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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 />Rouqh Ductwork <br />Vents <br />Toilet Room / Clothes 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 />lnstallation <br />F.D. Drop Test <br />Above Hard Lid <br />Rouqh Mech. <br />Final Test <br />Meter Release --z--\ <br />FINAL b-2- /g ,) <br />Notes, Remarks, Etc. <br />OWNER BUILDER DELCAXAIION <br />I hcrcby amrm lndcr p.mlr, ol pcrjury rhd I dm excnfl nnm rh. Cinractm LiccnE ttq aorlhe followi.S rca$n (SR?0:11.5 <br />Businc$ and Prolcsrion Cod.)r Any Cily or Counlt *hbh r.qlircs ! timit lo consrNt. rlra. irptovc. &mlish or Etat 4y <br />srode, prhr ro ns issusN, .lm rcAlircs rhc amliclnr tor such Fmi ro liL r sigNd .r{rcMl thd lE or sh. is liccncd PUN! <br />ro rhe pmehioni ofdE Co.lracroli Li.cnscn ks (Ch+ln 9. Commncing Pnh S..lion 7000 of Divirion I ofltc Busiics and <br />PDlcsions Code) or thlt lE o, she is cxenlPl thdcfrom Dd thc hasls for thc aucBcd dcnplio.. Anyviol,tionofscthnT03l.5byEny <br />amlicaor fo. a pemir subjets lh. applic&nl to ! civil p.Bhy of trol mrc rhd firc hutrdEd dolh6 (S5m). <br />-1. <br />rs osE, nr $c trcF.iy. or my.oplotrs *nh v!8.s .s lh.n rk sn\rtullio sill dr tlr qoi.rd 0E fiElE is ml <br />n cn&d oroff.r.d for slc (54.7044. Btsifts and PmfcssionsCodq Thc Contsctoa! Lic.N t w doci nol lpply lo s owrc. of <br />rh. y.Fry shoh rs ot iqm6 tr@tr ard who dG sh tr* hin*lf or lEelf or lhhugh his d hd osa cn{thycs. <br />pmvtol lnrt such inpmsmils @ ml inL'ldcd n ofierd for sL. l( ho&rd,llE brilding or iqmwmnl is $ld wnhi. orc Jtd <br />ot.onplctioll. rlt Oqn6 Buil&. will haw tne bndcn ol lming ltd nc or sh. did ml tuild or iqrcE Oc potdy lot tryuqDs of <br />l. d*ownerolth. pmFny. !mcrclusivclyconlrscli.s*irh liccnscd coilturoN ro .on ruct lh. lmjcd (Scc. 7044. Br\i.c$ <br />ard tlDhsbn Codc: 'l hc Co.r.&ro. s Lkcnsc hw dds noi apt,ly ro m ovnct ol propcny who hnild. or inprovcs thcrmn. <br />.nd who € mcts for s.h Fljccrs Firha ConlEdons) liccncd l)!B!d! ro rhc C.nrelols Liccnrc L!s). <br />-l <br />am .xcq,t undcr SRI <br />UOAtrEIN.:CQMTBiAIIIId <br />DECLIBAIIO! <br />I h€rby amrm und.r pcElty of pnju.y oE offic followinB dal@rions: <br />lhr\ru trilln lnrJiirC.nrn.rrc"fC.trrnlk,Scllltr{r.lit{orkdi.or,,ct\riu.rsDn,vntcdri)rhySNriorlTlx)olrhc <br />I rhtr(ixl.- lnrr[c ncrlonMnc. ofrhc work rr uhichrhr!.nni! i\ n\ucJ <br />A::',;rnd*ill uinrrin *orkcrJ .onrNns,rid insunn.c rs rcqun d bySdion 1700of rhc LiborCod., forihcpcrlortunccot <br />sion if,suroe @ricr ad nolky ou6t t @:n <br />I zlz t lt3 <br />t [,;;, <br />-l.cnify <br />thrl in lhc pcrtonmmc olrbc wo,k nr whth rhh,,.rn h tsucd.l shall nol cmploy.try peNn in <br />e N ro bccorft {lhixl <br />'. <br />thc workcis comp.nstrioo lawsofcaliforni( ond lge llul ifl sholld tEoft b.iccr to llE <br />*oAc6 oq)cnelion tovnioN of Sdion 3?(I) of ll* Lohor Codc l nrll. fodh*ilh conply wirh rho* prcvisions.. <br />WAIINING l,rilurc lo scurc qorlcA co'npcn\rrnn covcrrlc is u <br />civil nncs up h onc n!rt.usaBi dolltr.s rSltX).(XX)r. in <br />ZS <br />Ulil1,-\8r\IXrN <br />Il[rcbyrlrrnnund.r Ifn!lryol t)crjuryrh.r I !D liccnsdu crpmvi\trnoiChxprcr91.o.ntu.irt8wirlSc.li,nrmo)olDivi\tr:l <br />ot rhc Ilusincss rnd ft,,fcs\i(,.\ Codc. dd trry li.ctr{ i\ in full lar( r!x,clliul <br />C7s U sp <br />s , F lrr-+ <br />I lEBby !ffEn!nd6 Ftulryofpc.iuryrhat 0E Lir@.srodhn bMirg rg.my forll* <br />iNsucd (S.c. 109?. Civ. C.). <br />olrlr kork aor ahi.h rhis ,riinit i( <br />A.88I,ICAILDECI.AEAUON <br />I lEeby afiim undcr tcoalrt of Frjury om of rhc lnllo*ine del& r ions <br />Dcn,lirt,n P..nrir!Asb.sroi Nolificrlion Fcdcrll Rc8uldions (_fillc,a0. Pon6) <br />Rcqutcd Lcner ol N{,rifi (li,n <br />.Enify rhd rh. fcd.6l rcgubrio s rcBeding \rcnr)vrlaru Nl lnplicrhlc i,rhi\ thjLtr. <br />l4fitir, rhlr I lbk Eld rhi! lpplkerioi !d <br />odiutrc.s trnJ Srurc Lrw\ rc|fl iry ro blildin! <br />ltxnc nrnrioncd pDt ny fffin\F.rn,n <br /> Dnlicunr o. Alcm ti!n!torc <br />o <br />?-/.e <br />Above T-Bar <br />Ps i,Nij.s(p,n)_44 <br />I <br />tt <br />f-------T------ <br />i- <br />=