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APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DEI,CARATION <br />I ficq .rm lnrts t6dly of psjury lid I d ddF fioh llE Co nctdr Lic.e ttw for lh. lollowin8 tun (Sd.?011.5 <br />Buir6 sld Pmftsior Codc)r A., Chy or Co! y whi.h r.quiG . Fin lo co.niu( ,llq, inFovc dqmlih or r*rn &y <br />'trucloE Fft ro nr suMe rtro Eq!i6 lhc *Dlkdl ror 36h Fon lo 6lc . :i8!.d rndEl lh, lE or {E b lica!.d p@d <br />ro rlE F.vilioN of 0E Conlrelori LicrEd t w (Cnrod 9. Comtri.s vhh Scriou 7000 of Divirion I .f rn BdiId ad <br />Pmfdion! Cod.) d lhtr lE or {E t qdpl EdDn ard $c bGb fo. th. alk!.d d@Fiotr Any vbltlion ofscrion 701 LJ by 6y <br />!p?lic&r fo, . psilir lbj6lr th. lrplioDr b ! .ivil Fdry of iol doc Od filc hun<trcd doUds (ltm). <br />-1. <br />s o1r@.irh. FoFly. s ny drplord wnh w.sd s dEn $k oEp6aio4 *iU tb th.*nl tld lh. lr,rEG i rcl <br />i d!.Ld orofisd tu nlc{S(.?O!1. B6i!6 &d t ot<ioN Co&r Th.Co n rd ! Li(fu tedo6@l?91,touolrdof <br />rh. FoFty eho hili d iEF!E dEEE rn vb d6 $d wt hira.lf or h*lf or llElu3h fin or hd oa @9lot6, <br />p.!vii.d rlur iu.t oF!€D.dr E mt hoddotu tu rl..l( lbtr!6. tlE hrildi4 or ilFsqEi i $ld srhin 6 Jd <br />orNnpldbr tlt o'ffi &iLtr sill hE 0E hrd6 ofFovir8 rii lE d S. .td El hild d iiqow rtc FoFty tu lll FrP6. of <br />-1. <br />s o\[G oflk FlFry. o acn6ivcly @(6.ri.s wnh bcd.d 6e*6 b ono*l li. Fojer (s6. ?04!, hlirE <br />.n h!ki6 cod.: TIE connras , Lic@ I* &€ ml .rpty lo d oud ofFlFiy *ho hiildt or i6Irc6 Utdo,!. <br />cd rtr 6drll' ft. xt Foird! *il . co ndo(rl li6.d F4ui ro ilE con'.da r Lile t s) <br />-l <br />e.!mr, u'da Satsn-, B &Pc forlhtlKn. <br />D.r. oitr6 <br />.!a868&tC@IEISAIIO! <br />DICITAAIIAB <br />t n6d, .rm !.dE F.l, ofFiury o* ofth. tolbwinS ddlr.lirBl <br />-l <br />h& .n wil oid.i! . Cqrihr. of C.Nar b sdt-ldd 6. wr6 dp6!di,l - FDvi,.d for b, sdm ]7!0 ofdt <br />t bd c!d.. tu E Ft @ of t wt f( *fiit ih. FEn t aE d <br />-l trE.!drilt Mir b wtd oAdrbr iEus!. EqiEd by Sctb! l70O oftt lrtq C.d.,for lb Ffat!5soflb 6t fr ettt ibi F6i ir ild My Nt.it oo?.db. iq!t. 6i. !n Fli., tltbq GktrAI I' LATF FEQE-n;iG?tlol ltln$ <br />_l <€ri9 tr in $. Ffolm of rt mrt 6r *nit rni FEir i3 iE ( t $.! @r cryb, Ey Ft. i! .ry 6@ <br />- sro b6@ dill to tt dtd'oopa..ioi h*! ofc.lifomi. -.|xE llr ifl rl'.old t6oG rd*<r lodE <br />Nrto oqddir Fvirid of S.ab! l7m oflt. trh,r Coilc I ftnt!,ilt onPly rti rlE FoviriB.. <br />dr$bF b 6imii.l Frli',d <br />.ivil fin6 '4 ro m hd.t d thoBnd &[r! (tlo.ooo). b .ddii,n ro rtt 6r of &D+6 a Forikd ror dt <br />SBrirn !016 o,$. ll! Cod< iida &d.rdE1't <br />I |tatt, dEd @dd pdtry orFjE dr t r [6!.d E da Foih otct+.6 9 (@ira ei! s.diE 70O) of Dntio! ! <br />of t B6iE -d ftot $! Co.L. !d or li@ ir b tul rDG -d.&cr <br />,o, A'7o Lt@N@bq:uz317o <br />7 -at-A Aue€2J-A+Y{, <br />coNliItu(Tron r,!nll{(;acFilcY <br />I balby dfm urnE Frty of Fiury dld lhs! ir . @eBlbi laidqr .e@y tu tb. FfdtrE of llE $o* fot *'t'.h ltb Fni i <br />i$u.d (s6. !097. civ c ). <br />lrrr lcaNT DErctlnrTloN <br />I hc*t rftD ue pa.l, of FiEy @ of tb. folbwhi &.EaioB: <br />D.@lih. PqEi&tut 16 l&,rincri6 &d Rcgullbs (ri& 40. Pai6) <br />-R.quir.d <br />k rdof Noffdi, <br />-l <br />.di8 rhd rh. tcd.nl 'lsdrlioE Esditrs Bb6r6 lgmln EG er applt bk lo rh! F!j<r <br />-l <br />cdit rl'r I lft Md rhb lppli.cion rtd n c rhd ,E .h.r.t cor*r. l .rx6 t6 6mplywhh.ll( ily ud cou.ly <br />odtreB md str. t!$r ELr irg ro boilding r.Fqar.liv6 of rhn Cny..d Co@r,lo d6 r4o. E <br />.bov. mlion d pilpdly for <br />ly'nntcur o erar sicorc,-19 <br />Appliances <br />Metal Fire Place <br />Evaporative Cooler <br />Furnace <br />Compressor <br />Misc. Equipment <br />Duct Work <br />Pre-lnsulalion <br />Insulation <br />Smoke Detectors lnstalled <br />Rough 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 />Above T-Bar <br />Rough Mech.4tt//4 4nrrz,/D- <br />Final Test <br />Meter Release <br />FINAL Ul tllP *rw*//, - <br />Notes, Remarks, Etc <br />MECHANICAL.INSPECTOR RECORD <br />'/^.s->l-4 <br />(;