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MECHANICAL-INSPECTOR RECORD
<br />APPROVALS DATE IDiSIG.OWNER BUILDER DELCARAIION
<br />, hcEby arrn und€r !.nalry of l)c.rlry rl'!r I d crcmlr frln rlE Conr&lo6 Ltcns l:w lor lh. followin8 E&$n (5(.7011.5
<br />Burinc* lnd Pmfcssio. Codc)i Any Cily o, Cou y *hich rcqtrircr a lf,mn lo €onsttocl. lltcr, idtlrot. &mlhh or (Il.t rny
<br />srMtuE, lrior ro irs isuue. lho EguiEs rtu opPliclnr for sucn [*di !o nb a ,igrcd sal.m rtd lE or sh. is lianed pumMl
<br />ro rh. tmvisioos 6l &. ConlBrofs Lic.nsd tiw (Chaph 9. CommRinS *irt S€crion ?000 ot Diviiion :1 of 6. Busines and
<br />PmicsioN Cod.) or lnll hc tr sh h cx.hpr rhcrcfrom and rhc b.si$ lor rhe rllceed cxcnntion. Any viohtion ofSellon ?031.5 by iny
<br />q,lliclnl for ! I).mir subicls rhc ,0pli.ant h a civil pc.alty of nor mE lhd nvc hundr.d doux6 ($r0o).
<br />-L
<br />as own$ of rh. I,.Fny. or my cndoles wirh *agos !s rh.t $lc con .nslrion. wiu do tE woii od tr slrEt@ is ml
<br />i, cd.d orotrcr.n for sk {5(.1}44. Bu.iNsr and P.ofessions Codc Th. C.nr.dol. Ltctrs L€* docs ml aoDly lo,n.*n.r of
<br />lhe pmtrny wbo br:ilds d impmws rlEwl ud *no &6 seh hrt hidsl, or h.is.ll.r lhouSh hh ot bcr o*n.rpL,rtca,
<br />provid.d rhai reh inpmEmnts m ml inlcnd.d trof,cEn 6r $k. li howE lhc tDildins or inpowmnt Li sld widh om yr
<br />of mr{,lction. 0E Owrcr Buildd will hrE rh. hhkn of Isvin8 ftd lE o, slE di.l rcl toill or inimw lts pmpary for lhc P{m 6f
<br />BI}BtrESS.CAMTEIIAIOND&clnllAll0li
<br />I hftby iffirn undo pcrully ol pc,rury om of lh. followin! delmln,ns
<br />Irlxtr c(xlc. ti)r rhc l]crlitrnrrmc ol rlrc r$rk lU *[i.h rhc |Hnril i\ i\{Rl
<br />-l fiavc rnd sillminuin sork ^ conFnrarion inluhec.,. Equircd byS.crn n 3700 of lhc hbor Code, for lhc pdro.r@ce ol
<br />rhe work for whi.h $Lr Fmii is i.nEl. M, wor*6 o,llfnsation iNurNc cmis .nd ,olicy .unbai e:
<br />I ccdiryrh.r i.rhc p.rrormmcorlhc wo,k ror whichthhr.nrir is nsucn.l shall nol cmploy lny pcren inany nrmncr
<br />s {s ro tEcoN subjsl lo lhe qorkol coq'.nslion hws ofcslifffnin- ind asN rhar irI *hould tE om suhjed to llE
<br />wortcrl compcnsrtioD pmvtions ofSation 37dl oflhc titEr Codc.l shrll. t,nhsirh.o,nPly wirh rhos Imvlsions.
<br />WARNINC: llilrc ro s.ur workes .o'nF.ns in svcr,E is unlnwtul. ,trd shrll subjcct nn cnploycr to situinalFnrki.s rnd
<br />civil fincs up n' nnc h!.drcd rhou$nd dolln^ (S100,0(x)), in rddnn r t. rhc.os of cornl,cnsalion. drmE$ ur fiovid.d r.r rhc
<br />Ssrion 3076 of rlr Libor
<br />,.,,,9 / n/tA
<br />Codc, inrcrcn nnd 6my s fds
<br />DIIIABAIIONIhcr.h!.fi n udcr Fnrlry oi r.lury rh l !m li$n{.d un(lcr rovi\ion ol Chrpir 9 (.ommn.are sirh sccri, T(xx)) of l ) i i\ion l
<br />ol ric llusinc\snnd P!,fc\sion\ Codc. urd ryli.ttr\. i\ ir full ntrcc !d.li.0r
<br />4/n tb
<br />Ihcrcbyrlrtnxdcrp.nrlryolrErjuryrh thclc k r cotrsruciinr lcndins lEcrcr lor'hc Fraortukc orrh. wutk nn qhich rhis Fimil i\
<br />isstcd rs.c :1097. Ci! C I
<br />dIllIglNLDEgrrBiIIlgli
<br />Illntya0irnu crDcnrlryoltf,rjrryomof rhcli,ll.si'iSd(hrrrn,n\:
<br />lxnhlirn$ Pc nirr AslB{os Norill.di( !,.dctul Rc8ul i(rx (Iill. l0. Prn6)
<br />Rrqtrircd I-crtcr ol N.iillciri.n
<br />I ccdify rhar rh. fdicnl rcErhtions esodinS lsbcstos rc sral arc aot rylicuhle rr, lnh pn'Fr
<br />-l
<br />enity rhar I hd. rc rhh apllicllioi sid slol. rtul thc lt[vc inlbrmotion iscon.d.I dele to coq)I, wiih lllCilyod County
<br />odinarc\ and Sl!t. tjws rLrinC r{, htrilding c.Nrucridn. !d hcr6y rhorir rcFc*nlaliles oflnh Cil, Md Couo'yro.nrcr u,bn dE
<br />ahovc mnrion d prercny to,
<br />Appli6r or ABc Signsrh:K-r1.. '-;-
<br />Appliances
<br />Metal 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 />Rouoh Ductwork
<br />Toilet Room / Clothes Dryer
<br />Residential Ranoe
<br />Other
<br />Hood
<br />Type I Hood
<br />Type ll Hood
<br />Grease Duct
<br />Fire Damper
<br />Openinqs
<br />lnstallation
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Above T-Bar 7 'l/.,?-1. t9 J/.,LPl zku)l-/
<br />Rough Mech.t->
<br />Final Test
<br />Meter Release
<br />FINAL /2-?-r8 t //rL*b<'Y)
<br />Notes, Bemarks, Etc.
<br />COMMENTS
<br />Vents
<br />_1, rs owier oa rhc pmlrnr. rn cr.lu\ivcly $nrdinS trirh li.cnql conr$ktrs nr (nNrrucr rl* ,rlrjccr (se 7 H.l, Busirc$
<br />rnd Pn,[\sirclodc: ThcContrrxx s Liccrr Lrwdoc! Nr nnplyrt' stro*ndr.fnn,n( ytho huilds or imDrorcs lhcrcon.
<br />and rlr coikrcrs {l, iuch l,n,jc.R sirh , Gd B.rr( n li.ctr{d poNrtrl ro thc C.nh.lo s l,iccn{ l!w)
<br />_l urcrcmpr u dcrs.rrion .a & PC. turrhi(rcrs.n.
<br />Policy NumbB:-Expircs:
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<br />, /4.;'-
<br />Numh.'
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