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MECHANICAL-INSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS O*M-B!ildo &cl@liotr I hn.by rfilrn mdq p.olly ofpdJry rhll I rh q.nfl loro fi. Conr6c1oB L,c..* kw lor rh. follow'rs r6on (s{.?or1.5 Bcinca and Prcfdlio. Codc) Any Ciry or Counly which r.quir6 . pdnn to oslru.l. slrd, iEprovc. d.molbh or r.p!n uy lrrucru.. prio, to ik iii@tu . .Irc r.quiH ttc .pplicrnl for ruch pmir to lil. . signcd i!t.m.or $il hc or !h. i5 liccBcd p6uet to ln povbioa of lhc Contlcblr Lr..nr.d Lr*(Ch.pr69, comm.ftr.s wnh Sctior T0ooofDivir'onl ot$. B$in.$ and ProissioE Cod.) or rh.t h. m 3n i!.rcho rholnoo.rd rh. ban for th. .llc3d .x.mprior .Any viohion ofserion 70ll5 by my.rplicad for ! !@ir lubj.cB th.!prli.. ro !.ivil pdhy ofnot norc thm fiv. hwdr.d dollra(1500), l. s oun- of th. prcp.ny. or my .nploy.6 wnh w!8c .r rhei. sl. conp.nldion. will d6 rhc worl ed lhc amdB. ir @1 i od.il o. ofi.r.n for sl. ( Se.7044 Buicr .nd ProfBiion. coi. Th. Conhctor'! Li4N. Lrs do6 not .ppl, ro u owE ol $. prcpfiy qho build! or inprov6 lh.etr .nd *ho do6 3un wort hiN.lf or h6.llor lhrcush hi! or h6 own .nploy.d, prolid.d !h ru.h impro!.m.nrr (c nor inr..d.d or otf.r.d for siL. Ia, hovcvd. lhc buildiry or inprcv.s.nt ir rold wilhin on. y..r of.onpl.tior rhc Osn FBuildd will hlB tb. b!flt.n or prolils thll hc or !h. ml huild or improv. for lnc purpoi. ol sl.). dt . o*n* ortr'. p.p.nv. "n .x.lu!iv.ly cof,klcrin8 *ith lic.B.d co.rocroB ro .otuttu.1 rh. Foi.cr ( sc.. ?o.ta, BBinds &d Pbl.sion Coa.: Th.Cont.do. r Lrc.ns. rfl do6 nol rpply ro o owna olprerqiy *ho boil& or improvd rhB.o6, dd vho enlr.cB for such pbj.cB wtrh a conimdo(!) lrc.n!.d pu u,Dt to tt. Contn<ioas L&tu tlw.). _l !d cr@pl u.d.r S..lior _.8. & P,C, for lni! Bo. .!!atrEBt-c0!4rE!sa:MN-uEc!4aar!o! I h.r.by artrm und.r pcnalry orp.drrronc orlhc tollowins d.cldaliod _l havc ud will mainidin ! C.nin{t. olcoEnl rc tElfiNur. ao, @rk 6 conrp..slr rcn. as prcv'd.d ror by S.cl,on l70o ol rh. tlbor Cod.. for rh. polo@occ ofrh. uork for whi.h rhc pcmit is issuâ‚¬d. Ih!!.andwrlln..nl!'nwo.B @mp.Ml io. insumme, $ rcq!tr.d by S.ction J?00 oa rh. L.bor Cod., for rhc p..fom.c. of th. eo.k lor whict lh,e perdil it B3u.d My workds @np.nslion i.$Inc. dri.. .nd policy Nnb.r s.: trr.\ \r rLl( (ThBscction n.cd nor b. comDl.rcd illt. pcmn is lor On. hundr.d dorlam lll0ol - _l cc.lify th,! in rh. p.rfommcc olih. worr aor whi.h lhi! pmi i3 baamc aubr.d b rh.*orkds omp.n$lon hM ofcrfiorna, and conpcN io. proliliotu ol S.clio. l70o ol lnc lltor Cod.. I slu ,-'3-tsl WARNINCT Frilu..lo s@!r. worL.is @hp.6.lrcncovsls. n unhwlul, and 3hollsubjd !n.mplorr to simtul p.Ehi6 ind civilfrd up ro onc hudEd UoE nd dolh6 ($100,0m),ii .ddnion lo th. coir of.omp.Mrio.. d!Mg6 a provid.d fo! rh. S..iion 1076 or ifi. Lrtor Cod., inr.rdl and tnom.y r f6. U(!:I!ES!O!CIB4CruB!_UEC!48 I t.rcby.ffird undo p.nalty ofp.rjury lhlt I.m lic.nscd und.r povision oachapl.. s (comhcrcin! Bilh S.ction 7000) oaDivision I of rn. Bsin.$lnd Prof.ssions Cod...nd my li..N. is in full nr.. 3.d .0i{r (I)!SIB!(TO!_ID!D!NG.!C!ILr I h.rcby trflirm und.r rcn!lrl orrctjury lhat lhcrc t s coNlruclion lcnd,n* asency lor rhe perao'nhn(. ollhc \orl l'o rticI Ihis perfl]it is issu.d (se. 1c!,7.cn ( ) AIIUIAtrI:T.aECIAAAUqN Drnoltion Pmir'Asb6lG Nori,icdio. F..L l Reuhrjo (TirL 40. Pad 6) _ Rcquir.d L.lr6 ofNorifi..lior I ccnif, rh'l rh. l.ddll .ceulrrios rcgardi.s ab6ros rdoval arc nor .gpli.abl. ro lhis poici. I ccniiy lh.l I hlvc r..d lhis(pplia'ioo ie cor( I lgK ro co'nply wth rll Cny lnd Coury ordimnc6.nd Sur. kRs r.liiin! abovc n. ion.d rrcpcny for 9'9-tc Appliances lr4etal Fire Place Evap Cooler Furnace Compressor lvlisc. Equipment Duct Work Pre-lnsulation lnsulation Smoke Detectors lnstalled Rough Ductwork /o-ll-18 aai I Vents Toilet Room / Clothes Dryer Residential Range Other Hood Type I Hood Type ll Hood Grease Duct Fire Damper Openings lnstallation F.D. Drop Test Above Hard Lid Above T-Bar Rough Mech. Final Test Meter Release FINAL / L-3 -/g ,4r z'l A A.,'?4 -8--t z/ 1\Pâ‚¬mit-lnsp6ctlon Foms\Mochanicallnspâ‚¬clor Record doc 03 31.06 C$ri.r: o",.. f-S'tg ..",,".". r.pr.s.marir.s otthi! Ciry and Counry lo cnt.r upon th.