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MECHANICAL.INSPECTOR FECORD
<br />DATE ID/SIG.COMMENTS OWNER BUTLDER DELCAR TION II hcrctry a,rrn undcr lcnllr y of lcriurr r h l d dcq,t fron the Conrrcrou Lken* Lie for rhc tollowing rasn (Se.7011,5
<br />Busii.s aod Prcf*doo Codc): Any Cny o. Counry shkh EluiE( a lsf,it ro on{rud. alro, mum\c. d.mish or EIrn 0iy
<br />sIdcluE, prior b ns isusEe. stso r.luiEs lh. 4ldtd f.. such Fmir .. Iilc a sigcd sldcsnl lhal hc or snc is lic.lEd tumrnr
<br />lo lhc pmvkhns orth Conr!&ror'r Li.eosd Lae (Chaprcr 9. Conftkins wnh Sccrion 7000 of Divisior I of lhc Businc.s &nd
<br />Pmfcsshns Codc) or thal h. or shc is cr.ry,l lhcr.lioo rnd rh. tqqis fo, rh. dlheed ercnprior. Any violdrion ofselion 701r.J by any
<br />artlionl for a lcmit slhjels lh. ap0liqrl lo ! civil p. lly of nol mrc lhln fiv. hhdrd dollus ($500).
<br />-1.
<br />B owrc, of rhc IolEny, .r my .mplorrs eirh waecs as 6cir eL @r{E.s!rion, wil do ttE wo* rrd llE sruiB b rcl
<br />i cndcd or orcrcd for sL (SE.?044. AusiE$ od &lac$ions Codq Thc C! r.cbls Litne ljw d@s ml .prly lo !. o*mr or
<br />rhe,,FFay qho boilrls or inFmB dEen. &d wls &rs *h Nll hidscllor h.elf or rhoqn his or h6 own cn loye6.
<br />providcd rhrtsuch in{mm.h e mr inrcid.d orofiqtn for slc, lf. lDeB. $. buatdins or impewft i.$ldwirhi.om let
<br />ofsn{,Lrbn. dE Owmr Builbr eill ME rh. h}d.n olFlvi.s dld h. or $c dil ml t{ild or iryrow rtc ,mrEry for rlE IruF,$ of
<br />-1.
<br />3s o*ncr of lhc propc.ly, am c(lusivcly conlrelin8 wilh li.cn$d contreror lo snslrucl llx pmjer (Sa. ?iI44. Blsim$
<br />rld Proftlrbd Cndc: Thc Contdcror's Liccn$ ljq docs ml lpply ro an owncr of,no!'cny who buiks or impmEe thcron,
<br />aid *ho o.rfl.rs fr such pmjels wilh ! Conr@ro(s) lkc(s.d n!6uor ro rh. C4mBrm's Lien* Il{).
<br />-l
<br />m.rempt udcr Sftion- B. & P.C. torrhn Eason
<br />II)BtrI8S]:OUIENIA.IION
<br />OFCLARATION
<br />I hcrchy afiinn under p.Mliy of pdjury oft orrh. r(nb*ing dsl;trlrn'n\:
<br />-l
<br />h.te 3rd qill @iitd! . C.nifsr. of CrtMr to SctHmlE to, srk6' @nqEn!dio., B ,Dvided for by Selion 3100 ot llE
<br />L.!or C.dc. lor rlE lcrforeft. of rtu vo* fd whth rtE p.mi b i.scd.
<br />_! tavc atrd will minl,in work r' .onpcnsalion inruBtu.. a Equind by Scclion l?0o of fi. L.bor Cod., fo. lhc FrforllErc of
<br />lhc krt for *hich lhk F mil is ish,.d. My wortss .oorFnsarbn insunncc sEic! ud lblky numh.r ml
<br />-l.cniiy
<br />rhrl in lhc pdlortumc olrhc solk for *hich this rLrmil k nsucd. I shrll mr cmploy otry Fcmi in lny tunmr
<br />$ !sb b.mm subi$ lo rhc work n comr.osdion lrwr ofcalifomia. ard asN rhar if I .l$Uld lrroft iubirr ro rrE
<br />vortrs sn[Enetion pEvhioo! of SNrion ]700 of rnc Latlr Codc. I shull. tonh*nh oopty airh rtDc pmvl\io.s .
<br />NARNINC: Fdihrc h s.uto sorkc ..nltrns,i ion @vmec I unL*tu1 dd (hrll $bF' c.ryrlorrr
<br />'o rtninal IrEnH 0nd
<br />roo.c{ro). n lddr@nnhc mr, "t "."*ytr.",y Dmvdcd ror dE
<br />/,4A, .// ,,r'#
<br />citil 6n.s up to om hundBd lnolslrd dolhB ($
<br />rllc lrtn Cfllc inr.rcd rnl,norm
<br />LICINIITLCA.NIf,ACI!]f,
<br />Dli(I,axAllon
<br />I h.rby aflnm undcr pcnrlryol'pcrjurylnll I !m liccnsd undcr nn,rhion olCnrprs I (com,rcncitrE wilh Seclbn ?dn) orDivnbn:l
<br />ol' rhc Burim$ and Pmic$iolN Codc. orn my liccnsc k i. tull iorcc d ellNr
<br />C-z( /e comncror -11 DrP 6nRCt
<br />g)lsBjlcrl)Nl,lnilJtlllliErl.I
<br />isucd(Sc. :1(197.('rv ( )
<br />APILIIANI.DEII4f,AIIA!
<br />I I'ddry ,trm undo l,.nalty ot lerrury o* of rlE follo$in8 dc.bnrioni:
<br />Dcmlilion Pc.nik-Asbcslos Nolificdio. F.ncd R.euhkris {TnL 40. Prn6)
<br />-R.{uind
<br />krtd of ltuifsrbn
<br />-l
<br />ccnify rh.t lh€ lcdcEl rcBlhrions rcSuding ashc(os rcmval trrc nor .ppli.ablc to rhn pmrc.t.
<br />I.difyrhar I hav. r8d rhi. rpplkd
<br />ordinrNs rnd Srarc Li*s rchrins ro bli
<br />,b.vc mnrioncd Dmn€ny ntr inrn$rion
<br />onrr.r, - n**, a,.*,r. y'(
<br />I LErd t, cohdy sirh lll cirymd Cornry
<br />ofrhis Cirylnd Colnrr ro cntcr upoi rlE
<br />^", f-z<--rf
<br />Appliances
<br />Ivletal Fire Place
<br />Evaporative Cooler
<br />Furnace
<br />Compressor
<br />lrlisc. Equipment
<br />Duct Work
<br />Pre-lnsulation
<br />lnsulation
<br />Smoke Detectors lnstalled
<br />Rough Ductwork
<br />Vents
<br />T oilet Room / Clothes Dryer
<br />Residential Range
<br />Hood
<br />Type I Hood
<br />Type ll Hood
<br />Grease Duct
<br />Fire Damper
<br />Openings
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Above T-Bar
<br />Rough Mech.
<br />Final Test
<br />Meter Release
<br />FINAL /-t-/6 J/cJ;f .rtt
<br />Notes, Remarks, Etc.
<br />APPROVALS
<br />Other
<br />lnstallation
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