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MECHANICAL.INSPECTOR RECORD
<br />OlVNF]R B(J!I-DER DI]I-CAIATIoN
<br />I rRtuby nlfinn undc|rnrlrt rn ltrriury thd' I n cx. rU rtu r
<br />'h.
<br />(i rr.bF l-iccNc L)r i,n rhr lnlkJwnr8 r.rvs rs..7r,rr \
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<br />Ihtcsnn,\ Codc ) o! rhlr tuorrhc i\crrn{rrherrrrnnand ilEh'\n i(tr rhcnllcs. cr.nipnotr,ltryvdnrionolSccrir?o.ll 5 hv rtry
<br />+tli.r nr r Fnnir \uhjo.G'hc rfpli.,.i tu a.iuilNtrdlry.l lyr ucrlrtrlivchtr rcnnolrinlstlrD
<br />rhcpm|Env $ho huild\ or i'qn)v$ rhcrcni. dsla,J,{\\trh*.rkhi'n\cllrrh.r\cLf.rrhn,ophhi\nh.rosn.n otccs.
<br />-1.
<br />asowncrofrnc lmpcny, .m cxclusirly contmcliflg wirh lian€d co rrtoN ro co.srocr rlt pmjc.l (Se.7044. Businc$
<br />trod PrDlc$krn Codc: Thc ConlE.r, s Liccns. Lrw d@r nor atllly r. d oemr ofpmFn, who buildsor improlcs lhdcon.
<br />und Bho conlEcrs nr such lojccls wirh 0 Contnclorls) liccnsd pursunl ro rhc Conr6.roas Lkcn* Lxw).
<br />I Unucmnr und( Ssr It. & P.C. torrhn rMr.r.
<br />]IOIf,E8[lOMPidS/tIION
<br />!ECI48Ar10!
<br />I hcrcby afirm undcr !.mlly of Pcdury om of lhc following dc€lamrioNl
<br />-lh0vcand
<br />sillnunrrlinr Ccn irr0rc oi Conenr ro Scllltrsurc r'or *or[cE compcnsarion..\ pmvidcd fdnySc.liotr ]70oolrhc
<br />Lnhtr Cqlc.lor rlr.odn'nmrr! of rM wo* for qhich rhc Fnnii is i$ucd
<br />-l hnle u, qillnuinrrin wo,kc^ conFn{rion inruhrc. N ,.quircd by Selim 1700.tth. tibor Codc. for lhc I'c.forro.cc of
<br />rhc work for whih rhis r..dn ii i$uin. Myworkda cDmp.nsalion iNun.cc c,nid rnd loli.y numbc! sc:
<br />WARNINC: Fnil!rc lo surc worlcn' conEns.tion coEBBc is lnlasrul, ud shdl suhicr an.nDiorcr lo oin nol l€mlti:r und
<br />co( ol.o0Fns.rion. drf,ug.s rs pDlidcd lbr lhc
<br />]2I,ILABAIION
<br />ol rhcll lin.srf,tn.lr\i 'n(i)!tr.)ndnl\ l..n\c s i,lnllhrc. rntlrlli(r
<br />Liens CLs:-Lic.nrc Nu-"Y+Jl+
<br />Ih.rcby dffi uidcr Fnllrt or tcri!ry rhrr itur. "r.on{to.rinr Lndi'r!.edmy ro, rltr !.dn n0Nciirhcworllurhichrhi\r.rnriris
<br />i\rucd lscc :llr97.(-'iv. C ).
<br />APIUCANIjIECLAXAIION
<br />I tfth, dlim utuldr ncmhy orFrjoit onc ol rlE tullo*rns d.clel'n,tr
<br />D.nxnnion P.rmn!A$rios N.liricrrnnr ttncrul Rc8ul,riotrs (Tirl. 4l). Pan6)
<br />-Rcqun
<br />d l,llcrolNolitic inr
<br />I.rr'iyrl rrl,r r.tl.ml'.!u xrh n '.s ndnrg rni..{,\,.ntrrrlx,. ntrlrtflL. rln. r, rlrN f',)l.r
<br />=lr.nittrhsrlhJvcrc?rlrhi\rpdicrri,n,x
<br />drrcrllri rhcrh,vr i'rr.tr i.n i\.otrr.r Irliccrn.onrrlywirh0ll(iryn.dCo!try
<br />odinarcrs and sratc Llasrcleriryro tr8 consrrucriotr. nnd [crchy rurtniTc rcprc\cnrllivcr
<br />rh)vc f,nri{n*d ltrorny li'r
<br />Applica or As.nl SiBn rtrcl lrr
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Appliances
<br />Ivletal Fire Place
<br />Evaporative Cooler
<br />Furnace
<br />lQgmpressor
<br />l\4isc. Equipment
<br />Duct Work
<br />lnsulation
<br />Smoke Detectors lnstalled /.',\
<br />Bough Ductwork -z-Ylhl)
<br />l,
<br />Vents
<br />Toilet Room / Clothes Dryer
<br />Residential Banqe
<br />Other
<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 />Rough Mech.
<br />Final Test
<br />Meter Release /,..\
<br />FINAL la"q."s v.v{[)0
<br />Notes, Remarks, Etc
<br />,..Y /1l TU""
<br />Pre-lnsulation
<br />lnstallation
<br />l,c(e O*ne.
<br />civil Iitr.s ut lo otrc hundrc rfiousold dollan (Sl(x)-(xD),
<br />S(ri'{ lt)76 trrhc L+tr G{rc. inrcrc{.'nd k Ny!ltc{
<br />"",W//g n,,rr.*,,4I
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