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MECHANICAL-INSPECTOR RECORD <br />ID/SIG. <br />Appliances <br />Metal Fire Place <br />Evaporative Cooler <br />Compressor <br />Misc. Equipment <br />Duct Work <br />Pre-lnsulation <br />lnsulation <br />Smoke Detectors lnstalled <br />Rouqh Ductwork <br />Vents ,/_\ <br />Toilet Room / Clothes Dryer lo4-lr x.Wsd) <br />Residential Ranoe <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. <br />Final Test <br />Meter Release /-.,\ <br />FINAL lo-zs-ls.\-w)il] <br />Notes, Remarks, Etc <br />OWNER BI'ILDER DELCARATTON <br />I hcEby afI,o trMcr p.nalty of pcrjury lhal I m .r.nfl fn,m lhc Conr,s.lo* Liccns L!* for lhc follo$tins toon (5.c ?031 5 <br />Businss ond Profcssion Codc): Any Cny o. Cou y whict Equies a pcmn to oislrud. ah6. i.lpbk. d.ryolhh or EIEi @y <br />inudurc. dor lo irs hiuane. als rcqxiEs llE rpplkanl for such lcmit lo lik , riSned sltlcmnl lhol hc or sl* is litcnsed !!N!.r <br />ro rh. psvisioN of tlE ConrEcrois Lk.nsn Llw (Chqlrc,9. Co|nmxin8 *ilh Sccrion TOOO ot Diviskn 3 oflh. Lusine$ o.d <br />PmfcssionsCodc)orrharlEorshciscxcmptlhcEfronudttub.snforlhctlL-qedcrcmplon.AryviolalionofSNri..T0ll.5ilyaoy <br />aprlicr for ! |lem rubi(k rhc applicsl to a civil pc lly of .ol mE lhln fivc hundr.d dollar (1500) <br />l. trs owncr.l rhc ftrop(ny. or nythployccs silh wr!.s dt rhci \)le (mP.n{rion. sill do rh. qork 0nd lhc slBlm is nor <br />inr.BlcJ or ollircd nn yh ( s.{.7O1,1. Bu\in sr rtrd ltoicsn,n\ Cqll. Tnc C-In rs.ri ! I-kcnsc Lra ift\ nor qrPly b an owNr ol <br />rhcpn)nny qho build( or irrorivc\ lhcEnr u wh.tl{f,ssuchw.rkhirni.llorhct$lfo!rhmughhnorhcr.wncq,lorccs, <br />pruvidcd ihrt \u.1, in,F^nrnr\ . nn nncuk{ or.tcBl i $h.ll h.\.vci rh. blilding or iqhrcntN i\q'ldIirhinonr F_r <br />olsnuhrinr. rhr Owncr lJuil].r willhrvc tlE tnnlcnol pmvir8 rlN tE o! shc did n hoiU or i:r]rn)w rhc PmP.ny lhr rhc PnrF'r of <br />-t. <br />ostrcr orrhl lri)r'cny..mcr.lusivcly(onlnclirrs wilh li.cr{tl conrncio h.on(rucrlhc Pmiecr (Scc 70r'r' Ilu)i'r\r <br />Md F\nfs\inCodc lhc(tnrrlcttrsl.iccisct-rwd..s or rttlyk) an.!ncrol ptoFny$ho bxilk.riflfr)vcs lhctcon <br />and who co rlcrr n,r \!.h fmlccrs wilh u (t.rBdrtrl, liccnrcd nunur.l b rhd c.nhLrols Liccnsc Llqr <br />-l <br />d cxcmfl undci Secrion-. a. & P.C. for lhh rc$o.. <br />D.le: O$mr <br />llrMEEiLqaMPENS IOl! <br />DECI.ASAIIIIN <br />I hcrby omrm unds rnalry oa poiury on. of thc tbllowing dcchErions: <br />-l <br />hlE &rd ,ill tui.r.in . C.nifdtc of Com.l to Se lfiNuE for mrk6s otp..5arior s pmvidcd tor by S6lion l7O0 ol rh. <br />r2hor Codc. for thc p.rformm of rh. woi* fo! which rlE Frni n is.ucd. <br />I hdvc and will nrai ain worlcrs .omFnsarion insldnc, N rcqnircd b, scct ion 3?00 of rhc Llbor Codc. ror tl* Pcrforurc of <br />rhc *ork n,wni.h rhistxrn is issurd Myworkc(i6n insxr.N c|ricr lnd polty nuhhct oc: <br />-l.cniry <br />rhlr in rhc p.rfonmmcof lhc *o*ohichrhh Fmi ir i.flcd.l shall nol.mploy lny pc@n ina.yrMmr <br />s. .\ ro hcrotrr subj$r r,,lhc workcr co'npc sirnn!hw{or Calin,mid. !.d tr8N thal ifl \hould h..omc subld lo lhc <br />m.r.u' conlEn$tion Imvhions of Sed ion J700 of lhe Ljb( r Codc, I shdl. tudhwith c.nDly u ilh rtDs pmvisions. <br />WARNING: F.ilxE ro suE workcr' ompctrelion covcEsc is lnla$rul, ai shnll subiccl un ery)lot$ ro oninal IEMlli.s and <br />civil fincq !p b orc htr.drcd lhouslnd dollan ($100.000), in mFnsltion. daruecs os providcd for lhc <br />L:t r C.dc. inlcrst ond lrlomy <br />'t-A <br />IIECIJIAII!]N <br />Iherchylllinn!nd*penrtryorFrju.ylh l m liRn$d undcr Eovhioo olChnprc.9 (connrcn.ing wilh Secri,n 7000) olDivisio l <br />of rhc BusnE$ lnd Prnfc$n rs Codc, rid ny li.cnrc n in rull for.c.dcfGcr <br />o/ ?/ <br />CONS'I'RIJC'I'ION I F'NNIN(: A(:TNC\' <br />I h.rh, illnD uMcr Fnrlryoipcrjtrryrh"r rhcrc is r d,n{ru.rioi lcid$S rgcNy nn rhc pcrtonnrtuc orrhc sork io! r'hich rhi\ pc.n,ir is <br />is\ucd(Scc 1097. Civ. C ) <br />A.TIUCANLIICLABAUAN <br />I hrL:t y lulm trnlcr p.mlry of F-rJUry onc of rh. followinB d$lr io \: <br />D.nnnik P.i,nirsAsh. os Noriliclrion Fedcral Rr8uhrn,n\ lTiilc,{1, Pd6) <br />-Rcqutcd <br />ktrc' ol NorilLdion <br />-l <br />ccniryrh{r thc riicfuleSuhtions rcsardiis rsh((os rcmovsl fft n.r smlicrnt to lhn lmjccr. <br />-l <br />colify thlr I h.vc 6d rhir app n ann strrc rh{ rh. !tn!c inlormrioi h corMr LlrN lo .omply wnh all Cny lnd counry <br />ordimo.cs and Slalc tjws rchtin8 blilding con{dcri.n. old hcr.by Nrhoriz. Eprcscnhrives oflhit Ciry md Colntylo cnl.t ulloi rh. <br />dbov. mntiomd pmp.ny for <br />^,., ?hr/'. <br />! ->' <br />APPROVALS DATE COMMENTS <br />Furnace <br />Other <br />t nd.asNam'- <br />--------r------ <br />- <br />---+--- <br />t-