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ECHANICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Metal Fire Place
<br />Evap 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 D ryer
<br />Residential Range
<br />Other
<br />Hood
<br />Type I Hood
<br />Type ll Hood
<br />Grease Duct
<br />Fire Damper
<br />lnstallation
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Above T-Bar
<br />Final Test
<br />Meter Release
<br />FINAL a-2.1-t6 6dz'7)
<br />Ow-Buil&. DeL io.
<br />I [cr.by !fl]rD und.r p. hy of pqj!ryrh.l I.m qdpt form ilE Co.rod.6 LieMt w fo.rh. followiag Boi (!6.?011.5 Buin6
<br />r l Prof6lion Co.lG): An, Ci, o. Co6iy vhich r.9uir6 r p.mi ro @dlr!.4 .td, improrc, d.tubh or r.Fir ey rudu.. Fior ro iltiisunc."iloi.qlicir..pplionrfo!rucnp6irbfil.rri8.!dllrrm.ftth.tlEorrh.!tieN.dpBurtodEpoviriocof$G,
<br />CoiErcror'3 Licn*d Lrw (Cl'.prq 9, Comcncin8 with Sd6, ?0oO olDivitio. I of lnc Bui,4 .nd Pro66.i6B Cod.) or ihlt h. or
<br />s[. n q.Ept rhs.tom lnd $c b6rh for rh. .ll€8.d eopi.n Any v6h on of S.alio. ?0] r 5 by &y rpptiq for r pqni subjc.r dr
<br />.pplioll 10 ! civil pcEhy of aor sor. lt.trn 6v. hund.d .tolLB (t5m)
<br />I, a oms of thc prcplrty, o, my .aploy6 witt Mg6 u rh.n ob @Dp.urio,! will do rlc work md rhc .Euau. n tut i .nd.!
<br />or ofdd for slc ( Se.7044, AwrBi id Prcf$rioq Cod. T1E Coor.do, r Li@e Llw do6 nor lppt to !n owr of rh. prcpdty
<br />wno bui& or inprov.s tho@n, .nd who do6 tud worl himelf or hcslf o, rhrough hi, or hd oM .nploy..3, provid.n 6r! luch
<br />ihprov@.lE rG nor inr.id.d or ofr{.d for hl. If, how.vs, rh. building or idFowm.rr ir rcld wnhin oF yd ofcomDLrio\ lhc
<br />Omd'Build.r wiu h.v. l!. bud., of povinS th hc or 3hc nor build o! irpovc for tltc purpot. of *lc).
<br />I, a ow ot thc propsly, rm a.lu.iv.l, co.E..ti.8 pilh li..d.d @ll1lfud t6 6Bmd lh. prcjd ( S& 70aa, B6in6t rndpbfdio. Codcr nE Contnaor'3 Lien* Llw do6 not lppty ro f o*G ofpoDlriy who build! or ihprovd $s6a , rd who
<br />@iEr6 lor !&h Ploj*lr ein r Co.mdo(, li.ci!.d p6u b dE Conlnd&'r Liee t w )
<br />_l M.xenpr undd S@{io. .B & P C aor rhn r&mn
<br />WORKf,f, S COMPENSATION Df, CLARATION
<br />I hq.by .fith ud.r p. lty of pdllry orc ofu. following ddLErioEl
<br />I hrv. and will 6. inbin r Ccnifi@k of CoN. ro Sclf'Imur. aor mrk4 comp.6{ion,.s provid.d ior by S..rion r?00 offict hor Code, fo. thi pofortu.c. of rhc wo,l aorwhichrh. p.rmn B iisucd
<br />Y, ** *o *r, **o. *"rk.6' @mpcution i.suance, s r.quir.n by s.crM r?oo ot rh. Ilb.r cod., for rh. p.rromne of rfi.
<br />eo.k for which rhn pdmn is irrucd My sor[cs @np.nstion Nurrnc. drEr .nd polic, .!mb.. ar.
<br />c,,,,., //o 'z lt^'2 n"t
<br />W<'facu7-tot,&qi€3-72'(t_
<br />(Tti! s!.tion i..d iot b. oompld.d ifrh.p.rmn h lor OE hundrcd doltus lll0o) or L$)
<br />_I enii/ lhll in fi. p.rfo.mne ol.h. wo for shth thi. pqmit E i$ucd,l3h!U not 6ploy lny p.6oi inuyMnnsso6ro
<br />b.qn. subj*r 10 rt'. wrk.B @Dp.G.rio. hM oa C.lifomn, ..d .gr@ 6!t ifl should beod rubjd lo th. wort.6
<br />@mp.r{ion provirioa ol Sctio. rr00 ofrnc bhor Codc I sh.!|,
<br />WAiNNG: f.ilurc !o ieur. worlcd comp.Elrio. 6rce8. i! ul.*6) l, .d !h.ll 3ubjd & .hplotq to ernidl p. ltis.ndcivil
<br />fuq up lo on. hudrcd thou$d dolLE (tl00,Oo0),in.ddnion & $. @n of@Dp.n$tioa risds.s I provid.d for rn Serion30?6ol
<br />rhc trbor Cod., dsBrMd !trom.,'t fs
<br />LICiNSf,D CONTRACTORS DECLAR TION
<br />I hc.cb,.frirh u cr p.rlty olpajury Bl I.o li.4cd !id6 ptuvnioi of Ct6pl.9 (@tm..cirg with SdioD 70@) of Divirio.I of
<br />th. B8ir*s rnd ProfqtbN Cod., .nd ey li.ce i, h tull fore tnd .tret(1r)'7 Q?tz orEbS--------,J<-rt,(f'(('^'rz tat /
<br />aoNsl-RtrcTIoN l,aNDI\ro acuNcy
<br />I hereby a,fi,m u.der pemhy ofp.tjury $at $erc t a @Nrruclio. l.ndrng rg.ncy lor rhc pcd.rmnce oirh.,orl ror which ih'r p€.mir E
<br />issucd (S.c 109?, Crv C )
<br />AfPLICANT'S Df, CLARATION
<br />D.mohion Pdmir.-Alb.sror Nodliqtion F.dsrt R.sll{iods (Tirlc 40, P.n 6)
<br />_ R.qun.d L.n6 of Noifiqri.n
<br />_l ca$ry dr! (r lcdol EslLtioN r.s.rdils ab€.ot r.mql r. ior .ppliobl. ro rhir proirr
<br />I *niry fi l h.vc rEd ihis +plqrioi ind srl. thar lhe rbov. rnform ion ii cdiid I agr+ lo @sply wnh lll City tnd Counry
<br />o'diE&6.nd sl.l. L.* r.l.r'n8 ro lnd kreby aulhoriz r.pi6.nt.riv.s of fiis Ciry.nd Couity to r.td upon lh.
<br />!bov. a.nrion..l propdy aor iNp€t
<br />t-u,/t'//
<br />Cat -LOrP.min6 m.(pid _
<br />M \WP51\Permit-lnsp6ction F el-lnspedor R€corddoc 03 31 06
<br />7
<br />Appliances
<br />Openings
<br />Rough Mech.
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