Laserfiche WebLink
MECHANICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWNER EUILDEf, I}ELCARATION <br />I h.rcby afrirn !nd4 Fnalry ol pc{ury lh,l I m cxcmpl fion thc Cotrtrero6 Liccnsc t w aot lhc follo*ing rc@. (Sec ?03 1.5 <br />Burincis a(! Prntclsio! Codc): any Cily or Colnly whth 'tquirc. s Fnil ro con(dcl. &llcr, imProw. d.mlish or Ep.t &y <br />irudm. ri.r ro n, is!@e. !l$ Eauies lhe appliq for such pcmh lo filc g siSmn sllrcm thal lE or shc Ls liccnsn pu^laln <br />ro rhc lmtsions of rhe Conreroas Liccns.d tlw (ClEplr 9. Conftrcirg wilh Sedion 7000 of Divhioo I oi rtE Busincss and <br />Pmfc$ions Codc) o hd lE m rl* h exc4tl lhcttomed rhc busa.r for rh. !x.8cd c&mPl ion. A., viohrjon oa Sc.li,n ?011.5 bv &v <br />applio for!p.milsubjcchlh..Pplicdlrotcivilp.mlry.ff,oimrcthenvchundnddollesl$5m} <br />-1. <br />as owm otrhc tDpcny. or hy cnployc.s Pilh wdgcs s lh.h $lc @nlEnslion. will do ltE *qt a,td l]E slrBrE n tul <br />i .ndad or o0cr.d lor slc (Se.?044, Busircli 8d Proacsions Codc TIE C,oltulois Lico$ Ilw do.s mt E Ply ro o osB of <br />rlE pmp.ny wtb hritt! d irptoB ttE6r. od qln &s sh ftn niNr o. tdslf or dreu8n hi. d ho 6en cnployms <br />prcvided th sun imi,mtm semii.!d.doroftrnfo.sL.llhoww.the t ilding or irprowBnr khldwilhhnnc Fd <br />ofor?ldion, 0E OwNr Build.r {iI hlG llE bild.n of Fovirg dd lE or iE dA ml h,ild N iqrow dE PrcFly fd llE FlrIEc of <br />-,, <br />!s owner of rnc Imn€rry, rn gclusivcly conraclinc wilh liccisd confaclrl6 ro co.(rucl ltE poicl (S( TOr4 Brems <br />old hlf6iid Codc: Th. Co.tr.dol s Liccns t,a{ d€s nor .ptly ro u owncr of ro!€nt vh. h!il& or imporcs lhcren <br />and who conlr.cts for slch 0ojcds snh ! ConlBcro(s) liccNd pul:@l ro lh. Cdnrebls Limn* Lr*). <br />-l <br />ur cxcnrt'rundcr scc!i{, <br />traBKEEStloufENsArlQB <br />DESdAAfl!]N <br />I hcrcby rfiirnund€r lcnallyorpdjDryotrc otlhc iollowiry dNloroln'ns: <br />-lhivc <br />xlwillnu nlin!Ccnin.ar.of(onscnl bSclf.lnsurc tur *o crs comp.ns0lion.as rrolidcd li)! by Serion 3Tm ol thc <br />Lahtr c({c, tu rhc',nfoirMNc ol'rlc vo.* ror *hich <br />'h. l].rn i{ nsu.d <br />-lhale <br />andsill.[inrDi. workcN conFtr,albn in]urlncc, as rcqutcd bys..lion 1700ofth€ libor C.dc. lor rhc I'crt,tun.c or <br />ihc w.rk ror ehkh thh p.mil is nslcd. My worlc^inrurmc cqict ond Flty.!mb.. m: <br />I Nnitilh in rhc r,crformxc ofrllc eort lot rhis r.rnit h issucd. I $tll mr .mohy 0ny pcMn in rny @nmr <br />$ axto bccotu subicd lo rtE wortc6 compcns{li.n hws ofclliaoni,. dnd oBN ttlr ifl should bcrotr su6lc.l lo thc <br />sorkdi.onpcnsaraonpmvisionsofSNlio.lT00oarh.LrErCodt,lrh!l!.fonh*irhosplyqiihlho$povtiotrs.. <br />WARNINC: I,ailurc ro sc@ workcR co6JEnsrhn o is unlawanl, and sharl subJccr M 6plo}!. io dininll p.mlli.s ad <br />.Nil firs up k, onc hundrcd rl$u\ind dollrn l$100 L in oddirio. ro rhc co$ of com!,cnstion. dnMees al piovidcd for lhc <br />Sccrion 1076 olrnc Llbor Cod.. inrces lid <br />LICDNIID.(ANIXACIAB <br />DECIdMII!]N <br />I hcrchyillr undcr Dcnllry ol pcrjuiy rhd Lm liencd u dcr prcvision oi Chxl)rci 9 (.onnEn.nrg wilh S(lbn 7ffl() of Divnn,n l <br />Busin.ss rnd Proicssiotrs Codc. rd fryli.cn* h ifl tuu inrcc ! cifEr <br />ao) <br />k <br />(:oNS'f RTIC'N(}N LEND!N(I A(:FNCY <br />I hrrub) rfiirn ukl$ Fnrlr, ni!(rjur, rhd rhcru i\ r conntucri'n hndir! rFcn.y tht rh'lrrlnriutu. ofrhc work for trhi.i rhi\ J$nrir i\ <br />isstrcd lscc .ll)97. Civ. C ) <br />trdcir N!m: <br />- <br />APIUIANL!}iSAAA.IION <br />I hor{ry nlIm u.d.r r.n.lly ofFrjury onc ofrhc follo* i'rA .l(lahrion$: <br />ocrmliti Pc nits-Asbc(os Norili.arbn F.dcrulRcguhrb.s(lirlc &. Pan6) <br />-Rcquirci <br />trlcr of Norillcarhn <br />-l <br />rcnifyrh0l rhc tcdc lrcSuldiois rc8dding rshcstos rcmovrl rc n.r arpli.nblc ro lhis PDjccr <br />-lccnilylhlrIhlvcrc!.!rhi\, <br />rli.arn{ ,d silc lh thc itnvc inrbnnllion is$mc!. r !8Nro.omply <br />md Colnry 16 cnl( upof, 0Eordi.rNcs and Slarc Lnws rcbrins ro tiuiklinS .o.shcrion. arn h.Rb, <br />Appli.ant or ecn r S iSnorurc <br />Appliances <br />lvletal Fire Place <br />Evaporative Cooler <br />Furnace <br />Compressor <br />Misc. Equipment <br />Duct Work <br />Pre-lnsulation <br />lnsulation <br />Rouqh Ductwork <br />Vents /A\ <br />Toilet Room / Clothes Dryer 0t Y ) <br />Residential Banoe U <br />Other <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 />Rouqh Mech. <br />Final Test <br />Meter Release <br />FINAL l0et-l9 ,). !Htul <br />Notes, Remarks, Etc. <br />smoke Detectors lnstalled <br />t{-