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MECHANICAL.INSPECTOR RECORD
<br />APPHOVALS DATE ID/SIG.COMMENTS
<br />Appliances
<br />It/etal 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 />Rough 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 />Openinqs
<br />lnstallation
<br />TestF.D. D
<br />Above Hard Lid
<br />Above T-Bar
<br />Rou gh Mech.?ytqnr b1/
<br />Final Test
<br />Meter Release
<br />FINAL lt ttr),/
<br />Notes, Remarks, Etc ,t rl'-
<br />OWNER BUTLDER DELCARAIION
<br />, hercby afliro und$ Fn.lly ol p.dury llEl I m cx.nfl nDm rh. Conr.dm' Lic.nrc trw for lh. followi4 msn (S€.1r11.5
<br />Blsinc$ ad Profcision Codc): Any Ciry or Colily whi.h Eqlirs a ltmn lo.odru.r. rlrq, inprur, dcmlhh or mprn ery
<br />stnrlue. !.br ro iri isMc. .to equircs lh. .ppli.or for $h p.m,r m lih r siFed 3rrl.Mr lhrl h. or dE is lie.*d puBu!
<br />ro rhc !tuvisions of lnc Co atoas Lic.nrd L{q (Clqrer 9, Conmkins sirh S6don ?000 of Oivhhn I ol th. Eusincs lnd
<br />Ptutcsions Cod.) or rhdt lE or shc is cxcdpr rh.Efiom and rlE basis lor thc lllce.rl .xcmplion. Any viol4tion olsetbo ?031.5 hy uy
<br />appli.ant for ! ,cm flbixli rlE appli@nl ro ! .iail pcmtr, ot ior mE rh.n fiv. huided dou&s (t500).
<br />-1.
<br />$ owncr of lh. I,!,f,rly. or my cqrloyr{s *ilh pags rs th.n bk shpcns.thfl, *iI {h tlt *o* {d lhc $tur@ ir ml
<br />inrcnd€n orofftrcd tor sh (56.7044, Blsimss end Prcfossions Codc: Thc Contrerols l,iene Laa do* nor ap yroM.wnqof
<br />ihc pr{xny wlx, hlilds d in{tb$ dElra dd wt$ dds sh sd( hiniclt or hcmlf or thn,ueh his or lEr own.q,lotrcs,
<br />flovidcd rhar such opmkftnk E ml idcndcd or o,twd lorsh.lt ho*.@, lnc hoihiru Dr impNsmnr is sld ]ihinoft rtu
<br />ot..n?bIio.. rhc oB*i Blildd will hae tlt htdei ot Imviq rlul h. or lhc dii er boild or in!ftr lnc pbFry ror Oc p!rr* 6r
<br />-1.
<br />trs ownfolihc pmFny. rm.rclusivclymnrracline wirn licln*d contmron to coosrdct rlr lmiccl (S*. ?044. B!\inc$
<br />arn hDfc$i.. Codc: Thc Conkmloli Liftn\c Lle dcs nor applyro.noancr oftroFnysho buildsor inpr.v.s lhd.on,
<br />and who conrncls for slch pdcds wnh e CoilE.ro(d li*isd lusuMr b the Conhcbls Lt.tr* t w)
<br />lr rcx. r|n uilc' Sr(li,u .ll &P('ntrrhnr..*[
<br />glBf,E8S:gtMtlUSAIIq!
<br />DEI]I.ASAIIIIN
<br />I hcrcb, afim unrhrycmhy otF.iury o* ot llE following dcclddio.s:
<br />1..'tir Qtrlc. ri)rrlrc pcr mnn.eolrhcrqk rartrhi(hrhc |Ennili\n{'.n
<br />rh. {,rtl,'rhLhrhi.oa'nr'.N.u.d Vrr,'lfl. ., f .J, i1.u"r,r.rni JilF.'i,),,un'},,.u-
<br />.,,.,,, CAl, (o.rtio., fr4; Co.
<br />-l
<br />ccrlify lhnl inrhc p.rformrcc of rhc work for vhich rhis p.rmil h is cd.l shallnol cmployanyrcson in aiym.nncr
<br />e rs to h.$m subjd ro thc wrlcrs'smre.erion hws of Cllifohia. 8nd as@ thll it | \hould tt.om subidl !o ltE
<br />porkc6' sn{f,nstion lmlisions of Sccrion 3700 of lh. L{tor Cdq I nElL fonhwnh .onl,ly wirh lhoe pevhions..
<br />W RNINC: Faihrc lo s.uc wor*ns oft{rnslin,n cov.fl8c is unlnwful, lnd shau subj€ct cmrloyer ro oi6i.{l FMllil {nd
<br />civil fincs up ro om hundEn rnouslrd dolhs (ll00.m). in addirion ro thc cost ofcoftpcidion, damger a. tovided for rhc
<br />Sccrion 3016 ofrlE tzhor Cod.. inhsl dd anormy s tsl
<br />o",",aj!!t! E +pa*,.
<br />uc[N,sEDtllNrtdtraa
<br />IECIIISd.IIQN
<br />I herctt!{firm undcr I'cMlty of pcrjlry lhal I am li$flsd undcr pRvi\ion ol Chatrcr 9 (connEftin8 $irh S..rion 7fiD) orDivision l
<br />of rhc Buslrcsslnn PRncssions Codc, urd 'ryliccn\c is i. tu ll tbr.$ ald cfi'.r1.
<br />qZbtqz:Jct (-
<br />-l
<br />ccnily thar rrr Ldrn Fgubtio.s Ng,di.8 sh.sos Enn%l m nol spr,ltlbh lo tnis lrmJccl
<br />l&difyrhd I hlvc icad rhk lppl
<br />.dinntuci,ndSllk hw\ruhrnEb
<br />rhnr rhc abrc infnmr bn is.orel lr8te
<br />x,vc trf,nri{m.d pn)p.n} r{n
<br />Aprl'crnr or Agcor Signrru
<br />h...hy rurhtrirc ruprc\ctrhrilcs o
<br />lo.orply anh oll Citylnd Count,
<br />lihh Cirymd Coutrry ro cntcr upon fi.
<br />*,"a-/t-/8
<br />rutffia
<br />*t4 lr?
<br />nmatlv
<br />o^r*-"*,4LR5 39@1,,.,,,,.. 4-/-/q
<br />""" -/- ll '18 ( onrncror
<br />tl) J.IBUq JN.LlilDlNlrrilX(I
<br />is$cd lsc( :l0r)7,Civ ( r.
<br />I.trd.''\ Nrtr,r
<br />t.trd.. \ d'lrcsq:
<br />,rppr tc,rti orii an tittiF
<br />I iqcby lllmn undcr pcnolry ot pcrju,, onc orrhc n,llosins dclnlarions:
<br />Dcnnnirn Pcnni(iA\h.eos Norificdidtr Fcd.rnl Rotxhrnrs (]'nh 40. Pnri6)
<br />RcqutcJ ldlcr of Nolili.uirn
<br />tt
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<br />II
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