|
MECHANICAL.INSPECTOH RECORD
<br />OT'INER BUILDER DELq{RATON
<br />I lEr.by a,trrn lndcr pcndry ot n iuy rh l @ crcnpl t E llrc Contraclo$ Li.cns kq lor lk following ENn (Se.?o] l 5
<br />Bosinc$ ad Prcfcasi.n Cod.): Any Cily or Counly wbich rcqlies a ,tmn to @i!ro.i dr6, inprrc. dcmlish.r quir my
<br />srdclurc. prhl ro ns issu!rcc. als rcaun.i rh. arplitur for ru.h pcmi io fh r si8ftn shtcmnl lhd n or llE ir lkcEn !um.
<br />ro rhc pmvirhns ol rlE CoorEclm's Lian*d L3* {ch.pld 9, comrcing vnh Serion ?000 of Division I of llE Burin$r ed
<br />Pmfqsio.s Co{r.)orrhar t or sh. i3cfun,l thcrcfi'on.rd rhc b&rii for rlE.lh8cd crcdPtion. Ary vidlolbn ol SeInr ?03,.5 by lny
<br />lpplkanr for s pcmjr subjdr llE apl,licrnt lo r .ivil !.nalty of ml mrc tlEn li!. hondrcd doll$s (S500).
<br />-1,
<br />as o*ncr of lte pry)cdr. rh €rcllsivcly cofl.acring wilh licenscd conlnclors lo .onitruct ttt pmirl (S(. ?044. Bu5ifts
<br />ard Eoft*rio. Code: Thc ConlBclols Liccnsc Low dms not applylo mo$n* oltolEny eho builds or iry,mws lh.rmn.
<br />d who co mcts lor ru.h pbjcds sirh a C! B.ro(s) li.c.ed puisuni lo lh. Contra.rols Ltcn* L!w).
<br />l0ncnlnpl undcr Seli(A &PC r.r lhis,crson
<br />TII8f,ESS:CITMTEITAITAtr
<br />D&CLATAtrO!
<br />I lrrcby affirm under p.nllly of I)d.jory 6e ot lhc tollowiie .t {lrrtrrioN:
<br />ldb,r (i)dc.li,r rhc !!ni,flNrcd olrh. *o.[ lnr \h]([ rhc F"ni i\ trn]ud
<br />I hrrc,nd eillnri.tih sor&cr' coq,.n\olion i'N!tun.c, as rcqut d hys.cri lT0o olthc li$or Code, fdr hc lcrfonnotrcc of
<br />rhc work l'or which thh p.mir t hsucd. My*ortcrs .onrrcnsarion insututr.c cnicr ld,iolicy uuhcr d.:
<br />t
<br />I ftnililnnl itr lhc p.rformncc oflhc work for which rhis F ir h irsucd.I shrll ml cmploy lny IE{n in rny mnrcr
<br />$ us lo bcoflE suhjcct ro rhu Mr*.re' conpcnsrion hM of Californ[ and asB ihar af I rhould hccom 3ubjel lo llE
<br />workcis comFnstion rmvisions otsecrion 1700 of rhc titrr Codc. l nsll. fo.lhsirh drmpl, with ribs Povisions..
<br />WARNINC: Failuc o s.@ *ortcs' compcnsuliofl orcBsc is lilrwtul. and *hell suhjd sn cmplottr 16 dinamt FMnies dd
<br />cilil nn.i !p b orc hundrcd lhousnd dollos ($l&.000). in addilion b Uc cosr of comFnstion- datugc. as provid.d for lh.
<br />Srcrnr]0T6orrhc trhtr (ixlu. ir crc{ aM anormr'\ icc\
<br />zs
<br />LICI 5}:L TNI&!LIAB
<br />llliELlMIIoN
<br />I hcrcbyt'lnflnu c!r(nahyoipcrjur}rhrrI!nlrc!\cJunlcrn(,vi\i.nolCh!/d9(cormNi.8wirhScclion7UD)oIDivi\hnl
<br />of rh. Ilrsn.s nnd Pmfc$nlnr C.d.. dld mv lk.n* i\ in full foN ui cllirr
<br />Zg conrmdorx
<br />coNsTRUCl rON I I'{rllN(: A(;ENC-V
<br />I hercby lmm undq Fnally of Fqury lhll th@ n ! @iselion h.dir8 lg.my for th. l)crfomre .l rhc wo.k tor shicn this ltmh ir
<br />issred (S(.309?. Civ. C.).
<br />ATILII]INLDIII.ASAIIQN
<br />I hcni$y.ntm u ftl.r lf,nilry oi lcrjury onc olrhc nnL,*ins dc.lrrrbotr!:
<br />Dcnditirr P.nnitsArh.ltn Norilic rioo Fcdcrl RuBuhi i(,n{ llirtc .l0. Plnan
<br />_Rcquncd lirrcrof M ifiurirr
<br />-l
<br />.cniryrhrr rh.ltd.6lrcguhrions rcE&tira rshc{o\ rcmvrlrrc nor +lli.nhlc h rhn Prcjccr
<br />4..nr,n,,,t,",-r,t-rnflr.ntrJntlnrrcrhJrrhc!h)kinr.rmdioris.016..r.rr8teroconplytrnhrllcdy!ftj(butrr,
<br />Jniulnsan.t Sr.u. b".rct r,nE hrhu'u ra. nnru k{r. r,xi hcrch,rurhorizc rcprc*nrarircs (}fthn Cilynxl Colir, kr crr.r upotr dc
<br />!t$vc nE.riomd lmFny Lr in\F.in,n
<br />"..u- *,* rr,tuL-€o.l2\ +( Anl\ &tL .'.
<br />DATE ID/SIG.
<br />Appliances
<br />Metal Fire Place
<br />Evaporative Cooler
<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 Ranqe
<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 />Rouqh Mech.
<br />Final Test /r\
<br />FINAL I --t- )\
<br />Notes, Remarks, Etc.
<br />Dtsa0
<br />APPROVALS COMMENTS
<br />Furnace
<br />Above T-Bar
<br />Meter Release
<br />-1.
<br />as o*mrorlncpmlc y, or my cnploFd snh srgcs c thcir Flc.onp€nslion. $iU do tlE work ed rh. slmlm ir mr
<br />i.t.id€n or ofcred for slc (56,7044. Ausincas ed Prufcsions Codcr Thc ConhdoCi I"k nsc lnw .lo.s nol aPply lo d owrcr of
<br />rhc pDp.dy who bDilds or inprots tlFen, oln who &B tuh slt iin.clf or h.Blf or llmugh his tr h.r oqn enployc6.
<br />nrovidcn rhrt slch inpo14mrs m mr inr.dd or.fr.Bl rm slc. ll h.wrci tlE tdiuin8 o, inimEm.l is $ld *ilhinorc Fr
<br />of.oi{,lcrinn, rhc Owrcr Bui6., eill hsw t E t (k, olpmvi.g rhd h. or sh. dil ml l[ild or i'qnot 0t prttBry for itE l,urIn$ oi
<br />^,.,, 1/zsfP
<br />I
<br />I
<br />--------T------
|