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MECHANICAL-INSPECTOR RECORD
<br />APPROVALS tD/srG.COMMENTS OI'NER BUII-DER DEL(:ARATION
<br />I hcrcby ll'm udr p.nalry oa p.dur, Ihal I m ci.tr{,t 6om rllc ConFeton LiItr{ tj* for rh. f6llowhg E sr (Se..7oJ l.5
<br />Bu.in.si dd Ptufc$io. Codc)r Any CIy or Counry qhi.h Equn6. Frmit ro oi{rucr, dld. improvq dcmolist or EP8t M,
<br />srdcrurc. prior ro ils ksulR, also requiEs rlE ll,pli.anr for such Fmi ro nb a si8r{ srulcftnl lhlr fic or 3lt b licc.sd plNmr
<br />lo thc lstirionr or 0E Conlmror. Lic.nsd Lrw (Chaple, 9. ConmminS wnn S.clion ?0OO of Divirior 3 oalhc Alsimss !trd
<br />Pmfcssions Code) or rhar lE or shc is crcnpr rhmfrem and rh. lEsis for thc llb8cd crcmpriotr. Any lhlarion ofs.dion 70:l1.5 by any
<br />ll)Pli.anr fo! a !.mn srbjers rh. applicrir to ! civill)emlryof Nr m6 rhln fivc hundEd dollai ($500).
<br />-1.
<br />ne owmr of lh. lmpent. or m, cmplorrcs wilh wo8 e as th.ir $k conE nsl n n. *iU &, lrt work &d ln slnElrc is ml
<br />intd& or ollsEn for $le (56.?044. Busincss and Pmfcssions Codc: 1 h. Coolndd\ Lkdsc tls dds ml ,!ply to e owmr of
<br />rhc l,sp.ny *ts hril& or nrym6 EBn..,n wb des sEh w* hinsclf or lEnlf or llmogh his d lrr 6sn.n'pk!y.es.
<br />pr.ridcd thlr such irproEmnlsd nor i €nd.{ orolM for sh,l[ how6, ttE buildirg o. inFowmrl t$!dwhhinom )@t
<br />ol corph&,n. tE OwN Buit r vill haw tlE to h. of pmving th! lE or dE dn ml build or invow th. PrDFIy for ltE lurro* of
<br />_1, dsowm,6f rhc rhtcdy, d.&turivelyco r.dns whh lienscd conrldoft ro.onsrrud rlE pmiccr (Sa. ?044. Busn.$
<br />sri hoftsrhn Codc: Th. Conl@rols Liccnsc hw d@s nor .pt,ly ro m o*rct of polErry who blilds or iq)r.vcs rhc@n,
<br />ond who onrturs for slcn tFrc.rs *ilh a Co racro(s) liccnsed nrrMfl b rnc Coini.rofs Li.cie L!w).
<br />-l
<br />mercmpt lndcr Scdiotr-. B &PC forlhn rc!$n
<br />OrEi:-
<br />]TOTSEIE.COMIENTA.I]!]N
<br />DECIIIBaIIAIh.,.l,rrll,tr,trn(hr |{ lrr.ln.rrtr'\ otrc olrhr il'lL,i{ i,Jr Jo(h,rritr\
<br />IlvcrxlwilliunirirrCcdifi.rrcolCon{trrt,S.llln$r.nrB.rkcn.or|En! iotr.as providcd f{trbySc.rnrn]Tmolrh.
<br />l,rlltr(ixl..lnrrh.lxrt)nnncc.lrhc*orknr$hichrhcnti,nir i\is\ucd
<br />{ how and willnainroin wo*cn Nmpcnssrion insnncc. as
<br />thc wnlk tor*hkhrha Bm ir n\uqj Mv*mlc* or{tn*r
<br />,.^.,, ihk 4*1
<br />eqlirn iy Srdion 1700 of rhc tjbor Cod.. fo, ttE p.rformN of
<br />ion i.su@c cdi.r.,t Flhy numb.r dc:
<br />4 b 7q1 9 I I 'L- I
<br />-l
<br />anifyihal in ln p.rformmc of lhe wort lor whi.n $is pcrmil is issucd. I shau nor cr{tloy .ny Frsn in tny mnmt
<br />so as ro beclm slhjccr ro rhc Dorks @npcniAln,n hw. ot Crlifomia, lnd 3€m rhsl if I stuuld b..om subjel lo tl*
<br />workgl ompensorion pmvisiofls of Ssr ion 3700 of thc L*o! Co<le. I rhlll, tonheirh s6ply wnh lhos pmvishns..
<br />WARNINC: Failu'c ro snrc so e^ .otr{En\arion cnrcasr is onhwrrl. and sh,ll \!bj{r !n cnpb}rr lo aimlul pculris and
<br />cilil fincs up ro ore hundrcd rhou\nnd dolh^ (51(D.OO0), in lddirn,n r. rhc co3r oicotrrprtrsrtior, drnE8cs as provid.d for rh.
<br />Se on 3076 01lh. t t C.de i.bEr.td
<br />".,. Lllt lzp ^
<br />ulElllpiouraagroR
<br />DECI.AB.{IION
<br />I ncrcby nflnn uftlcr pctrullyolrrjurr rhar I um liccnql lndcr pFvkion ofChq'rcr 9(.onnxmin8 wnh Scclion ?fiir) ofDili\ion l
<br />ol rhc Busincs Md Pn,r'csions Codc, drd my liccnsc h itr tull lorce ana cftcr.
<br />cto 'LO g-Lt@q
<br />CONSTNUCTION LTNNINC AGFNCY
<br />I lrrby dlrm undr Felry of Friury lhar rhc ii . @inocrbi htdile aE Ey for ti. pGfffic of dE *dt aor whth lhb I6nn ir
<br />issucd (Scc. 109?. Civ. C.).
<br />ATILI(;ANfD}:ILIBAIIIJN
<br />I lrd,y rflinn rndcr I{nalry ol I)crjtrr, oic ol rh0 l.lk,wnr! dLllxrrri(nr\
<br />Dcnmlirnn PcrnrirrAshc{os Norin. iqr l:cdcrulRcsul ons ( l irb rO, P!n6)
<br />-R.quimd
<br />lrrrcr o, Norifi crii0n
<br />-l
<br />enify tlur Oc fcd.6l r.lrililioB rsadinB arb.nos Emvil e nol +!lic.bh lo lhis pmj..l
<br />rldfaniry rhar I hlvc rcod rhG arpl
<br />odina.ccs dnd stot tiw. rcl,liry lo
<br />icadon dd $ar. rhd thc ah4 i.fornErjon h corel. I aeE ro ftoply with rll Cit, srd Counl,
<br />lrd h.rcby luthorizc Eprenlarivcs orrhil Cnydnd Counly to cnrcrulnn$c
<br />llbve mnlioncd pmFcny for instcrlion c >6
<br />Appliances
<br />Evaporative Cooler
<br />Furnace
<br />Compressor
<br />Misc. Equipment
<br />Duct Work
<br />lnsulation
<br />Smoke Detectors lnstalled
<br />Rouqh Ductwork
<br />Vents
<br />Toilet Room / Clothes Dryer
<br />Residential Ranoe
<br />Other
<br />Hood
<br />Type I Hood
<br />Type ll Hood
<br />Fire Damper
<br />Openinqs
<br />lnstallation
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Above T-Bar
<br />Bough Mech.
<br />Final Test
<br />FINAL Ll7"lzc2 Dkna 6L+ \-q
<br />Notes, Bemarks, Etc tt
<br />DATE
<br />Metal Fire Place
<br />Pre-lnsulation
<br />Grease Duct
<br />Meter Release
<br />.^,-"""O a9Sa (t>ac
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