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MECHANICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS owNE.BTJILDER DgLcAnAnON
<br />I h.r.b, rfr@ u!d6 Fmll, olpdjury tlld I e d@fl 6!6 dE conlr.croE Lic.ns. bw for lhc lollowinB lcen (sc 70ll i
<br />Busin* and Prof6ior Codc)r Any Cily or Counry which r.quiG a p6nit to con$toc1. 6lE. ihprovc. d@olilt or Epan my
<br />nrudu., pmr lo irs isudc€. allo cquiG tic applicd lor such pdri to lilc a si8.cd rld@ml thal h. or 5h. is licots d pusudl
<br />to rn lmvirioN of rh. Conractois Li@G.n L6e (Cn!!t6 9, Conm.ncins vhh S61ioo 7000 of Di!i!io! 3 oa ln BBiIB rrd
<br />Prcfsions Cod.)orrh,l h.or3hc i! d.6F thdctoh d rhc bsB fo, rh. alhg.d !x@piio.. tuy viohlion olsclion 7031.5 by 6y
<br />appti.adfor!p@il3ubjdith..r!lic&rrc5.ivilp@rltyof.ornoEtbEfiv.hutrdrcd&'[{s($500).
<br />(R0. * "*- .rrr'. p,.p.ny. or m, cmplo}ld w,rh s6e6 6 rh.ir $lc omp4ar.oi. wirr <to oc wo* md rhc sllud@ is nor\ n/qd.d or olls.d tor e]c (s<.70c{, BcrB dd FolsioB Cod.: ft. coilactol! Lic@ Llw do6 nol alply lo d oMd ol
<br />tn prDpdy wlE hril.ls or inpr.v6lncqn dd who do€ Mn mli hims.ltor h@lf or dbugh his or ha oq, @plorc.
<br />prolid.d ihd su.h inFD\6@!5 E mr idad.d or ollald 6r eL. I[ ho*M. rn. hildina or inrrcroetll is sld witni! onc ,w
<br />ofo"phtion, tlE 0*16 auids lin haE lhc htrd6 ofproli.g rha h. or sh. did ml hih or ispmvc lhc proFty for tl& purp.& of
<br />-1.
<br />6 oM.r ofrh. prop6lr. an qclNilcly cortrocting vith licmcd contrcroE to on$ruct lh. Fojc€l (Sd. 7(}44. BuinB
<br />.trd Pofsir Cod.: Th. Conrrrcrols Lic.ns Law do6 nor lpply ro o ownd ol p,opdry who blild! or iapbrd lh6on,
<br />ad who co.nEcle for $ci Fojd! wirh a Conr.&ro(!) lk@!.d pmumr ro th. Conrrdor'! Lic@ L!w).
<br />A. & P.C. lorrhis,6on.t
<br />u!1 !. \!t t l l!\
<br />I h6€by .mrm unds Fnalry of pojurr-. onc olrh. folloeing dEl@tios
<br />_l hntr ed vill minrsi. , c€rri,icar. of coNdl ro s.lf-lNur. for \rcrt.R @mpcn$rioq a FDvid.d for by serion 3?00 olth.
<br />I-abor Codc, to, thc pffoirffic. of th! erk lor whict tt. p6nit b isucd.
<br />-l hav. .id vill ,nriiraii work{l conpcBaion imu&ce, a r.qoircd by Sqlion l?00 of ll'. Labor cod., lor lh. pq6'll@. of
<br />rh. Nort for which rhis paoil i3 is!.d My Mrtdi conDos.lioo iGurDc. cri6 ed policy nunb6 a.
<br />Poli.yNlmbe: Erpn6
<br />(d|.airvrr',r . rr'. p..r"mucc orth. wo* ror which this Fnn is i!su.{ I shallnor @plo, dy psen in uyr.M
<br />r 6 ro b€oru *bct o thc ort6'@npoIdioo las of califomi.. ald asE drd if I 3houd beom 3ubj..r ro rlt
<br />wrt6 @mpcdioo ps$ioB ots.<lio. 3700 of rh. Lrbor Cod!, I dall fonnwnn onply with lnos povitioa..
<br />WARNINC: f_aihrc Io *ue *rrk€rs' cofrpcierion $remle is u.lawfol, ed sh.ll srbjccl an erploys lo sinin.l pdllri6 dd
<br />fiouMd dollBs {$100.000), in addirion ro fi. cosr ol co,nFNlion, danaad a provld.d lor lhc
<br />lr/X ,"",l<t lf,
<br />I,I(:EISEIICOtrIAA(NT8
<br />Dfclrt&llAN
<br />I h@by rlrm lndr padry of rcjury thrl I m licn$d uf,d6 pmvision ofch.prd 9 (.omddng wilh S.dion 7000) of Divisior !
<br />of th. B6in6 dd PmadioN co&. ed ay lic@ k in tuU aore dd c,L.l.
<br />qorilaucuorrErD.trclc[lcr
<br />I hftby altun undd Fuhy of pdjury thli fi@ is a .ociucrion ladinB agdcy fo. rt. Ffol:mc ot th. work lor which lhis pdai b
<br />Bsu.d (Se. 309?. Civ. C.).
<br />AIIIrcAILDECIJSAIIOA
<br />I hart'y.fiim unla pcnahy ol p.rju.y o!. oflh. hllo*ins dc.lar.lioB:
<br />Dcmoltio! P6nits-&b6ros Notificdioo F.daal n.guhrioB(Titl.40. Psr6)
<br />-R.qui!d
<br />Ldla of Nolific.ion
<br />I c61iay rhar fi. ftddd lcalLtioN r€geding ch€tos dolal e. iol appli.abL lo rhi! p&j61
<br />@f ..,,,'ru,u-",*.,r..,n,
<br />orJinrnisd,! srarc la\r(Lr n! !'
<br />icariob &d $atc riar rh. ab.v. inhmarion is cotu.l aara to complywnt all Cily md
<br />buildiog cosrtudion. dd holby aurhoriz. r.pr6..lariv€ oflhis Ciiyud Couotylo
<br />abov€ motioa€d Dop.ny tor i6p..lion purDos6.
<br />\ pptimr or A86r sisBrurc: _tzt t(/ r--''l
<br />D0?f (V tl
<br />Appliances
<br />Metal Fire Place
<br />Evaporative Cooler
<br />Furnace
<br />Com pressor
<br />Misc. Equipment
<br />Duct Work
<br />Pre-lnsulation
<br />lnsulation
<br />Smoke Detectors lnstalled
<br />Rough Duchvork
<br />Vents
<br />Toilet Room / Clothes Dryer
<br />Residential Range
<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. Drop Test
<br />Above Hard Lid
<br />Above T-Bar
<br />Rough Mech.
<br />Final Test
<br />Meter Release
<br />FINAL \\q\\q /_/4q(,)
<br />Notes, Remarks , Etc.
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