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MECHANICAL-INSPECTOR RECORD
<br />APPROVALS 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 />Flough 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 />lnstallation
<br />F.D. Drop Test
<br />Above T-Bar
<br />Rough Mech.l at\K-$
<br />Meter Release
<br />FINAL /ZJ /N $K[
<br />Notes, Remarks, Etc.I
<br />OWNER BUII,DDR I'EI,CARA'TI()N
<br />I h.rchy sfl,r und.r pcnrhy oflrlury rhd I anr cr.nfl lh, rhc Cotrtr.ttr! l-i.. s. Liw lnrhc followirS rcnsn (S.l70!l5
<br />Irusi'rcs rxl I'rolt{ion Crdc) Atry Cily or Counr! $hi(h icquir.\ r tsnit lo co.{fl.r. rhcr. nnFrvc, dcmnirh "r rclot Jry,
<br />shrchtrc. prior ro irs irsnncc. also lcqutcs lhc lpplicrtrr n, su.hrnnir ro ilc 0 si8ncd sr.rc.rnr lnllhcorsic is liccn\c,l nu^urnr ,
<br />r, rh. pn,ri\t,n\ otrtr Coakr.kn \ Li.cns.d lj* (Ch3rrrcr 9. Com'Encins sirh sccri('n Xxn.r Divisn,n I .l rhc Bulirrs a.d
<br />Pi{nt\\n \ Codc) or thrr hc .r \hc ir crc Dr rhurcrrom d ihc h!\i\ ntrrhc rl[!.d.r.trpri,,n. Anyvir,l0ri(,nolS.cli 70]1.5 hyony
<br />rrpli.0 l lnr nI'txnn suhjLrrs rhc apflicanrk' r.nilpcnrlryornot m.rcrhan n\c hnndrcd dollnm (35(n).
<br />!, qs osrcr of rh. poFny. d my cmploFg wirh qagcs a. rh.n sb onFnrdion. will do lh. wdt lri lh. sltulu k mt
<br />inrcri.d or oilcrcd ftr sl. (Se.7044. Susircs !.d hDfcsri.rns Cod.: Tlrc ConrE rols LienE !j* d{Es nor arply to M owkr ol
<br />rhc poFny who hoil6 o. nr{rbB rtEm.. irn who dms seh w* himclt or hcr*lf or lhmugh his or har oqn cnt loy..s.
<br />provid.n rhar srch inqmEm.rs m mt htcnd.n or o,Icr.n for sb. lf. ho@E 0r lrillii8 or anvll@B.r k $ld sirhin om ) *
<br />ofn,rpkrh., th. owrr Builhr w l noh fi. tord.n of nEvi.g tlul h. or dE did n build or itrpmrc thc polEty for lh. lulTre ol
<br />-t.
<br />!s owflcr of thc ,ro!eny. am ciclrsivcly contreting wirh lkcn*d contracroF ro onntud rlE t!rcrd (Scc. 7or4. Buims
<br />od Abfc$bo Codc:Th€ C6ntd.bfs Liccos. Lrw docr oor rtpl, k' !n own.r olprcp.dy who builds or impovcs thcreor
<br />trnd who co.lmcrsfor such pmFls wirh a ConrEcrorl9 ltcn*d llBuMr torhcConrracrd s Li€cns bw).
<br />I mc&'rDr uDd.r Sdio . B. & P.C. ror rhri rcsn
<br />loBrE8ti:lot4rENsArad
<br />DEq]$AIIq!
<br />I lErcby .rrm un 16 !..rlry ol Frjury oE of rhc followh8 &.h6lions:
<br />-l
<br />h,vc u{l u ill ruinrai" r Ccnifiur. ol Cdn\cnr ro sclf ltrsurc nn $oIkq' comlrn\d ion, A ll.!idL{ rn hy Scclion 17(n ol lhc
<br />Lab.r Conc. lor rhc N oiruncc ollhc $ork forwhic[rhcncnnil is ns'L\l
<br />_l hslc Dnd *ill niiorain wo*.n conpcnsarn iDsrrdn.c, ss Equircd hysccrion.lT0Oofrh. Ilbor Codc. for rlrc Frlormoncc oI
<br />rh. work ror shkh rhi\ Frnir as asscd My *ortcB r,d,.n\art . in\lEn c cmifi dnd polic, nun$q Nl
<br />-l
<br />ccdily lhd r rh. r.rrormnce of'h. work lo! which rhis F.,nir k issucd. I sMll nol cmployany Nron in rny mndr
<br />$ s ro heom slbr€r ro rhe sorkds comri.oerion h*s olcalifomtu. ond agE rhar if I {hollrl b..oft cubicd ro rrf,
<br />workcc' conpcnsol ion pm*n,ns ot Sadrn l70iD ol rh. lihnr Codc. I ihall, ronhwirh smnly *irh fios ,f,,visions..
<br />iIARNIN(;: Fnilurc ro {curc solk.ra conDcnsr'i,)n covcrulc i\ 0nlnelnJ. and ihall suhtct rn c'nploycr ro dimiml p.mhics lnd
<br />.i!il finc\ trp n) onr hundrtd rhous d dollar\m.(Xn), in ddnn,n tu rh. cos oi.ompcnsorion, diNB.s as [ovilcd for rhc
<br />Seriun 1076 of rh. tihor c.d.
<br />I hcr.6ydltm unncr pcnJlry olF-rjurv rhd I rn,
<br />DECIdSAIIQNudfi trevi.io. ol Chrplg 9 (onftmina wirh S+thD ?000) of Division l
<br />of lhc Busimss lnd Pmfc$iorr Codc. and nry liccfl$ is nr tuI toEc od rficct.
<br />,/o
<br />q lz+lfa -----t*=
<br />I herchy ,lrtrn onder penalry of F.flry
<br />hsucd (Sc.. 1097. Civ. C.)
<br />ion knding ,e.n.y r.r rhc p.raormncc ol thc work tu which lhis pcrmil t
<br />il cord. I alc ro coryly witfi all Cny ond Counry
<br />reprc$nrd ilcs ol lti city dd counry ro .nrd ursn lhc
<br />*.**""q,rf D,l{lc{ Shechou"L
<br />q /zt/ir
<br />Above Hard Lid
<br />Final Test
<br />I).le: Osftr:
<br />PdicyNlmbnjtiE:
<br />*, Ql2tlir
<br />Lcnd.r'c Nrm:-
<br />kndcis Addrcss:
<br />-
<br />rppr.x.iiiliiiiliiff
<br />llrEhydimuMf p.nolry olFrjury oflc ollhe folh*ing d(lardhns:
<br />Dsmolirion P.rmis-Ashsros Norificarion Fcddal Rcsllarions (Iirlc 40, Pan6)
<br />R.quncd hll.r ol Noincabn
<br />-l.cniiyrhrr
<br />tlr rcdcnlrc8uhtn'ns ESodinE asbcslos rcn$rul arc nol qrllic06lc h lhis lmiccl.
<br />I
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