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MECHANICAL-INSPECTOR RECORD
<br />APPROVALS DATE tD/stG.COMMENTS
<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 />Openings
<br />lnstallation
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Above T-Bar
<br />Rough Mech.w g b
<br />Meter Release ,\\
<br />.\ )u 1
<br />FINAL *1"7)U)$l
<br />Notes, Remarks, Etc.u
<br />owNl uutt,DER DELCAT{,\ UON
<br />I hdcby lmrm udcr Fnalry of r.riury rhor I d .xcq,t liDm rlr Conrado6 Lbetr* Lls ro.lhc followang Af,sn (S<.7(u1.5
<br />Bulincs lnd Pofc$ioo Cu<tc): Any Ciiy o. Counry *hkn rquiEs a Fmir lo oNrud, allcr, imprcE, d.mlnh or Epan My
<br />strucrurc. Fior ro irs hsuamc. &o r.quircs rhc rpplicant for slch Fmit ro file a sisned alctu rh lr or lhc h liened nlNur
<br />ro rhc pmvisions oi lh. Contrbls Liccn*d trw (Chq,l.r 9. ConmminS wnh Scctioi 7000 olDivision I ofthc BBincsr.nd
<br />Pmfcssions Codc) or rhar hc or slE h crq rncrcfron and rlE bosn tor rh€ all.gd ei.nprion. Any ri.lari.n of Selbn ,ol1.5 by rny
<br />lpplican! for ! I'cmir slbjc.rs rhc atplicrir ro acivil p€nahyofmr mE rh.o 6ve hundr€d dollr! (S500)
<br />-1.
<br />6 osftr oa0r preFny. or my.nploycis Bi$ w!96 N rlEi. $lc @np.rerio.. wil do tlr !o* sd tlt slixl@ it ml
<br />i cid.d or or.r.d for eL (Se.rO44. Burimss Dd P,olcssh6 Cod.: Tn€ ConE .lols Litr* L,* de, m tpply lo u osmr of
<br />th. Forlny wlb hril& or inp,oB $cEn. .nd who dm sh kJ* hin.clf or n mlf or lhmurfi his or lEr own cnploycc!.
<br />pmvid.d rhlr r!.h inlpnErnB e mr inrcnd.d trotrqEd for slc. ll h.wE dE buildnrg or in?owrnl k sld wittin oN rE
<br />ofsnoLriolr iE O{rcr Bui&r }iU lurc t E t{rd.n ol pmvi.e Od lE or slE dil rcr build or i@rcE ,E FDpsr, fd lh. portD* of
<br />-l-
<br />oso$mrofrhc pmrcny. smcfuhsi*lyonrBctinE wnh [.cnscd conir&loE ro.onimi,lr loj.cr (se. ?04. Ausms
<br />RrlLssirn Codc:1hc Conkn rort Liccns! Low des nor rpplyio.nosnc, ofprorcny wn builds or inrFovcr rhc ,n
<br />*k' ornrBls aor \!ch pmJcck siu tr CodBcton, liceo$d pdB@r ro rh. contacroa s Li..ns lju )
<br />UAASDf,LI;AMPTNSAIIO!
<br />DEgIJBAIIQN
<br />I h.rcby,ffirn xnd.r Fjn0hy.fpcqxryom olrhc lollowinB d(ldarionsl
<br />I tolc$dwill roioilinrCcnifi.r'corConsenrro S.lf lns!rc for worrcN .o'npcNrlion. os prcvidcd for bySslion:1700 ofrhe
<br />pcrformncc oflhc wort( for *hich lhe lcir n i\sucd.
<br />I hawandwill m.inrsin worlcrs'coopc.sarion irs!,arcc.ns eqlircd b, S6rbn l70o oi rtE txbor Ood.. aor lhc pcrforromc of
<br />I c.ni! rlht ir rh. p..fo nrrccollncworklorwhi.hlhispcirnilisissucd.lsh{llnolcnployanyp.ftninrnrnmner() !sro hcom suhjcd ro rtr ${rkcrs conptisarion hes orCrlif.mi4 Md agm 'h ir I should tE om suhFt b l,'c
<br />workcr' o'nll. suri('n ,mvi{io.s ot sccrion l71D of rhc l/h, C.dc, I shdl, ronhunh .onrrly s il h l,n,* lslisn,ns
<br />WARNINC: l:lilurc h $curc *orkcr compcn\dn,n .otc.rgc i\ rilasful, rtrd shlll sub],cl r cortbyc.lo cri[inrl pcnr[ns md
<br />ro ono hundrcd ihor\rtrd in addirion lo tbc cosl ofconDcnsalion. damEcs !s nrovidcd fo rhc
<br />I h.Nhy rlnD undcr plrrliyofrrJrr, rhxr I rtr1
<br />ullilsfD_coNr&lgaa
<br />I,2trCLABIIIUN
<br />Itan{d und.r rn,vnr,i orChipr.r
<br />i..osc is io lllltutur nDd clfocr
<br />9 (orllm irS wirh S.llirn 70q)) of Divi.io! lqqt65\
<br />COXSIAICIIONIENDINGTICEN(I
<br />I hcrhy allirn udcr rEnrl!, of pcrjury rhnr th&c i\ r.o {fl.ii,n lcndiu,Sctrcy tor lhc pcrfonrEacc . a I hc suk fttr whrh rhN Fnni n
<br />isrucd (s.r 3097,Civ. C )
<br />AIEIICANLDEILIBAIIA!
<br />I tebr.llm undcr polhy.fp&jury orc otrh. r.llcwinS dc.lddri.ns:
<br />D.nk,lirion PcrnrirsAsh.nos Norific!rion FcdcralRcgul ionr (Tirlc,lO. Pin6)
<br />-Rcquircd
<br />Lclrcr of Noliarcstion
<br />-l
<br />ccnily rtd rhc fcdcrul rcsul0lions rcsardi.s lstEnos rcn&lol oc nar Jrpli.rblc k thas F,jrtr
<br />l..nilyrhr l hrvc tuaJ thir tr orld n,r. rha[hc atbr inlonmrion is corecl l orxe ro omtly wirh lllCnyrnd Cuu.ly
<br />ordinirccs and Stltc Llws Ehr
<br />&oE nrnli,nrll fft|tny tur 2
<br />buildir!.onsrdcrion. d hcrcbyrdkrizcrcpBsc dri(csof rhk
<br />Vents
<br />Final Test
<br />D.r.:
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<br />II
<br />I
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