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MECHANICAL-INSPECTOR RECORD APPROVALS DATE ID/SIG.Own FBuildn Dqldlion I h.r.hy rfii.m und.r pâ‚¬mty of perjury rhd I rn qcnp ford rh. Co.tncror' Lic.n.6 t w lor lh. followng raon (!e ?0r1.5 Burin6! 6d Profdsior Cod.): Any City or Cou y which Equird ! Fmn ro @nsrrucr. dt6. improv., dcnohh or rpii .iy stru.lu.. prio. to its i!3u!nc.. llso rqutq lnc .ppliccnl lor tuch pmil ro fila ! !i8n.d !r8r@.r( th h. or sh. it lic.6.d p!6usr lo ln! povisioB oflh. Conl..crois L'@tu d tr* (Ch.prd o. Cohto..chs rnh S6rpn ?0o0 ofDiv6ion I ofrh. Bu$nBsrnd Profdnoro Codc)or rhrl h. or 3h. ir .i.npr rh.r.ion md rh. bai! fo. thc llLgcd a.hFion .A!y liol.rioo ol Scrio! 701 L5 by ay lpplic&r fo, a pmir rubjc.t! rh. 6Dplic. lo . civil pcnlly of not mr. $d aN. h@dr.d doll6 (SJ00). _1, a o*n r ollh. pop.nr. ormy.mploy.d wirh wr86 $ rh.ir !ol. co6p.nsdion, silldo rh.wor*&d th.slrudG is noii ad.d or ona.d ror sl. (S* 70!t. au.'6i rnd Prora3ion! Cod.: Th. Conr4cloir Lic.n$ llw doB ior.pply ro,. ow..r oflhc prcpdry who buil& or imptor6 thnon. Md *ho do6 such wor& hitu.lf or h6.laor lhrough hir or hcr own.6ploy6, proeid.d lhlr 3uch improv.n..c d. nor i 6d.d .r or6.d tor srk. lf. howcrd. rn blildinsorinprev.hc.r6sold*nhinoncycarofconplcrion.thc Ovn.FBuildrwill h!v. th. burd.n ofpmlinA rh.t h. orsh..oi build or ihpro\! lor rh. purporc of$1.). L a o*ftr of th. prop.ny, .n .rclusi!.ly contrdins *ilh liccns.d conk.crou ro conslrud lhc projd ( Sc. 704.1. Blsin6s md Pror.lnon cod. Th. c6nrld6ar LiccBr Lrv do.s nol spply lo m osnr ofprepsly who brilds or nnlrov6 thdd.. lnd who contrrc( for.uch !rol.d3 w h d cohkicro(, l '..ns.d puuunr ro lh. cont.cloar L'c.n!.trw) _l rm !x@pl und.r Sdlion _,8. & P C. for thir Esn D.r.i O"rdr IlaBtrEBSgII{tElS4-r9r-SlC!!&{i(lN I h...by !mrtr unds pcMlly olpcrjury onc ofthc aollo$ing d.claotio6: _l hrv..rd will minr.in. C6lifist. ofcoN.nl to S.lf-laur. fo. worl.r! comp.@rbn.d p.ovid.d aor by Selion l70o ofrt r.bo, Cod.. for rh. Ffo,ruic. oalnc eorl fo. shi.h rh. p.mit i! i!ru.{t. I h.vernd*illnEinrlin*orl.ri comp.n$rion r.slrane.as .equr.d byS..rioo 3700ofrh. L3bor Cod.,lor n'. p.dorronc. ollh. *orl for wh,chtn p.rnit is isu.d M, wor!.6 conp.nldion insu6nc... idlnd poh.ynunbde: c.r*,: ' E ll^.'a1-il ( Itis stion o..d nol b.conplcr.d if thcpmir is lor Onc nundr.d doll6 l$100) or lc$) I ccrlify lhat i.lhc p.rfoo.occ ofth. wort for *hich rht pmit is i$u.d.l !h.ll nor nploy any pdsn in rn, mdnnn so B to b.c.oc aubj6t ro rh. woit.u @mp.ns.rDnlawsofc.lifornia.lndlsrerhlriflsholldb..oncsubj.atofic*o.u' comp.nslio. polis ions of Selion 1700 ol rtu tibor cod.. I shnll. wAlNlNG F.ilur. ro !cur. erl.B @mp.n$non .ove'!s. u u.l.wful, and ihrll slbjEl !n .mplor.r ro dimi l p.mh6 .nd civil t@B !p ro oG hu.dr.d lhosud dolLB (1100,000),i. lddition ro llE cod ofcomD.n ion. damsB e prcvid.d ror lh. S..liot 30?6 of th. rrbor Codc, inr.r6l lnd.llorney s fs UCENEDSTEIBACIqS$.DECIABAI4! I ho.by .flim u"d.r p.@lry of p.rury rhll I d lic.ro.d ud{ povbion oach.plcr 9 (6mâ‚¬n ins whn sddon 7000) oa Division I ot ft. B6ies lnd PrefBsioB Cod.. rnd Ey li..M i! in tuU fore ud .lI(l. Lt.M Nunbs /b/3/ a./ c0!fl4!lcu9!_LEN[IN!laENc! I hdchy.0im und.rp.n.lly orpcdurylhar 6cr. is rco6rru.lio. hndinBats.n y aor thc pdaomrncc of lhc aork for Nhich lhis p.mlil is issu.d (S.. 109?,Civ. C ) ATEIIIANLIDECLA8AI&N D.mohior Ptuil3-Asb.nG Norificllion F.d.dl Rcsul.rioB (Tnh 40. Pin 6) _ R.qun d kl6of Nolific.lion .lcm'lyrhrr rhc r.d@lr.eular'om reard'ngab6ro! l(ftulcnor rppliclblc ro rhL p6j('. Il!{r.iliry rhlr I lE!. Bd hn.ppLc'rioD &d rc rhd $. !bov. inaormrion is coder. l.sr.. lo comply *hh.ll ciry md counry / ordioncB .nd Slrl. Lr,3 Rl.linB ro building co6lru(lion. ud t@b, lulhoriz. r.pBrt'livq of thi5 Cily .tril CoElr ro ..td upon !h. abov. m.nlion.d prcpdy aor FotFK Appliances Metal Fire Place Evap Cooler Furnace Compressor Misc. Equipment Duct Work Pre-lnsulation lnsulatron Smoke Detectors lnstalled Rough Ductwork 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..----a Final Test Meter Release FINAL /h*/t* 'Trlrn tlY7, MlWP51\Pâ‚¬mit-lnspoction Foms\Mschanlcallnspsclor Rscord.doc 03.3r.06 COMMENTS ('oolroctorl =