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MECHANICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS <br />Appliances <br />Metal Fire Place <br />Evaporative Cooler <br />Furnace <br />Compressor <br />Misc. Equipment <br />Duct Work <br />Pre-lnsulation <br />lnsulation <br />Smoke Detectors lnstalled <br />Rough Ductwork <br />Vents <br />Toilet Room / Clothes Dryer <br />Residential Ranqe <br />Other <br />Type I Hood <br />Type ll Hood <br />Grease Duct <br />Fire Damper <br />Openings <br />lnstallation <br />F.D. Drop Test <br />Above Hard Lid <br />Above T-Bar <br />tll'.r'-Qb1Rough Mech.ble 2 br .( <br />Final Test <br />FINAL <br />Notes, Remarks, Etc. <br />I c.niry rhal in fi. Flomanc. oarh. sork lor which lhis pdmil is i$ucd. I shdl mr op16, oy F6o! in .oy menq <br />$ B to b.corc subjdl lo rh. sorl6'@npcation las ofcalilomi., od .gEc lhal il I $ould b..orc subjel lo lhc <br />erL6' .onp.Mlio! pr$ioN of Serion l?00 oalh. tjbor Codc I CDll, fonhwirh rchply vitlt lho* povi5ioE.. <br />WARNTNCT Failur. lo su. wrt6' <br />civil lln6 up lo o.. tundrcd lhouend <br />S<tion 1076 ofthc tlbor Code im6Bl <br />covm8. is unlNtul. !d shall rubjd & @ploF ro stnin.l Frtti6 ed <br />00.000). in a.lditiofl lo lhc cosl of coareGdion, dnrugd a provided Io! lh. <br />uc[NsxD_coNrlacfoa <br />DEC!$AI]OT <br />I hftby 6frm u.dd p6uX, of pojur, $,l I @ li@s.d @<hr rrolsi@ of Ctsptd 9 (cod,lfuitrs *nh Sdlion 7000) of Division l <br />of tn Bcins ed ProfBios Cod., ed dy liccM L ii tull hrc &d c,Ic.r, <br />!3 <br />I hcrcby alrm !nd6 Fnally of pdj!ry rlEl <br />tiucd (56 30s7. Ci!. C.). <br />lodins asdcy lor lhc pdfoi:@cc oafi. wo.l aor shich this pnnn 6 <br />AfIIICANLDICIiAMIION <br />I n6!y ,Irm und6 p6.lty oaFjury oDc of lhc folloNirg delealionsl <br />Dcdolition PdnieAsb6ros Nolificarion l€ddal Reularions (Till. 40. Per6) <br />-R.quircd <br />L.rlfof Notiiolion <br />haE r.ad rhis applic.rion and slal.ltal rhc abov. inlomatio. n .oftc.r I !8ra to .ompt Nnh all Cny and Cou.ly <br />tlws r.l.Iin8 lo buildins coBlrucr ion, od h.r.by aurhoriz. rqrBdariv6 o f $is Cit, dd County to .nls upon lh. <br />rhe: <br />Hood <br />Meter Release <br />OWNER BUII,DER DEL(]AIIATION <br />I h@by ,mm und6 pmalry oa pdjory thrl I m cxcmpl fNrn lhc conlG.lou t,kos. L!* aor th.lolloNing r€8n (se70ll5 <br />Brsin6r lrd Proaeion Cod.): Any City or Counly Nhich rcqune a pamil lo @drud. ah6. inp.ova {kttolish or Ep6n ey <br />nru.1ur.. pnor ro its isutrce. alio r.q!t6 $c aDplicet for slch p6rir lo filc a sran.d slalmol lh,l n or shc b lics.d pnmei <br />ro rhe lrolisio6 of th. Co.lr.crors Licms.d Liw (Chapt6 9. Conncncins wilh Sdion 7000 of Division I otlhc Busin6s and <br />PElsions Codc) or rhrt hc or shc i! .xcmpl lhs.iioh dd lhc bsis tor lhc allcs.d c{@priof, Any viol.tirn orsedion 7011.5 by an, <br />applica for a pmn subjars rh. arplicdrlo,civilp6ahyoinolmor.rhdfivcnnndraldolles(t5OO).' <br />l, c ownd ofthe pmp.ny. o ny €mployG vilfi was6 s lhci $L .\rtpcl3.lion. will do rh. wort ud lle srude b .ol <br />inradcd or otIs€d for *le (Sd 704{. Bsins dd Proasions Cod.: Tn. G)otraclols LicGc L.v do6 nol ,pply & e ownd of <br />$c pmray who buildi or impmce th6on. .d who do6 such *o't hituelf or h6.ltor rholBt hi5 o! ha om o.ployr6. <br />provid.d thd sucfi imFoYs* s @ nor i dd.d or olfd.d tur sL ll ho$6s, fi. boildins or iqro!..Ml b sll wi,hin onc ,a <br />of(ohpldiotr tn. Os.6 Blit€r will fisvc lh. hetd ofprovins lhd h. or slE drd mr tnild or inFov. lh. Flpsty 6r $. BrIDs ol <br />t. s osnq oflh. propqu d d.ldiv.ly .ontocriog wio li..6.n conlr0ctoB to onslrucl llE p.oj.cl (5*, 7ol4. Auin6 <br />atd EDfr.sion codc: th.Conraclois l-icosc t w do6 trol .pply lo u ovni of propdt, *ho builds or inprov6 thcmn. <br />aod Eho co.,lEds lor 3uch ploj&ls *nh r Conhuo(, licdsal p6udl b lh. Conhclois Li.dc t *) <br />- I mcxcmpl und6 Scdion-, B &PC aor Oi! rcaon. <br />D.l. _ Onnd <br />xoatrESaiaMEll ro! <br />DECLARATION <br />I ls€by atiim undr p6ahy ofFjury onc onhc touowiig ddledioBl <br />I havc ed will ,mintain a CcnificaE olcon$t lo Sdlf-lnsurc lor $ork6 comFM ion, s provid€d lor by S*rion l70o of rhe <br />L,bor Code, for tn. p6lom c€ oilhc worl for Nhish lhc p€rmil it iisued <br />I hlvc and will nai.lain worlds' .omp.Ml ion i,La..ncq s rdtui(n by S*lion l?00 ollh. rabot Code. tor lh. p.rfom ccoa <br />d. wo,k aor $hich this p.mil is necd. My work6 osFNlion iGurtuce ceier and poli., ,rmb.r E.: <br />/./4='- <br />fcd66l csuLlioB Gsdding abdoe rmld d. nor applicdblc 10 lhii pmjel. <br />I <br />--------T------