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MECHANICAL.INSPECTOR RECORD <br />DATE ID/SIG.COMMENTS <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 Detectors lnstalled <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 />Grease Duct <br />Fire Damper <br />Openings <br />F.D. Drop Test <br />Rough Mech. <br />Final Test <br />Meter Release lr <br />FINAL Z\2r\\1 ilLq(q <br />Notes, Remarks, Etc <br />OWNER BUILDER DELCANATION <br />I ho.by alfm &do poulry ofpdjury rhd I @ qdpr ton fi. Cor,lncloR Lirru t w f6r tb. 6do{ins E Si (Se.?Oll.t <br />B6ir6s ard ProfdioD Codc): Ary Ciry or Courry stict r.qunB a pdnh to codrucr. .lra. iaprovc donolirh or ED.lr.uy <br />srrucru., prior lo irr i!sudc., also rcqutB rh. .pplic&r for su.h Fftir lo fiL r sigEd $d@d thil lE or sh. t licoa.d FBid' <br />lo rh. provisions of lhc Conrlctofs Lic.n$d Llw (Chlprd 9. Com'n.ncins snh Sction 7000 of DivGion I ol lh. Bcins ed <br />Prcf6sions cod.) or rha! hc or shc is €xcmpr rhd.lion dd rne bais lor $c .llcrcd .x@pion. Aly viohlion ofs..rion ?03 L5 by my <br />arplicdt for a pmit subjets lhc applicet to acivilp.oallyolior mo.. tn& nv. nE&cd doll@ (S500). <br />-1.s <br />oMd oflh. propqry. or mymployc w wa86srh.ir $kcompcBalioa wil6 dEwod( &'d dE.ti(lE bml <br />i oid€d or o{daj lor elc (Sc.7Ol4. BusiB dd PbfdioB Co&: Thc Co.rr.dols Lt.e lts do6 ml rpply lo o owr6 ot <br />lh. poFly who builds or ihFDv6lhcEn. ad wlb {t 6 sch M* hnMr or tasclao,lhmuslt tL or h6 om @ployG, <br />provid.<t rhil3uch i,rpr!\@l!enol intq'6 orotu d 6relc ll how@, Eb(ildiDs orihprov€ffit issld wihiiooc <br />'6ofonpldion. lhc O*G aui!:lq will haE rh. butln olprovins rhd lE or 3hc did rcl tuild o, iritror. Uc <br />',Dpcty <br />for th. Frpoe of <br />-1. <br />6 ownd ofrlE pmpqly. m qclBivcly co rocrins qnh LcsErd corurado6 to consrtud lh. prej.d {Se. 7044, B$DG <br />Md PJrEsion Cod.: Th. Conlhcrol s Lic.ns. Llw dos not dpply lo u owns of propeny who build! o, ioprcvd Oncon. <br />&d who co ,ads for such p@j..rs vit. conE .ro(, lic..5.d p6Dd b rn co ra.roi! LicN t{w). <br />-l <br />m .ropt und6 scrio!-, B. & P.c. for t!i! r@E <br />D.ts Ostrd: <br />laaaEas:colltlltarla! <br />DECIABAIIQ! <br />I hftby alfinn undd paalty ofpgjury otr oflh. Iollowing delmlioB: <br />-l <br />havc dd B-ill maintain a Ccrrific,rc olcoelll lo S.lf'lGurc for elt6i anrpdelion, d prcvid.d aor by Satioi 1700 ofthc <br />L{bor Code for tn pqfonnm. oflh. mrl for trhich rh. p€nir is isucd. <br />_I h4. and will mai oin vorl.6 conp.alrion tuufuq a r.qut d by Sdrion 3Il0 of lhc Lrbor Cod.. for lh. patofuc. ol <br />fie wrt fd *hich rhis Fdh is isc4 M, workdJ .onpasarion iaulmc @i.r ed Flicy n@b6 r.: <br />PolicyNunbd: EipiB <br />_l cdiay thal i! rhc poaoliMc. oarn wort aor which fiir Foil ii i$ucd, I shall Dol strlloy any pssn in dy oend <br />$ d lo beomc subiet lo thc uork6 ompsolion la\6 of Califomi& ud rhd if I snout bdomc arbjd b thc <br />r0lt6 comps$lion pmvieioa of Sc.lion 1700 of th€ Lator comply wih lho* pmvisiore. <br />WARNING: Faihr.lo su€ w @' comp@0lion <br />civil nn€s up lo on tun&.d lhousud dollm (Sl0O <br />L md shaU subjd 6 dnplorglo oimiial ,E allt .nd <br />ion to the con ofcom!.nsarion, d@e.s a providcd for lh. <br />Sdrion 10166frh. bhor cod.. im66r <br />Iht : ADplro! <br />I hady arm unds p.ndry of pdjlry 0lsl I m liens.d u.d6 provnion of Chapro I (omocine wht Sdliotr 7000) of Divhion l <br />oa th. BBin6 ed Pof6sio6 Code ed my licd. is in tull lore dd tllel. <br />I b@by ,tt o 6d6 pqlrty of pdjury lha tt@ ie a co.nruction <br />isued(sc. 3097, ci!. C.). <br />ASEUCANI.DISAEAIIA! <br />I hs.by amm lnds p6ahy oip6j!r, oncollhc tolloving ddldalions: <br />Doolilion Pmns Asb6ro! Noriicarion lr.ddat R.grlarion. (Tnk 40, Pm6) <br />-R€qun.d <br />Lcu6 of Norifimtion <br />-l <br />ccniry lnal the lcdEal re8nlariod Eadding 6b6ros rooval dc not spplicablc to fi6 prujft!. <br />O'l $. ahovc inforndioo is cor...l. I alre ro ooply witn a[ cny dd co6ry <br />iotr e'd hdby luthoriE Epr6al'livd of lhi! Ciry od <br />above mfltion.d prcpsry for iNpario <br />LI t] <br />APPROVALS <br />lnstallation <br />Above Hard Lid <br />Above T-Bar <br />F[omtuc. ollhc wo.[ aor $hich thi! Finh b <br />- <br />=