Llbor Cod., for rh. Frfomft. of rhc e* for *,tijh rhc !.mI i! i!!!cd. <br />_l hi!. and will E,inlaan woik.N conrpcnsatio. nsurrncc. !s rcq!ftn by Sdion l7(n orth. ubor Cdc.lor lhe p.tfomncc of <br />rhc vDrk L, whichrhirpcmir is i$ed. My workcm ompcnsrthn in$Eic€ fficr a.d policy rumb.r e: <br />Policy Numhcr-ExpiEs: <br />-l <br />ccnifyrhor ii llE l].rnrmne or rh. wort forwhichrhis p.rmn is ixsucd.l shallnol cmployany pc^oo i. any mnncr <br />$,st,bc.om b.isr lo rhc *o*c6 compcnetion laws ofcllilomia. and lsrcc rh,r irl should tE om subrcd lo ltE <br />w.rkcr(.on{rnsalionpmvtionsofS.dion3100olrhctihnCode,lslull.foahwiih.onplywilhlhoBl,mvnioN.. <br />14ARNING: Fiilur ro scurc sorke^ .on1pcnsnln,n.ov.ng. is unhwful. lad shlll subicl an cntloFr ro oinrinol Ftr0ltis ond <br />.iil fincs !p ro otu huidrcd rhousud dolhus (Sl00. x)). i. ddilion ro the co( ofomp.i{,lion. drsrg.s trs prolidcn aor rhc <br />Scclion .10?6 otlhc l:'htr Cod.. i,nci.{ <br />DI(LABJIIAT <br />I rh. hr\i',.\\ rRl trr'n.*itrx ( ,r1. ri nrv hc. \t s i llll tui!. clL.r <br />'2---1t {t< h <br />I hcL-by ltmu.dcrFmhyorF o,y rhcE ir a onsfldb, L.di,g aScncy for lhc rErfomn.. oa rhc work for shich lhis lEmir t <br />i$Ed lse. 3097. Cit. C ). <br />AfIIIIAII.DICI,AAAIIO! <br />I lrt*,t !lt'6n undc, rorXy ofr.rlury o cofrhcfolLqir8dccl.r.rions: <br />D.frririon P.nni'$ shr\tos Nolific.lion l_edcrclRqulirions ('lillc.l0- Pan6) <br />-Rcquirc'i <br />l.llcrof l'lorilrdi,o <br />nptyw t aI Cny rnd County <br />City.ld Co! yloc d upo.lnc <br />,'t lrt-l 15 <br />APPROVALS <br />-------T------ <br />----+--- <br />--------T------ <br />=