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MECHANICAL-INSPECTOR BECORD
<br />APPROVALS DATE COMMENTS
<br />Appliances
<br />Evaporative Cooler
<br />Furnace
<br />Compressor
<br />Misc. Equipment
<br />Duct Work
<br />Pre-lnsulation
<br />Smoke Detectors lnstalled
<br />Rough Ductwork
<br />Vents
<br />Toilet Boom / Clothes Dryer
<br />Residential Ranoe
<br />Other
<br />Hood
<br />Type I Hood
<br />Type ll Hood
<br />Grease Duct
<br />Fire Damper
<br />Openinqs
<br />lnstallation
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Above T-Bar
<br />Rouqh Mech.
<br />Final Test
<br />Meter Release t
<br />FINAL a 7)
<br />Notes, Remarks, Etc I
<br />OII'NER BUILDER DELCARATION
<br />I h.Eby ,rrm undcr p.mlty of pcrFry thal I m cxen r fmn fic Co r(loF Lienf t w for the following E&on (St.m.11.5
<br />Blsincss ud Prcfcssion Cd€): Any Cny or Colnry whicn rcquiB a p.rnl ro onift( ah6. inpmve dcmlish d qun dy
<br />srtu luE. pri.r ro irs hcnue. sl$ rcquircs ih. applicanr for slch,Ermir ro 6lc a sign.n slarctunr llor h. or shc t lie.*d l,uNer
<br />ro rlE,,ovbionr ofth. Coir&rois Lhc.€d Liw (ChrDtet 9. Coomefting wirh S.crior ?000 of Divisior l|oflhc Susincss t0d
<br />Pmlcasions Codr) or ihlt h€ or ih. is cxcElrt lhcEfmn od rhc bBi for lhc .lL8cd crcmllion. Ar, violalion of Serion 701 1.5 hv anv
<br />lpolicrfl lor a rEmir suhi6r! thc rpplicmr lo a civil pcmhy or @i mrc th fivc hundrcd dolrdi (5500). ' 1
<br />-1,
<br />as owm. of thc pqrny. or ry cmplorccs uirh qrrcs us rhct sle @Dperurio.. will do dE sGt orn dE slrucrE is ml
<br />nncid.{t or ofrcEn ,or qh (Se.7044. BusiRss ud Pmfessions Cod.: Thc Contnclolr Lic€ns L{w &E\ not q,ply ro u o{no ol
<br />lh. ps,Eny wno hitls or inpros tlEotr old *,h &* skh eli hiosclf or n .slf o, tmu8h his or hcr own cmploye\
<br />pDvid.d rh'l r&n idptuvt1Mrs @ rcr idcnlcd o, offc,ld for elc. l(. h)wcw. r buildine o. imp,ownEnl b sld wnhitr oft y@
<br />ot odplcti'q ilr O*tur Sritd *ill haE ilE lrdcn 6f povin! ihd h. or shc did mr bdld .r in{,6w dE l,oJlny for drc puqrs of
<br />L a\ owftr ol fic popcdr. !m cr.lusiv.ly co .sti.8 wnh lccn{d conradou ro consrtuc[h€ pn&cl (Sa. 7014. Bnsmcs
<br />ad PmfcssionCod.: ftc Co etols Lkcnsc Law drcs nol aplly ro u owocr ot prope y who builds or impmvcs lict€on.
<br />a.d {ho .dm6.h for 3Nh pmj.rr{ wirh { Conr.a.to(s) Iic.ns.d pursua ro thc Co rucroas Licens L!w)
<br />I m.knDr udcr SNlion .B &P.C forlhhresn.
<br />Da(€: Owner:
<br />-l
<br />hsr adeill tuinhin ! Ccniflarc 6lcon*or ro Self lEuE fo wo.lsJ .omFns.lion. !s pdidcd ror by Sccdon l7m ofth.
<br />Libor Codq aor llr ,Ffollr]&c of rh. wort for *hich llt pani i. niucd.
<br />-l
<br />h.!c and will Erinrain eorkcR comp.nslrion insurarcc. N equncd by Sccliotr 3700 of lhc Lat r Codc, ib. rh. l.rlormmc oa
<br />rhc w.rk ror which rhh Fmn is hsucd. Mywor*cu omp.nsoiioD insuroncc cMicr dd lolicy nlnbcr @:
<br />PolhyNlEb.r: ErliE3
<br />-l
<br />ccrriay thar in $c Frlormtre ofrhc $o* for shkh thn l,crnit h hrocd.l shill n r €nDloy any Fren in lny matrrcr
<br />s s ro tNm slbh.l ro rhc woltcc cor{Ensr ion lnws of Califomio. ud agB lh if| should tEcotu subjccr lo rlE
<br />wo*crs' onpcnsorion FDlisionr of Sdrion 1700 of rhc Lrhor Code. I sh.ll, fonhwnh coryly with lhos ,hvhioos,,
<br />_ Appfior:
<br />LICENS.ED-CAIIBSIIO&
<br />ITXILIBAIION
<br />.l rhr Llu\ircs\ rni Ptuicsi(nN(inlc. rnd nry Ti..D\c n iI n,lll,tr.c u lr,ncr
<br />CAIS1A!,IEIIANIIiNDINC.AC.ENCT
<br />t hcrchyrlfirrundcrlicnxlryofpcrturyrhlr rlEc is3cotr(rucrion k inEiE.n.ynrrhctfrlor uncc ol lht work ttr lhirh rhi\ rqnrir i\
<br />isrudd (Sd. :1097. Civ. C )
<br />AITLIIANLDECLTAJ]IgI!
<br />I hRtyallirmundcr Nnnlly ol'E-rjry on. ol rhc lnlk,winx drt-hrdid'\:
<br />I)cnx,llri(,n P.rnir\ A\tf,{os N.rifi.arion Fcd$rl Rcguhrions Irnt,10. Prn6l
<br />RL\tuir.d brcr oi N.rifi cari,n
<br />I cniiy rhor rhc fcdcrol rcBul0lions Esudins ostE(os rcmvrl lre nor aprlkat'h ro
<br />'hi\
<br />pnrjRt
<br />-l
<br />cfiify ln l havc Eld lhi! +pli.lion dd slatc thd ln $orc iofo Erion is coml. ! agrE |o 6n0ly wilh dl Cn, and CounIy
<br />ordiEres a.d Srsr. Lrws rhirS to hildinS .onstrocliotr rrld h.Ehy authoriz. rcpEsnt livcs of this Cily ard Couly lo ctrl6 utrn lrt
<br />ahor tunriomd pol*ny for insDerion pu,Dsi,
<br />AnDlicurorAscnlSiEn lrc
<br />NE1TIZZZLil,
<br />ID/SIG.
<br />lvletal Fire Place
<br />lnsulation
<br />l,voru(ans' coMPENS,{T(rN
<br />DECI,TAAIION
<br />I h.rcb, nfim undo ,..,ny or Frjury oE ol lhc followinE dchElioni
<br />WARNING: Fliturc to suE turtcc' moF.nrdion s!m8c is t.law6rL ald !t ll sublrl u cnploF to ainl,sl Fmhh &d
<br />cilil fincs up ro oN tundrd rhouBnd doll&s (t100.000), in addnion to 0E.orl of conpcNtion. d.tuBcs !s Povljci for ln4
<br />SNrion 1076 of rhc tibor Codc. irflc(n lrd oromy\ l(i
<br />( onlm(lor- - .
<br />t .&43Nrmr-
<br />t nds! Addr!t3,
<br />-
<br />I
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