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MECHANICAL.INSPECTOR RECORD <br />APPROVALS DATE COMMENTS <br />Appliances <br />Ivletal Fire Place <br />Evaporative Cooler <br />Furnace <br />Compressor <br />Ivlisc. Equipment <br />Duct Work <br />Pre-lnsulation <br />lnsulation <br />Smoke Detectors lnstalled <br />Bough Ductwork <br />Vents <br />Toilet Room / Clothes Dryer <br />Residential Flange <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 />Rough Mech.7-g-t8 'tStn ,@a <br />Final Test <br />Meter Belease <br />FINAL 8-t3-t8 Jl6J-,-€a <br />Notes, Remarks, Etc. <br />OWNER AULDER DELC,{RANON <br />I h.rcbyaafimu lcr pcnahy of Friury rhd I d crcmpr filn rlE Co racros Li.ctrc Llw Io. rhc followin! rc{$n (Se.7011.5 <br />Burincs drd Pof.$ioo C6<tc)r Any Cny or Co!fl, lhich Equits ! Fmn ro onimd !116. ihprorc, dcmlht o, EI,,n uy <br />slrucluE. pri,r lo its kslcc, lho ftquncs lh. +plicer for su.h IEmn lo 0L a signd st.lcm* rh{ h€ or shc n [snsd tumont <br />t6 lhc piotirions of tlr Co.ro.rois Lkcned ks (Cfiaprn 9, Comn(ins wirh Sccri^. 7$\) oa Divnion I oIlh. 8Bircsr and <br />Pmlessions Codc) or rhar tr or she i. ex.m[ t rcfrcft .rd rlt hErir ror rhc slkgcd ercflrrFn. Any v6ldrE;ol S(lhn 70] L5 by ony <br />q,plionl for r FrnI subj.tts rhc rptlic.nl <br />'o <br />!.iviltc.rllyofnol mrc rh& fiv. hundrd dolles ($500). <br />-1. <br />os owrur til rh. pbpcnr. or my .nDbrr.s wnh wl8ci .s rhcir $!c con .nsurio.. will do llE ,oll !d rhc sltrrft k mr <br />iddrtu or olt€rd for Fle (Se 7044. Busitu\s md Pbfcs\ions CdL: Th. Co.ricbr's Ltcnsc t,rw d@s not apply rd n. o*ncr of <br />thc nmrEny lho toild\ or itr{,o6 rhcNn. srd *t dds Gh wo,t hinsclror hcrslr.r rhouBh his or hcr opn cqthyccs, <br />ptuvtcd rh.r such nnpmv.motsm nor inlc .d ororaqd ltrsL.ll horcv6,lh. bninin8 or in{,mrcmnl hFld*hhrom Fr <br />ofcotrplcliotr. ltr Osrcr Bliu.r qil hat tte trrd.. ol prcvi.8 lhal hc or dr dt not build or iqmt lhc Fapcny fo! llE llurpo* of <br />-1. <br />aso*ncrolthc rm,Eny, smcrchsivclyconrracrins *irh licenscd co.tet*s b con*Iru.i rrh pmr.! (S(. ?(}l,l. Ausflcs <br />und FofLxsiotr Codc Th. Contoclols Liccnp Llw docs .ot +ply lo n y who huinh or nnp0vc\ rhcrcon. <br />rn,l who conrr!.rs ttr \!.h rmjcc( $irh a Contrt,(\) <br />tE <br />l)t:( l.1k \ ll():! <br />I hcrch, {ltrn uidcr l,cn&ny ol loj!ry onc of rh. tollowiq dcclusrinnsl <br />I hNc ad wau minl'ln ! C.nirf,arc orc.ncnr to s.ll- ln ur. ro. wrk.s .oq*nerion. a Fo{id.d for b! S.crion 1700 ol E <br />tlbor Codc to, rhc &rfomm ol rlE so* for whkh lhc Fmi! b hsu.d. <br />-l <br />hnvc .nd *ill nBintoin *orkctr coryEnsalion insu6mc. as rcqunld 6yScclhn l?Oo oflhc Lat or Cod..lor rhc pqfdmN of <br />lhc rork for whin lhG p.rn l is issucd. M, wollss .onpcnsolion insunnce curicr ard policy nu'nbcr e: <br />_l.enify rh.t in rhc pcrlorEre.rrhc vork ror whkh rhis r.rnir k krucd.l shrll noi.mpby rny ptilon in any mnncr <br />$ as lo tIsnx subiy' lo rh. worl@*' .onrpcnsalion lnwe of Crlifonin. .nd UE lhar if I should h.toe sub.jcct to llr <br />*oltda.on{xnsli.nri,vi\ionsolScclionlT0oofrh.ljhorCdl..Ishill.fonhsnncoq)lywithlno*pmvisions. <br />WARNINC: Foilurc ro scurc wolkcr $np.nsorion covcmg._r rn urpkrr.r ro dini'rdl Fnnhics rnd <br />civil nncr up to onc hudrcd tholsond doll6 ($l conrpcn$rhn. drnrgc\ r\ fnrvidcd lar rh. <br />Ssrion 1076 orrh.lru (:i,l€ inrcrc{and <br />D.,e: a/dub a <br />DEEIAf,AIIAN <br />I lrcrcby rmnnund$ lEMItyofncrjury lh$ , rm liccn*rn under !$visiotr olChrrtcr9 (<,mmnciis Birh Sccri,'n 7(xn I ol Divkn,n .l <br />of rh. Busincsrdnd Prutcs\ir)n\ (l'd..0rrt my li.cn\c h in tullforNd cllGt. <br />l)irr <br />SANIIAUEII0N]I:XDIIGrI{jIIII <br />Ihcrchyrllnnr! cryEndryoIpcrjuryrhrrrhcrc tasnr(tucli,)n h insrsciryfttrrhclcrrohuh_corrhcsorkbr*hi.hlh(Efriris <br />ir{r.d lScc lU)7. Civ C ). <br />Aftl.lcatrLDfcl. x uaN <br />Ilrrhyaflinnundcrpcnalryof p.rjrtryoic.f rhc lblkNing cclrdion\ <br />Dcnx,lirnnr Pcirnir* sh.!os Nolific0rnn Fcdcftl Rc!ul{i('ns 1l (lc.l0- I'rni) <br />-Rcqun. <br />l.c(crolNorilirtk'n <br />I rmilirhar lhc lirdchl r.lrldons nol epli.,bb lo lht poi.1. <br />-l <br />ccnitilh.t I hrvc rc rhisarp I asE roo6dyqirh rll Ciryand Counry <br />.rdmrn..\ rnil Sr.rc Uws r.ld ivcs oarhis Ciry lnd Counry h c.r$ uBn' lh. <br />ohov. nEntiorcd proFny <br />ll)Ira <br />ID/SIG. <br />Policy Numh.r:Jtipncs: <br />- <br />F <br />f-------T------ <br />--------T------ <br />--------T------ <br />: <br />--------T------