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MECHANICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUII-D!]R DELC RA'I'ION
<br />I hcr.b, aflinn r!d.r F.rhy oi Nrjury tl l in cxcnu fturn rhc C.nrtucroF l.i.c!{ lls n,r rhc ri,llo*inA rcav,n (S.c ,0rl 5 ,
<br />Busnrcss and Pmicrsi Codc) Any Cir, or Counly whicn rcquircs a Frmi' t, r.n{fl.t. rlrcr. nn|k'E- dcnFli\h ,tr (F,n Jn}
<br />(rucrurc, nrior ro irs is\uancc. aho lcqrn.lrhc applicn tur such Fnnir ro tilc, siS cd (0tcnEnl n{ heorshc i\ li.cnrd nuKu$r
<br />k,rh.lr.\isn,n\ofrlrContr.ro.\Liccn\cdL.w(Chrnler9.Conrnr.n.ing$irhS..rion7lfl).fDivision.lotrhcRusinc*ud.
<br />Pnr'c\sn,nr Codc)orrhd h.oishc isgcnrplrhcrclm rnd lhc h!si\ tu rlt ,lll8cd crcD0 tun Anyviolaliu'otScclion70.]l5hyany
<br />applic!nt IorrtErflrir suhjccrs rhc rppli.rnr n, s.ivilr.fulryorior.$rurh.n fiv. hurncd noll s($500)
<br />l. $ owftr of th. IroIEnr. or nly cq)loyes qnn erscs as rhcn sb conpcndion. wil do E wdk ed tlE dtul@ ir rct
<br />inr€nlcd or o frcrcd for sale ( S e.7044. Bus inc$ Md Pt fcs.ions Cod.r Th€ Co nlraclol s Lhnsc L.* docs nor apt y lo 3n owmr of
<br />rh. |'oFny vho hil& o, inim6 $Eor. .d who des srh wlt hinsclt or h.elf o. rhmugi his or lE ovn.n{,loyccs,
<br />prcvftn rhat such itrqmrm'nr e hi hr.n&rl orofr.r.n lor eL. lL tbM,0E l,ildin8 or nr{mEmnr is sld tihin ok }t{
<br />ofmn!,hihtr rlE Owncr Buil+r will fi.E tlr lnden of pmving $ar he or shc dil noi btriE o. inprcw tnc pmFly for llr pu.tD* oa
<br />-1.
<br />$owrcrof rhc prci'dry, ad.r.hsivclyconmctirs tnh lieo.cd conrrdos ro $nmrl Ihc pmii (56. ?044. Bulift$
<br />and Arissir Codc I Thc C6nrBcror's Lic.nsc Law des nor rpply lo !no*ns otProrcdy Bho blild3 o, inProvca lhcr.on.
<br />.nd who onrdsfor slch pmrcrs wirh. Conl@k,(r lien*d luBuur rorh.C.nlmctols Li.cns &q).
<br />-l
<br />nmcxcnrrl u cr Scct
<br />I)rr.
<br />lla8f,EB5:.cllMfsl^ro!
<br />DEqdAAtrO!
<br />I h€rcby lmm !.do Dcnalry ot F.jury om of $. tollowin3 delralio.s:
<br />-l
<br />luvc tlldwill nntrhir !Ccnificrrc ofCon\. b sLll ln\u turw.rkcls onDctsrrior. ns Drovidcd t)r bys&1n)n:l7llo nfrh.
<br />lrhrtr codc. rorrtu p.rlirnrmc ol lhc wo.t lor *hichrnc pcrnil n n\u.d
<br />-l harc snd will minltrin workcG codrcnsotion iniuBkc. I requircd by Selion 3700 of lh. L3hor Cod.. for lh. P.rfoMc of
<br />th. wort ftr snich rni Frhjr is iitu 4 My {orks @r{EBnio! in$l,G @ir rid polty nlmber e:
<br />cmicr . Aot,t tQ,it goyvtA
<br />u(.tlt t 46)6 - t-A v/-Nlq70
<br />-lccnili
<br />rh.i in rhc pcrformn e oilhc work for whi.hlhis !. n i, nsucd.I shollnol cnployanyp.tson i.a.y mnncr
<br />$ as ro trs@ subjdt to th. NortcN'coqEnsllion law. ol Colif.dia. Md lgec rh!! ir I should tEom rubjerl lo ll*
<br />so*6r onlF.srion tmvhions ofscclion l70Ooflhc Lstor Codc,I shdl. fotihwnh conply wirh ssI'Dtisions.
<br />WARNNC: Failurc b scurc *orlcrs Lunpcisrk,n colcns. i\ unlnsful. rnd shall subict .n cnl,loycr ro Gininal p.tulri* nod
<br />civil fiacs up to onc hundrct tnolsand doua6 (S10.J.000). a. dddnion lo cost of comrcnsdion. dlnDscs 3i nrovilcd lor rhc
<br />Sccrnrn 1076 ol'rhc Lqbr cl)dc. inrcrci and dnormy r f.cs
<br />7 -tc,-ta nrrronr, {'
<br />DECIAAAIION
<br />I hcfuhy.rfinn und.i lc.rlry.fprrjury rhnr I rm liccnkn utrdcr pmvhion olChrprn 9 ((nnrrtuin! rilh SL{li[ 7(l0Orott)i!i\i(,n.r
<br />of rnc Busirc\\nnd Pofrssi.nsCodc. urd 1yli..nrc i\ ir full6r.c rrrl.liccr
<br />715d81
<br />7-tu-ro ---l-1
<br />1lrruclNfDlicl. n la!
<br />I lutbl 3finDtr (lcr Ntrilry o, fcrjry ru.r rN hll virls,l..hnii,nr\:
<br />l)cnn,lir io tr Fcnnir \ Ash{o\ Norillur irn lrc .ful Rcguhr ii{( r'l r lc 40. Prn 6)
<br />Rcquicd Ii(cr or Norl_'.rti.n
<br />-1
<br />.{nary rhar fic tcd.dl Esuhrions rc$rdins astEstos rcmvd G ml rldkabh ro thk !oj.sr.
<br />Aklny nat ttaw rcnd 6s trrt,.d
<br />,di nes Md Srarc tjw! ELlins ro hu
<br />ahorc nEnrioEd nmll.ny ntr in\rdhtr
<br />rion and $al. rhdr th. sbov. informrion iscorer. I arrc ro dntly *irh rU Cilyand Counly
<br />ild in8 conntucr io n lrd lErcb, aurhoEe npEsnltrlives oflfis Cilyad Cdnnr,lo.nlo upon lhc
<br />Applicanr or Agcnl SiSMlurc:
<br />Appliances
<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 Ranoe
<br />Other
<br />Hood
<br />Type I Hood
<br />Type ll Hood
<br />Grease Duct
<br />Fire Damper
<br />Openinos
<br />lnstallation
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Above T-Bar
<br />Rouqh Mech.
<br />Final Test
<br />Meter Helease
<br />FINAL K/70//,,4 fj
<br />Notes, Remarks, Etc. 4u\rMu+ i("h* frn -{.
<br />-+
<br />lriletal Fire Place
<br />C(INSTRIJCTI('N LENDIN(; AGT'NCY
<br />I hcrcby,filrn uR!.r pcnnlryol,Erju) rhat lhcrc is ! con(rucrion kndins a!.tuy r.r rh. P.tfornuncc oI Ih. *ork [, shi.h rhi\ p.nnir i(
<br />irsxcd (Sr. 1097, Civ. C ).
<br />tf,nJcr'' NJn'(
<br />-
<br />o,",r 2-tO-/3
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