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MECHANICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.0WNT:R BUILDIN DELCARA'IIoN
<br />I h.rchy olllrnr nndcr t:nall, ol p.rjury lh l nnr cx.mpl liom lhc O)nrBci{n' l-i.cisc lis fin rhc rolk,$ 3rclol(SLt70Jl5
<br />Bu\inc\\ usl lrorcs\nnr Gdc)r Any Ciry oi Grtr'! shich rcqtrncs r lcirnn ttr con(ruc|, nllcr. im[.'c. dc'noli\h .r r.n]n r+
<br />{rurror.. lrnrn, i( tsu,tr...,ko rcquncs lhc l,)plic.nr rar such N.nrilo filcr {isncd shrcftnr rhar hc.r shc i\ li.cn\.d NrsuJnl
<br />lo rhc proynbn! oI ltE Conlrlclrtr s l-iccnsd l^ lctuplcr 0. Conrncncin8 sirh sc.rn'n 7(x$ ol oiv^ion :l ol ltc lrurinc$ ond
<br />PDlc$ioosCodcrorrhar hcorshc i\ cirmrr rh.'r,rom od rhcitr,\i\ {(n rhcrlLtcdcxcarJ,riun Anyriol.lionolSarhn?O:ll5hyany
<br />rrplicrnlturrpdmirsuhj(r\rh.,!fli.$tha.ivilpcnnlrtorn.rnn"crhrtrlivchundrc{dollu (S5lx))
<br />-1.sowMofIh.pmpcny,orm,.rploy..swilhwrecs.rrhctsk.omFn$lion.willdorhc*orked.nftr@iimrinicid.d or oficed ror sL (5d 7044, BusiB*s and Pbf.sio.s Cod.: TIE C4rrsrols Ltenr Lrs &,.s .6t arpty ro d oencr of
<br />thc pmFny w,m t{il& or nr{'Ms t,t@n. &d who &6 tuh md( hinrlr or h.rkrr or rhmuah his or hc. o*n cdpLrds,
<br />pmlid.d rh.t such inrmrcmnh @ ml inrord orolIe'ld for sk. li ho*ffi, rh. t{ildin8 or itptwEnt is sld wilhitr oft yw
<br />ormnpldion. tlE ownn Blitcr sill hlE rhc burdcn of ImviiB rtor hc or she dii 6r blild o inpDlc rhc pmpdy for llE purpos of
<br />l. 6 owrcr of rhc roF.'ly, m .rclusilcly .onnoding eirh licorcd coiteroN ro e.socr rrE l,.jdr (Sd. 7044, Busircs
<br />s'd AbErsi, Codcr Tnc Conr@roai Li.€nsc Lrw d@* rer Eiply ro own$ olpropenywno buildsor impoti rhc.co..
<br />8nd uho onrtr's for such pmj(ls with o Contmcro(o lien*d punuir ro rhc Conreror's Lrcnc tnw).
<br />I rNdcnrlr rn .r Sc.rn)
<br />lroB(E8S:t0!4fENtAfION
<br />DECIJAAIII}N
<br />I h.rcby nftnn undcr Fnrlry .f !.dury om of lh. l'ollowine ddlaEtions
<br />-l
<br />h.r ald will mirt.h . C.nifBrc olcorsnl b S.rlB@ tor srt6 ompcnslion. a Fovidcd f.r by Sslh. 37m oid.
<br />L,td C!de. for rhc ,dloltlgc ol rlE wdt tor which rlE D.mi b i!s!cn-
<br />I hivc,nd willm0inl,in wortcB cornp.nsalioa insuEncc.0s rt,n:l7mof rhc Iihor Codc. for rh. llc lormotrccol
<br />Ir1,.rri.. rid F,li.y nn $or rcl
<br />a l r
<br />-l
<br />eniryihdr in rh. pcrrormm. of lh. work for whichthisFrmil k irslcn- I skll nol ed0loy lny peMn iD any mtrmr
<br />s s lo tx.om suhtrl ro ltc wortsl cotr{Enslion Ltrs of Cllifom and a€xB lhlr if I sthuld tE .m subjecl lo lh.
<br />workm omFnsorion pmvilions of Salion 3'700 of rh. L.ntr C.dc. I dEll, fonhwirh sryly wilh tho$ r,mvnions..
<br />ro $cuE workcs con{cnsaln,n ovc68c ir utrhwfu ll subjc.r m cnDlorr ro aiminal pcMlris and
<br />tou\rld dolhr\ (Sl(ro.(xx)). in sddir comFnsllion, d.m8cs as provid€d for rh.
<br />urljlsri!{t}lrB-\-c-roB
<br />DECIJSAIION
<br />I hcEb, rlhirn undcr lcnolly of lcrjurr lhal I !'n liNn{i undcr pmltion orChtrprd 9 (.onrmncinS vnh Scdhn 7000) ofDirnhn l
<br />of rhc Burift$ dnd Pmfcrsbns ('od.. 0nn my liccns is in tull foN and ciTccr.
<br />cornto.-L
<br />CoNSIallI]oXLXJIllN(irIriUM
<br />/llfucnNlDl:erAlauaN
<br />I h.rohyoiirnufdcr |tnalry.l|rrlr!.nc ol ih. Ihlh{ingd..hrari,nr
<br />l).nn, irn Pcnnir\ Aslxn.\ Noriliuri,r Fcdcrnl RctuL na ( Irrl.-10. tan6)
<br />Rcqutrrd l{rrcr ,,l Norili.rli(i l
<br />I c.nify $m rh. rnLhlrc8lbrions EBffdinE ushcsros rcnrvll ac .ol amljclhL r. rht fl6ii
<br />I ccnifyrhar lhrvc rad rhirrmi.rrir r I agrd ro smply wirh allCiryond Counry
<br />ordinlncc* and Snrc hws Ebrio! ro brildi rcprcscnkrrivc\ otrht CnY rnd
<br />rh,ro trrnrirD&l n'oFdy tur i'If(rtrrr
<br />Applica or AScnl Sisndlrc:
<br />Appliances
<br />Metal Fire Place
<br />Evaporative Cooler
<br />Furnace
<br />Compressor
<br />Ir/isc. Equipment
<br />Duct Work
<br />Pre-lnsulation
<br />lnsulation
<br />Smoke Detectors lnstalled
<br />Rough Ductwork
<br />Vents
<br />Toilet Room / Clothes Dryer
<br />Residential Ranqe
<br />Other
<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 />Above T-Bar
<br />I
<br />Rouqh Mech.x //t //t nM-,,1)
<br />Final Test 7-\
<br />Meter Release I'
<br />FINAL 4/i,//9.i4 Ltf)
<br />Notes, Remarks, Etc. 'r/ t
<br />COMMENTS
<br />Hood
<br />I h!rb, lltifln undcr Fnahy .l i'crju,y Ind rhcrc h a co.{ocri,n bndine n8cfry r(r thL ,)crformne of lh. sort for whkh rhk Fnni, i1
<br />isiu.d (se. 1097, civ. c.).
<br />I ctrdc sNJmc
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<br />II
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