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MECHANICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWNET, AUIDER DELCAf, ATION <br />I hcrcby lfftn undcr l,cMlly of Fdury lhal I m cxcrpl lmn lh. Conr.c{oR LiNre Lrw for lh. folh*ing iasi (S$,7d31-5 <br />Buiim.s 3rd Profcssion Co&): Any Ciry or Comry *nict EquiB ! prni ro otumcr. .hd. i'rpoE &mlish or rrEn rny <br />slru.t@ Fi,r lo ils lx{ec, rl$ rcquiEs 0u.pplhsr for such I'mi lo nb r iaer.d slarcGnt fiar lt or dE b lic.D*d plll@r <br />ro rh. prcvtiDns oa tlr Co ncrois Lken$d Llq (Chaprcr 9. Comrcing wirh Sccrion 1l(r0 of Division 3 of tlE BBim$ .nd <br />Pmfcrsions Code) or $fl he o rlE i! cxcqrr rheEftom{rd rh. beris for lh€ {lbgcd excr{irioo. Any viobrion olSc.lb.703l.5 by rn, <br />applic! for !p.mil subic.ls th. rppliclnl lo r civilp.{hyofrci mrc rh& liv. hundEddolbr (t500). <br />-1. <br />a. owM of rh. |nDFny. u my cmplorrd *irt ergcs I fien sb @mp.ns!rio., wiU do dE ert ,td 0E arErrc n m! <br />i,tc .t or ollcEd Lr eL {Se.?O14. Busincs 0nd Prcf.sion! Codq Thc Conlnctols LieE t w d@s rcl lpply lo d owmr ol <br />the pDFny oho hikls or in m6 lltoll atd *h {km uh srt hinsclaor lr*lf or rnough his or her o{n.nploy6. <br />povidcd lh3l s.h impormnk e not inl.ln n or otrcrcd ror slc. lr. thwi th. t iuing or inpmrcmnl ir sld whhin oR Fa <br />of.olphrbtr tl! Oce, auiEa sin luw rlE hlrLn oarrnaing drd h. or $E dn mr h,ild or ir{'rE dD 06F!y for lll porpo$ ol <br />-1, <br />a owEr ol rhc pmFdy. m .x.lusiwly conhcli.8 wnh [..Ncd conlrdo^ ro of,slrucl ltp prtrj.rt (Se. ?044. Busincis <br />dd Proltssion Co<lc: Thc Conrlcrois Liccn* Law &E! not .pply ro an o*nc. of rml.rry eho builds or improwi rhci6n. <br />and who .o 6cls lor sh proiEts wnh a Commro(s) lk.ns.d ptrdunr ro rh. Conrmrols Lier* t w). <br />, m cxcmn' undcr SMDn , B. & P.C. for <br />'hir <br />lEsn <br />l)nlr l)\n.r <br />EOASEf,I'.CIIMEEIAIIO! <br />DIqLABAII{A <br />I h.Eby afilm undcr pcMlly of pdiury onc of $. rolosin8 d*ldriions: <br />-l <br />tuv. lrn will minrain ! Ccrriartu of Con*nr ro S.lfinsuE lor sork6 ompcNarion. .s P,lvklcd for by Sftrion lru of rlr <br />ttt r Cod.. fo. ihc pcrlormre ot thc m* for which lh. pmil ir ksrcd. <br />_l ilvc lnd qill mainrain $orkcs compcns n,ninsur0ncc.as rcquncd byScction 3700 ofrhc LsborCodc. fo, rhc Pcri,mtc of <br />, worlGl ompcnslio, i.suEm. @ir ard polty aunltr sc: <br /><'otl rq <br />_l ccnili thnl in lhc pcrformme of$c wort for which $is pcret h bsucd,I sh0[ nol cnploy any p.Bon h lny mnmr <br />$ $ lo b6om subj8l lo lhc *o 6 oqEn*tion bwsof &liaomi& arn.grcc lh3l if Isholld beom suhjd lo lL <br />*ork6j compcnstion pmvlsions of S€clio. 3?00 of th. tibor CL{c. I shall. fonhtith mmply qnh lhD$ pmlisions.. <br />WARNINC: Foilurc ro ccurc w.rkcB cotr{Enslrio. covemsc is utrlr{tu|. lnd shall s!bj.{ !n edpl6$r lo cinio,l Foxicr dd <br />cilil lincs up ro om hundrcd tholsnd dollas (.ddirion ro th. osr oI Nml.nsarion, &tus.s as lrovidcn for rtr <br />'"*"iaTrg:tt'"". <br />LlclxsEotoNrlacltaB <br />DUCIAAAI]I.IN <br />IhcEbyarfiflnundflrnnltyofprlju,yth l on liccn*l utulcr ptuv(i"n ofal;iid e(mm*-Nnrs wilh Scclion ?mO) ol Dirnion:l <br />ot rh. Busin \!aid Pi{,lc\sio n s Cod.. rnd 'nyli.ci* ir i'r full lorcc fll cit.r <br />c3b 1,o-z \14 \ <br />CI]]jSIaIEITANIIiNDINCJIiINI:I <br />n\ucJ (Scc :liD7. Civ C ) <br />AffLlCrlltLDI:CLta IQl <br />Ih.'!byrflnnru .rI{Nlt,ol plrjryomulrh.li)llo$i'udd.hrrrior: <br />Dcnrolli,rtr Pcnnnr \hcno\ Norilr.rNn ltdcril RcSultrrio \(1irlc l0. Id6) <br />Rcq rcd I clcrolNorili.rri'n <br />I ccditi rh.i th. r.der.l rulllnrions oe,dine rsb.stx qmldard nor rtpli.$|. io rht pm,ccl <br />-l <br />ccnify rh.r I tuvc rcod thn lppltarion 0d srarc rhrt thc.hnvc informrion h consr.I acrc ro compl, wirhallCiryMd Couoly <br />ordiMnccs dSrorcbwsrehr od h.rcby NrlDria Eprcr.ral ivcs of lhis Cny dd Counly lo cfllr ll'on fi. <br />lhove mnlioncd lotcny lor <br />Atllic r or ABcnt Si,lnoru <br />q.-utg <br />Appliances <br />Metal Fire Place <br />Evaporative Cooler <br />Furnace <br />Compressor <br />Misc. E quipment <br />Duct Work <br />Pre-lnsulation <br />lnsulation <br />Smoke Detectors lnstalled <br />Rou gh Ductwork <br />Vents <br />Toilet Room / Clolhes Dryer <br />Residential Ranqe <br />Other <br />Hood <br />Type I Hood <br />Type ll Hood <br />Grease Duct <br />Fire Damper <br />Openings <br />F.D. Drop Test <br />Above Hard Lid <br />Above T-Bar <br />Rough Mech.I 4 trflt(G tt,tcil4 >b) <br />Final Test \)' <br />Meter Release <br />FINAL *>trtl>-tl .,//1- <br />Notes, Remarks, Etc./ <br />lnstallation <br />/d/a /rt' <br />-\<\g <br />t---+---