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MECHANICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNEX BUILDER DELOIRATION
<br />I h.rcby amrm undcr p.Bhy of Frrlr, rhd I m cx.D/ frDn the Conrructon Liftn* Lrw for rhc folloqing Er$n (Sd,7051,5
<br />Busincsr atn Ptof6sion Codc)r Any Cil, or Coury whkh rcquiEi r psnn ro 6nnel. a, itrrpovq rt molici or q r rD,
<br />slruoE. prhr io ils i.suaB, slso r.quGs llE alplicmi for suclt Fmir lo file . si8ftd shr.mnl thal ll or sfic n fi*n*d !!M
<br />ro rhe pmvisions of rtE Comr.cro r Li.eNed Lls (Ch.pr( 9. Conmmilg wilh Sccrion 7000 of Divisio, ! ol rhe BusiDcss rnd
<br />PDfcssioNCodc)orlhatlEor!h.ircr.n9ltbcrcfiooDdthe6arasforlhc!Lg.d.x.nplion.4,,viohlionofsc.li,n7011.5b,a.y
<br />llplicanr for o Fmir subjels rhc lpplic!fl ro ! .ivil p.Elly of nol mrc rh3n fivc hundrd dolbs (t500).
<br />-1.
<br />.s ow.cr ol lhc ImtEny. or my .mplors sirh *ag.r e( (Eir Fh mn{Eosdion. will do ltr *o* 8td tlE sEt16 h tul
<br />inrerdql orofitrcd for sole (Ss.7044. Busines lnd Prclcssions Codcr Tnc C,nrmrols LIB€ LlwdGs er rpolyro osftrol
<br />lh. rmlEny who b{ild.6r in{,o6 086., &xl wlh &n sh s* lins.lr or lErclf or rkor8h hir tr hcr own mployes,
<br />providcd lhar su.h inlpmrcmnts m ml hlcnd.n or offcEd lor sb. I h.wE. itE hilding or iIprcwmnl h eld wilhin om ra
<br />ofoq'lclion. rh. Ownd Buitlcr will h!rc lhc h{rd.n ot Foviry rlr! lE or slE dil mr trild or i,pror rhc ptuFny r.r llE ,,{rpos ol
<br />-1.
<br />trs ownr of rrE l'mpcny, am cxclusivcly mnrtucrine wirh liccn$d mntrocloF to otrsrMr rlE ImFcr (S(. 7014. Burii.*\
<br />lnd Eofcsion Codc Thc ConrEcrol i l-ic..E ljw .!ocs nor rrply ro !n oqns ol lolcny who bnilds or inDr.vc. rh*con.
<br />Md sho.onlB.rrlorsuchpr+dswilhaCoihcbns)ltcBedpn6@t'oih.Conth.roliLiccnrL,w).
<br />Lm.xcnrpt und.r s.crn,
<br />}ITBf,EIII.:COMENTAITON
<br />DEC:I,AIAIIO!
<br />I lErcby !fiih undcr rEnohy of pcrhry onc of lh. follo{i4 delellions:
<br />-lh0vcaMwrrlf
<br />ir ri.aCcnificltcolConscnlloScrllnsurc{or*olkcN Nmpcn\alk,n. ar rotidcdf(trhysccrn,nl7{Dtrrhc
<br />tibor Gdc, for rh. r$fonmn.. ofrhc wolk lorwhich rh. pcrnir k isucd.
<br />$illDainrain worlcF conrFn\arn,n io\!r!ncc. !s rcqlircd h, Secrion]?00 ofrhc Lrbor('odc.lbt rhc
<br />zu
<br />I c.dilythar in rhc p.d6mk of th. work lor whi.h rhis pdEn h h.u.d. l shrll nol .nploy r.y FMn in .ny mnmr
<br />s N to b.sm slbjer lo lfic srtsl sm,)cnslion lnws of Caliaorni., and aercc lhll if I should bc{oft iuhjd lo th.
<br />vortc6'otr{f,nsdionpmvisionsofSetion3TO0oflhcLoborCodc.lsnolifont*ilhomplysithrln*l,ovni.nr..
<br />ItrARNlNG: Failurc 16 soc {ek ^ comF.salion 6i!Gg. ii unlawtnl. a6d ihrll sub}d m cmplo!.r lo simiml 0cMlli6 and
<br />.ivil fines up ro oe hud4d ihousand doll{s (SI00.000}, in ddnion ro lh. oi oa compcnsalion, danBses a, polidcd for thc
<br />Sdmn 1076 olrhc t$or @., r.r.{ rnd drof,ry 3 lNr
<br />AppXot-
<br />LL;!X5D[-(r.]!rlAgrllB
<br />I)ECIdBAU0X
<br />I hrcbynmrflundur pcnllry ol Frjury rhal I am lr.cnkt uftlcr pmvision of(helcr 9lconrmncia8 *ilh Scclioi 7l[{D orDivhion ]
<br />ol rhc ausnrs Md P(na$iorE Cod.. and my li..n€ is ir nill ibtu. dd cfladl.
<br />AfILICANLDSCLT&II&N
<br />limhy!,liflnudcr l,tnrlly oiprrjtrry onc o,lhc nnhwins dcchrrlhns:
<br />lx r,lirnn Pcnnir\ A\ltno\ Noiifi.rri,)i l].d.rrlRcEuhrio.\ (tiilc 41). PJn6r
<br />Rcqtrircd hn.r I NotilLilior
<br />I ccn ify $d lh. fcd.rul rcBuhlions rc8odinB oshcstos E,mval .rc trot q,llicoblc lo rhn pmjccr,
<br />lccnilyrha'lh.!crcdrhttrpplicnrionand{arcrhdrncah,ecinl'ornE,iori\.otrc.rlagrmn,d,mfltwirhrllCilyrndCounly
<br />odinah-.cs unLl Srirc ljws rchriry lo l,uildine c.n .tioo. ed hcreby aurhorir reinceorarits ol rhh Cny ud Counry ro rtrrd upon E
<br />Eholc mnriotud rrtr'pcny ror in
<br />Apdicant or A8ctrl Si8nal
<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 />Rouqh 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 />Openinos
<br />lnstallation
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Rough Mech.?r/e fls ,\zt'
<br />Final Test
<br />Meter Release
<br />FINAL VZ)/rE 9t\7{
<br />Notes, Bemarks, Etc.
<br />Above T-Bar C(INS'TRTICT(TN LENDIN(; A(;ENC}'
<br />IhcrcnyBfli.undcrrEnrlr,olllerjlrrlhltlhcrchtrconsh hn hndins ascmy nrrtu pc'trnutuc orrhc woik rot whi.h rhic,tcanit is
<br />issucd (Src.1097, Civ C.r
<br />Lc .''\ N"'i.
<br />I )L4
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