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MECHANICAL.INSPECTOR RECORD <br />APPROVALS DATE tD/stG.COMMENTS OWNER BUILDER DET,CARATION <br />I lE!b, eftm uid6 p.n ny of pdju.y lhsl I 6 ctdpl 6oh lh. Coorasos UcoE Lw lor tlE foltowiry l@)i {Se.7011,5 <br />Buiils and Prof6ion Cod.): Any Ciry or Coutny qhich r.qur6 r Finn to cotuirucl, tI6. imprclc dcooliln or ,!Ft ay <br />ltEcruq prbr ro ns k l@.. .bo r.q!n6 {E appli.el frr such Fni b 61. 6 siSn d $d.!Ml lhlr h. o. sn n lca.d PuMl <br />lo lh. pmvisioc oa ih. Co turol3 Li.c8.d Lrw (Ch.Oa 9, Comdcing with S.clion 7000 ol Division 3 of ttc BuinN d <br />PDfsioBCo.b)orlhd hcoislc b.i6npr ih66o6&dth.bdb fo.tt .lLgcddmp{ioi. Ary lioladonofselbtr ?011.5 by My <br />.ppli@r for ! rdnn lubjels lnc ipplicet lo a cilil pq8lt, of nol mor.lh6live huntlr.d dols ($500). <br />,, s own6 oflh. Flpsly, or my .dptolB silh was6 s lhci $L conpGalion. wil d. th. wort ed th. nn(lu. n f,ol <br />inroxH or oII6.d for eb (Sa 7044. BBilB ad PrcasioB Codc Tn Conlrscioas Lic.e Ltw &6 rcl tp?ly lo e osttr of <br />ihcpopol, {no bildr or intPDc lh@r ed vno do6 Mh sd( hiosclf o! h@lf or ll'nugt hi! or lE oM rnploy.6. <br />povid.d rhar su.h irFDlEeB @d idor,.d o. oilc.d rlr la]. I( lDtrda. tlE t{ildins or iDFoml ir $ld wihi, one tu <br />of conpkrion, lhe Own6 Bu di will h.!c $. hdln olproling rhd h. or 3h. did nol hild o! ihprovc fi. ptepdty lor rh. p,po* oa <br />-1. <br />6 oMa ot$. Flpdry. e dd$iEly conlr.cli.g $rlh licd.d co'nr!.loB lo @nlttud tlE Eoicl (Se. 7044. BuriB <br />ed hlfBir CodG: Th. Conm.roas Lic6s. Law do6 nor orDly to d om6 ofprop.ny who bnilds or iiprovd fiaon. <br />ed who @lIsds for sch FDj*l' whn a Codr&lo(,lE@.d p6uir ro rh. conradoa3 Licde te). <br />I ecidF uda Selio. . B. & P.c. forthtlt&. <br />laBtrE8lllolrtErsAlro! <br />DECI,ASAIIO! <br />I h@by affm unda pddty ofpqjury o.. oflh. aollowi4 dslE Iio6: <br />I hav. and sill mainrdin aC.nificat.olcoBdr ro S.lq @h,!0116 @npoBdion, s Fovid.d for bySdliotr 1700 oaln <br />kbor Codq for lh. psfo,rMc. otlh. w tor which th. pqnil is i3tu.d. <br />-l he. ed witl dai ain *o.td conpcation iBrrs.. 6 r.quircd by sdtion 1700 of lhc L$ot codc, fo. lhc pdfomuc. of <br />ftc @rL lor vhkh rhis pdmit is islcd My woL6 omr..erioi iBulm. .ei6 tnd policy nunbd e: <br />--l.di&rhlr <br />ii $c pdforjr@. of th.tr rt for vhi.h fii! p.rnil is irsn d. t shalltut mploy lny pd$. indymmnd <br />$ a ro b..onc aubjat lo rh. workqa cooposlion laws ofcdifohi( ed ,g@ rhat if I ihodd t com. subj..l to lh. <br />wo&6'onposrioopovtioNolsdion3T00of$cLlhorCodc.lsltsll.fonhwnhcomplyqnhlhGpmvtio6.. <br />WARI{INC: Failuc ro se wortc' cooFGlrion cov@g. i! uf,lawtul. ed shall subj..r e dPlorr to qiminrl pdEli6.rd <br />.ivil fin6 up ro orc ,undr.d tho@d do[6 ($100,000). in addirion to th. oq orconrpc@rio.. .&dt8e d p.ovid.d ror thc <br />S.sion 3076 onh. Labo. @c im6!s ed dlo@y ! fc€. <br />Apprst- <br />UCENID.qqNI!ATfaA <br />DEcldaAug! <br />I ha.by ,rm undE p6aly of p<jury lhsl I m timrd undd Fovisioi of ChaDra 9 (.onnacii8 with Selion 7000) of Dilision l <br />ol $. BBinB od ProaeioN Cod., ad y lic.N i! in aull aorE Ed cltel. <br />c9NiIalcuol-lEND.L-aGE!(r <br />I hmby arun nndc Frelly of pEjury thsl lfise Ls a consrrudion l€.dins ssqcy lor lh. p6fommcc ot lh. \rork for whi.h lhis Fnil 6 <br />isued{se 1097, civ (') <br />AfII.ICANfD}ICIAS{IIA! <br />I borS afm u.dd pcnalr, of pGjury oR oalh. following d€.lmlions: <br />Dunolilion Pdmirtr-Asbdros Norificarion F.dml Rcsul.rions (Tirl..{0, Pan6) <br />_.,R.quicd klta of Norifi @rion <br />I cqrify that lh. f€d6!l resulatioN esddinr 6b.sro! rqnoval de ror applic.bl€ lo thls projGt <br />, cBliay rhd I hsvc rad lhk appli.arion dd n.lc lhEr rhc abov€ informadon is corcl I .g.@ to cooply with rU Cily and County <br />ordile6 od staic hs Ehrtrlg to b{ildina coD{flcriotr ed hq.by aulh.riz. rrrenaiv6 oflh& Cil, ed Comly lo 6lr upon tl* <br />ahov. 6olion.d prepcny for iapcclion purpos. <br />Aprlicdl or Alst Sisnarnr.: <br />Appliances <br />Metal Fire Place <br />Evaporative Cooler <br />Furnace <br />Compressor <br />Ir,4isc. Equipment <br />Duct Work <br />lnsulation <br />Smoke Detectors lnstalled <br />Rough 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 />Openinqs <br />lnstallatron <br />F.D. Drop Test <br />Above Hard Lid <br />Above T-Bar <br />Rough Mech. <br />Final Test <br />Meter Release I <br />FINAL l0lr<lt(l..,lJ tdt ;v,r*?tN <br />Notes, Remarks, Etc.I <br />Pre-lnsulation <br />cmie- - <br />- <br />Lic@. CIB:-Li..@ N@b6r <br />- <br />D.rq Co i.rorl <br />l,' ',,\,,, <br />I <br />I <br />I