MECHANICAL-INSPECTOR RECORO
<br />APPROVALS DATE .COMlt'ENTS
<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 Delectors Installed
<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 />Fire Damper
<br />Openinos
<br />lnstallation
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Above T-Bar
<br />Rough Mech.z)rc\q rrth(4
<br />Final Test
<br />Meter Release
<br />FINAL gz-/'
<br />Notes, Remarks, Etc t'0
<br />OW SR IUII,I'ER DIL]CARATION
<br />I bglty .trE !.dE porfty or Fj''y rht I d d.dF tm E Co'r*rdl U..e lrw 6r rb. blb*hs tx'. (5...?011 5
<br />BItid rn Proisir Co&): A.y Cay d Cor , *tth c$i!. r Frn lo @drlr. .16. it4.!ec 6rd! 6 !q,.i -,
<br />imdur. Firlo b i$e.,.1o.lqliE tlc +tli.lr tu ist FDil lo tl.. rbrd flod lnr lEd a. i lia.d Fnd
<br />to O. FivbioE ot rlE Cmr.d6! Li@ir.d tt* (4try6 9. Colrtldilg wilh Scrb. 7l]0O ol Divirio! 3 of rhc BBina. !d
<br />ftlErbi. G&) d $d lE 6 rt h .rapr tlErt@ -d r,t bil tu $. dLs.d a@Fbtr !, vbLlbtr of Sdhn 701 I 5 tt &y
<br />rf?lt.d 6. . F6i alitr. dE +9liqd ro t .ivil pdrl, 0161 6E ttt- 6c h!'.H tb[B (1x,0)
<br />-1.
<br />s omd of rh. p.oFly, or sy oqlot€ wilh *q!. s t.r .b @6pdrion. sil & lh. $eir ad dE ii-c b Dl
<br />i aild d oftld br Et. (Sc.7o4a. BdnE rd PtlinoB C!d.: TIE codncrd! Li:a.. Le &6 d lplr lo o olc of
<br />drFrfdty vL. toib d itg!6 dEq -d *lto a-id Et ftdf d iaxlf or &$t6 hL d ha lM dqlttq
<br />Fwir.dit! *t iqo\ffi F d nod.d nofld a(.L lf. hoffi. dE t(ild4 a iq@r ii -ld *th- c rc
<br />of@dpki,! tlE ovM 6ild. * htE ttE hrdo ofFovES dlr h.tr dE dn ful hild or irqlE ltc FDFI, fq lh. Frlot of
<br />-1.!ffiof
<br />E plFry. d a.[!iv.tt coddns wtn liEid @drr6 ro @'trr!6 lb Fi.{ (sc. 704,{. adB
<br />aDJ rh,lcsbn ( , . I h. Cont..ld r t.!(ds. I a$ doB nol pply ro u omq of FoFly who b{ildr or i6proG 1fit6ll'
<br />ed $ho co' r*r! lor s.h Foj<I! wnh !,lis!.d poEu to rh. codrclvi Li..e l,w)
<br />DECI{EAIIA!
<br />I td*r drm @d.r F!h, olFjlry oE or0E blbwiB debah'
<br />-l
<br />h.E .d will Did&! r Cdti6.n. of coler lo sdl-t6@ 6. wtfl @np6t l,oq . FovtLd for by sdix l?00 oillE
<br />t t . C.d.. &. U. Fft.DE of llE w.t ii rnin thc I.!i a br.d.
<br />-l h.w .rd will 6.i !i! m o .orFolniotr i.rEr!l... s Eqgild b, Sclio. !700 oftl* L.b.r Co&. tu tlE FfolrlE! of
<br />lh. xqt 6r wtth ti' F6i i' io.d My wl6 6dFurir! iElrc ffit !d Poli, odh6 G
<br />Polt, Nubq: ErPiB:
<br />-lc
<br />iry Od ii rl8 Ffo.rtrc of rh. mn G, whib 6n Fdn n asr( I iul! ml .FLy uy ttu. i. !, EllE
<br />$ G lo bcsm abjdr r. rh. edt6' 6oF!rb! hs of c.l,fo6ir rd tsc rhl ir I tlbull bcom urFr ro rl!
<br />wA6' @mFudion Fovbiod olsclioi 1?00 ofrhc trbd Cod., I rldl. fonhshh onply with rlF* FovirioB.
<br />uiL*ftL ai tlull !(6id o 6'ploF to dintul r@lb rd
<br />civil fin6 up lo oE hudr.d lhous.d &116 (ll00.0oo .ddnion b rhc .on of comFilcion. dh.86 a pro{d.d fo. rh.
<br />IJqEIIED.CONIBACIAA
<br />DICSAAIIO!
<br />I lE*y ttffr u'l<Lr tdly of Ft y U! I D licd Eda Fvibi of Chlra 9 (o,EtEry wnh S.dbo ?@) of l !6 !
<br />of rlE Buh6 ud Prcfdio Cod; !dnrltd.ir in tuU hr.d.frcl.
<br />LieN@bs:
<br />qorfl8qqllo!.lj8Dllclcllsr
<br />t holt, .rEE uds p@.ly ot Fruy th! rhfr b . 6ffiu(rb! lcxli!3 !84, ror tlE Ffoffic oltk wr fot vtic! tib Fna b
<br />iB!.d {sd. 3097. civ c.).
<br />a&!cadfD!ct38Auq!
<br />I h.drr.ftn ulds Fdy or FFy c of tlE folb*ia &.bri(61
<br />Ddolnio! Pml}AlhddllorifErb. F.dad rcrdniB Girlc ao. Pal6)
<br />-tcqud
<br />tclqof t{orjhi,
<br />-l
<br />cqiiry dd LE f.ds.l naltrnB Esrdil8 rb.t6 .!e!.1 e ml .pda6L lo th.' FoF
<br />-I
<br />.rrit fir I 18. rdd lln .trrli,r!h.irl'r'rt\(,l ,, ikr,\!,i'..i l,r,,rri\f {,1\\th.,l1lt\,trJrrtrr\
<br />hildiis oiirurb[ td h6.1, .!rh.rn. EF&rin 6 o
<br />.6ov. l6rirn d FnF!, tG
<br />41
<br />':|;),,7*"*
<br />qailtAitilfrild
<br />III
<br />I
<br />ID/SIG.
<br />Grease Duct
<br />A^,4
<br />I
<br />=
|