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MECHANICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS owNul. arilr_Dr]R DFr,( a&!TtoN
<br />I h.rcby alfiirn uMcr lfntrlrr ol p.rJury rhlr I m crcnrU ftu r rhc Coinn.rh Li.cns. Lnv lir rl[ li)ll,)Bing rurnr(S.c70315
<br />Bu\itrcss rfll ttotcsion Codcl An), Ciry or Coutrry *iich rcqrirc\ r pcnnir lo roi{tu.r. rlrcr. nnfnrv!. dcndhh,r ru!'n nnJ
<br />{rucrue- lYitrtr ir\ i\\urncc. rho Equncs rh. applicanr ntr su.h l.nnn k,lllca.iBrrd {nrc rnr rhd hc.r dr is li&n\rd ,ursunnr
<br />ni rhc r.vt\io,\ ol rl[ (nntlcntr s Liccnsd Lrw (chllrcr 9. C.nuncn. ir8 $ rh Sc.r i,n rlxD oi Drvinon I .1 rh. Busnr\\ $d .
<br />Prclcsio \Co(lc)orrhnrtu.r\hcircrcnrnrlhqcl'rorrndlhctus lor rtf, trlLSlrlcrcmpti n. Anyvi,rhri,'noiSldirnr0ll 5hyrny
<br />rpplicanrturFnrirsubjccrsrh. rprli.r xr arivil!.nnltyolnor m,clho iivc hrndr.ddollm (S5([,)
<br />-1.
<br />s owmr of thc rrc|Efly, or ny .t@loy.{s {irh w{.s I rh.n $t str{Ensrio.. will th [r s(t snd th. slndm is mt
<br />inrci(H or o,YGEd aor sk (Se.70{4. Blsim$ @d trof.$ions Code Thc Co.rFdd . Lkene Las dos not .,rply to !n ow8 of
<br />lhc I,mFny wh. hiilr(r or infloB tlErcB lrn who doca sh slk hinElf or hcrElf or thmush his or ho own.mployc.s,
<br />provtrted thil slch inrrrowmnts e m! inl.rdcd or on€En for eL. lf, hosq. rlE hiklin8 or irymrcm is sh *irhin oft )ts
<br />.f.oq)htiotr, ltf, O*ncr Blifthr wil hlw dE boidcn of rmviis th,r l* or nlc did mr hn! or inpmw lhc pmFny for th. purlss .l
<br />-t.
<br />!s owmr of
<br />'h. roFny, ah cxclucively conrEcrins wirh lian$d conlncloF ro dlnsrrucr rrE pojccl lscc. 7044. Busias
<br />and Plbftsd,n Codc: Th€ C.nrracror's LiQn* Low docs nor apl1, k, an owoc ofpropeny*ho builds6r inpr.vrs lhcrcon.
<br />and who snlmcis for such pmI.h wirh a CoirEcro(s) licctrsd pursua ro rhr G.lrucrofs Li.cns tie).
<br />-l
<br />amcxcmor uMcr sc.rio
<br />WORXERS'COMPFNSATnN
<br />DECIAAAION
<br />I h.6b, nmrnunder I'cnuh, ol psjury om ol rhc followinS deledi.ns:
<br />_l har ad will minlain cCcnifror.of Con*nr ro Sclf-ln rcfmmll6 6Dp..dio.. ar pmvid.d lor hySe on3?0ofln
<br />L!tD, Codc. lor lh. lcrfoflEm oa rhe w.ft fq {hich rhc noml h is.ued.
<br />_l have ond qill tuinhin qork€rs comlcnsllion inslromc. $ rcquircd by Ssrhtr 37m of lnc llbor Codc, lbr llE p.,fomrc. of
<br />rhc sort for whkn lhis Dcmi n is$€d. My workss omp.nslhn insunM.Mir .rn po[.y nu'nber m:
<br />I ccnily lh{t in rh. p.iro.mrc ofth. worl for *hic,r rhh pcrmn is iss!.d. I \hallnor corloyany posoo i. ao, n.nmr
<br />si s lo bB!tr subjer lo lh. $orkdr m,np.nr{rbn law, oa Crlia.mE md .86 thd ia l sh.uh txonE subicrr lo lhc
<br />workcr'con{.nsarionpmvisionsofScctio.lTfi)oflhcL,b.rCodc.lsh,ll.lonhwnh.onllywirhrho*tbvi*ions.
<br />WARNIN(;. Fiilurc t' *.ur. workcs !. d.d stull subixr e crglorr. ro ainind Fmltlx a.d
<br />n rh...{ orcomn n{rinn, datugcs N pmvid.{ for !h.
<br />I hcreby Bfltn undcr rEnalry of nclury rhrr I !m licctrxn pmvisionofChlplcr 9(codmrciis qilfi S*li.n 7000) ofDivtidn l
<br />of Ihc Busincsrnd Pofcssn,nsConc, and my li.nk is in lull torc drd.fast
<br />?45?,
<br />I hctby !fiirm undcr Fnrhy of pcrjury
<br />issucd (Se. 3097, Civ. C.).
<br />tndinS a8cnc, for thc ,Erfolmrc of rhc &rk for whtn rhis prhir i\
<br />AIIIJI I.LDICL A/IIIQN
<br />I lHr$r anlrn, u rlcr rEMlry or r{rjury oD. ol rM l;ll,,slnA dc.linli,in\
<br />l)riilni(rI).'nnrsA\lI{o\Noririuri(trrI..cnll{rgulnri{)Nali{lt4)_l,an6)
<br />. -Rcqutc,l l-c crol Norili.lli,
<br />rcnDvlllre nor lnnlicat lc x, rhi\ projcr
<br />ion is coret. I !8rs lo conrly wnh ull Ciry&d Counry
<br />hy aurhori?r icrrcrnrarircs ol Ihis Ciryand Coun
<br />,^, cbr /Y
<br />Appliances
<br />Metal Fire Place
<br />Evaporative Cooler
<br />Furnace
<br />Compressor
<br />lvlisc. Equipment
<br />Duct Work
<br />Pre-lnsulation
<br />lnsulation
<br />Smoke Detectors lnstalled
<br />Rou gh Ductwork
<br />Vents
<br />Toilet Room / Clothes Dryer
<br />Residential Ranoe
<br />Other
<br />Hood
<br />Type I Hood
<br />Type ll Hood
<br />Grease Duct
<br />Fire Dam per
<br />Openings
<br />lnstallation
<br />F.D. D rop Test
<br />Above Hard Lid
<br />Above T-Bar
<br />Rou gh Mech.
<br />Final Test
<br />Meter Release I
<br />FINAL /AnrVl s#t-<./)
<br />Notes, Remarks, EIc
<br />Iind.is Jd'r$
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