Laserfiche WebLink
MECHANICAL.INSPECTOR RECORD <br />APPROVALS DATE tD/stG.OWNER BUILDER DALCARATION <br />I h4by a,tur lndd t sdly of pdjurr lltd I @ qenpl non lb. ConrmcloG Lic.nF Law fot th. follo$in*,@D (56.?031.5 <br />Buin6s ud Prof*ion Codc): Any Cily or Counry which tequt6 , Fmh b otr(d€l. dta, inro!.. d@olnh or @.it ev <br />sdlde. Fior to ns Buecq atso r.quiB rl'c arplicm for su.h pqni ro filc r si8..d slslod thal trc o. eh. b lictu.d p@.rt <br />lo lh€ provirioG ol $. ConlrEloi. Li@nsd Law (Chlprd 9, CoMd.ing witb Serion 7000 of Divisio. :l of thc Bcind &d <br />ProfNiors Codc) or thai h. or sh. is .xdpr lhccfton dd lh. b€.i. aor lh. tllcg.d cidflion. A!, violdion of Sdion ?01 I 5 bv ev <br />agplicei fo. a p@ur llbjcrs rh. appli@r ro a ovil pclrlry or nor mor. rhd li!. hu.dr.d dolas (t500). <br />-t. <br />6 ollG ofih. propdly, or my dplo,l6 wilh wrge s $.i. el. @6Pcaado.. *iU do $. $!* ed {E srElc ! rcl <br />idod.d or o,t6!d for sk (Sc.7044. B6i.B dd PDtBioN Cod.: Tnc ContEcrol3 Licce Lrw &,8 rot .ptly lo o ow of <br />thcpoFty eto tni!& o, tl9roc rh@,\ dd who do€ Mh wn him*lf or lss.lior lhduslt hi! o( hd om .mplov..3. <br />providcd rhd 3uch sp@!qno$emr ii6d.dorotT6.d foreL.I[ how@.lhcbu ring orirlPlv!@t i!$ldwitltboic]a <br />of@npl.iiorl rhc O(c Buills win havc lhc hd.. ofpoviis drd hl or sh€ did mt hrild o ihFM dE ploFry tlr th. pEPoe of <br />-t. <br />s om6 ofrtG prpp6ly. d qclci!.ly co.tracline Mfi li.sd conttac,rou lo .oErNcl llE Foj.d (sc 7044, BBinR <br />ad Prokbn Codc: Thc Conlrldol3 LiccN. L.w do6 rcl .pPly to & oms ofprop<ly f,ho builds or imPots lh.en. <br />od rno co.lncl3 for $ch rojd! wnh a Con!..to(, lEd.d pEur, lo $. conrr.dd s LE.ffi ts} <br />I m .r.mrr uds S6lion . B. & P.C. Ior thts rdstr <br />rdotsrEBsl(alEENl rlo.r <br />DECLARA'IION <br />I hcreby amrn und6 p€naityolpdjuryon of rh. lollorvin8 delararions <br />-l <br />ha!.a $illhainlaifl0Cenifical.otcons.llos.lflnrur.aorrvorle('o!tup.nsotion,4cprovidedlorbySdlioilT0oofthc <br />l{hr Codq ror lhc psfommcc ollnc rvork lor vhich lh. p€rnil G isucd <br />-l <br />nrv. md sill mai ain ,otk.B co'np.Ealion iN@n.a s r.qun.d by Sclion 1700 of thc l,bor Codc, fo. lh. pqf.m c. of <br />lnc wort for which lhb pmn b isu.d. My qo*6 .obFsalion iBLfuc. 6i< ed policy nunbd ac <br />r$,r:- <br />Policy N@bc ElpiE <br />-l <br />cd|iry fial in lh. pdtomdc. oath. wo* for which lhi! pdni b bu.d. I 3h.U not drloy any p6son in anv ddnd <br />s s ro b.(om. subj..l ro llE soih6 onFEdion lak of Colifomia dd asE Ufl il I should hdofr. 3ubjcl lo lh. <br />wort6'.omFulionplolGioGofsetioolT00oflhct lor Cortc l slEll tonnwilh @mply vin Oo$ pro!i!irs.. <br />WARNING: Failur.lo suc Nort6' ompostli.n cov@g. b unkwtul. ud thall subj.ct e dploF lo dmind FElti6 &d <br />cilil lin6 up to on. hun&cd lhoudd dous (t100,000). i. s.Uniot to lhe con of .omFMlion. ddag6 a Ptovid.d r.r rh. <br />Sdion 1076 ofrhc t bor Code irl6.d &d .nomer'! f€. <br />I.lcErlELcoNrSacroa <br />DECI.AEAIION <br />I hdrty dkn oid, pa.Iy of Fjury thd I @ lids.d udd rrcvii@ orclEdd 9 (colffiilg wilh Scdion ?000) of Dif ilion 3 <br />of rh. BuirB ud PrcLslioG Cod., @d my lic@ t in tull foN.nd cft61, <br />: Lic.eNlmbd <br />CONSTRUCTION I rNNINC AGENCY <br />I hdel,y arnn undd pdralty ot pqjury lh3l rhdc is a c..sln,.lion lqrdins .sm.y roi lhc Flonnflcc ofrhe s otk lor $hich rhis pdnn ir <br />issu€d (Ss.1097, Civ C ) <br />I cdiav rlEt rh. tedsal rc,rular io6 resardins sbebs rmoval d. not apnli.abl. to lnis preje(1. <br />-l <br />cdi! rhal t hav. Ead rhis applicaliofl dd slalc rhar rhc .horc intomalion ir cotrel I asr€ lo c{mpl, wilh all Citv d aountv <br />ofllinanc6 and Srarc !rws Elaring lo buildinB @Nlruclioll. sd hscby.uhoriz r.pr€glalird ollhis Cny d aounty lo dld lroh th. <br />.bove nalion.d pDpdy tor iapsrion pupos. <br />Appliances <br />Metal Fire Place <br />Evaporative Cooler <br />Furnace <br />Compressor <br />Misc. Equipment <br />Duct Work <br />Pre-lnsulation <br />lnsulation <br />Smoke Detectors lnstalled <br />Rough Ductwork <br />Vents <br />Toilet Room / Clothes Dryer <br />Residential Ranqe <br />Other <br />Hood <br />Type I Hood <br />Type ll Hood <br />Grease Duct <br />Fire Damper <br />Openings <br />F.D. Drop Test <br />Above Hard Lid <br />Above T-Bar <br />Rough Mech./1/-17 Ecz ') <br />Final Test <br />Meter Release <br />FINAL t/72f//.1 4,Y*",'4) <br />Noles, Remarks, Etc <br />COMMENTS <br />lnstallation <br />LendersAddre:-rpprrcaniieciiqlo-N-- <br />I hq!$, 6irm u.dd pcnalty ot psjury on. of lh. aollorvibS deleations: <br />D.molirion Pmis-Asb6los Notiicalior F.d6al Rcsulations 0 nb 40. Pd6) <br />Req!ir.d L.tb oaNorinc€rion <br />-------r----- <br />-------r----- <br />f-------r------