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MECHANICAL-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.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 />Rouqh Ductwork
<br />Vents
<br />Toilet Room / Clothes Dryer
<br />Residential Range
<br />Other
<br />Hood
<br />Type I Hood
<br />Type ll Hood
<br />Fire Damper
<br />Openinos
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Above T-Bar
<br />Rouqh Mech.
<br />Final Test
<br />Meter Release
<br />FINAL ftyl,il,'t a6a
<br />Notes, Remarks, Etc.
<br />OWNT]R BUII-DEN I)EI,CARATION
<br />I hctuh, tfinn untlcr t nrlry.t p.rtury rh l nmcxcnDr ri.nr thc O ra.kns Li.cn\c I1r lorrhc iolk'{ins rcrq,n (s.c 7011,5
<br />Busnrsi $d Prodstu Codc)r Any Ciry or Cou ly which rcqun \ tr turnil ln con(nrcr. alrci inrPDvc. d.mol^h or anrn dny .
<br />nrudurc. plitr to irs i\sunncc, al$ r.qunc*thc aptli.rtrr rar {uchFnnilro lllc a sigocd srrrctunr rhar lf,.r nrc i [ccn\cd lD^unnl
<br />ro rh. pn)vhion\ .fttE Conlrrlols l,iccnscd tjw (Chaflcr 9, C.mn'ricnrg qilh SNrion 70(JO ol tlirnin I or rhc Buliics\ ind !
<br />Pflnassn,ns Codc) or thor hco. shc iscrcnurrhcEfro ,ndrhchrskfdrhrdlLtstdcrcnDlt'n AnyldJriuorSdrion70:11.5hyrny
<br />l|pli.o ntr!pcrnrir suhjcchrh. applicrnrb r.,viltcnrlryornor nxtrcrhun fivc h nnrcd doll r\(S5fi))
<br />-1,
<br />I owrcr of rhc pmtErrt d ny cmplorre silh wagcs &{ rhcir slc omFnsation. sill do llt }nt !.d llE rretr it ml
<br />iflcn&d or o[crcd for $le (5€.70421, B$ircs ed Pmf.ssio,s Codc] TIE Codreloas L@tre t s dss ml lPPly b an owftr o{
<br />rrE lmFny who trildr or itrlmrs ri.e.. s'd wlE de. sBh @* hin*ll.r n clf or lhDusn his q lrr oen.tployccs.
<br />pr.vidcd rh,r such inprlwmnke ml htcrHuofreEd for eh l( horeh. rlE hrildi.S r itrporcrnl ii sU onhin oft )@
<br />of.orplcriotr rtE o|h( Buitlcr si! ME llE htrdcn of pmving lhtrl lE or sh dA m| hik! ot inprcE dc popsiy for lrrcI,urln$ of
<br />-1.
<br />,s owkr of rhe F.rEny, o q.tusnrly conrrcl inB wnh liccnsrl onlEcloB ro .onnNl rh. rmin {S(. ?044. Butim$
<br />dn Eor6sion Codc: Thr Cootrel.ls Liccnsc Law d@s ,ol apply io o. owncr of pmp.ny who hlilds ., inproves thcmn.
<br />ud who .6{mck fo. su.h prcjcls wilh ! Conlraclo(s) lienscd pusldr k, rhc Contlctn\ Liccnrc t w),
<br />-trmexempr
<br />$d.. Serion-. B & P,c. for $L\ rcrmn.
<br />WORXFITS' COMPFITSATI(IN
<br />IECIAIAII!]!
<br />I hcrebyamrmundcr !c lty of p.rjury one of l hc fo Uos ing delardt ionrl
<br />-l
<br />hrvc r.d vill @intrin . C.nifrdc ofcon*fl m sclf-lnsE for mrk6 6EFns.rion. a Fovidcd foi by Serbn 37m of llP
<br />tibo. Codc, lor rhc |,.rfrcc of llE *o* for ,hkh llE p6nn ir i$u.d.
<br />I hav. 0nd Nill mainhin Norkcri .onFniarbn ins!rnn.., ui rquncd by Scclion l?00 ol lnc Libor Codc. for llE lsfotmrcc of
<br />pcnnir is issu&i. Myworkch .. l,.ns nn iNurcmccorierand F,licynu'nbcr ml
<br />r
<br />-l
<br />ccniryrhar inrhc p.rrortun.colihc sorl lor whichlllis pcflnir i\ is'ucd,I shall nol cnrtloy rny Pcrnrn indiy 'ai.cr$ i\k, h...m nrbr.r h) rhc *orkc^ qnnpcns(i,,n hw\ orCrliroi,nr, dnd n!rc h0r ill {h,uld h.c.nf, \ubi.r ro llE
<br />sork.r{ c.nlEtrsrrnr f)vhn,nsol S.clio.:l?O(lofrht lrthtr Crx1c, l .lllll. lon h$irh comply wirh ttxJ{ Pt,vi'nns..
<br />WARNINC railurc tu *.urc work rJ conrpcns.rior cov.rueo i\ utrh*tu|. and shrll subrccl an cmploFr ro .riniul !..rlrt| ud
<br />cilil fiocs !f kJ ok hundrcd lhousund do ro rh. cosr ofmmD.niari naScs as lrovidcd lor lhc
<br />rh. Irktr adL inr.rcrr 'nd
<br />DICI,Af,AIIO!
<br />I h-Dbr rmirnudcr p.nrlry ol pc,jlry rhar lnn liLrnrd undf Eoviqion ol Chq,t( 9 (dhneE,ne *irh Sdion ?(x)0) oaDivhioo l
<br />ol rhc BoriNrs dnd Pmlcssi.ns Co<lc. ond my licens i\ in rirll aor.t dd.u..r.
<br />.4
<br />c(rNst'kt c'fl oN LFNDtN(;,\(;t Nc1',
<br />,\nrd rSr. 109r, Civ C.r
<br />I ccniiyrhs! rhc itdcrrl rcBularions rcsudi.g lstidos enovrl ,rc .or ,Ifiiclhlc r,lnis rn,iccr.
<br />-l
<br />drify thll I hrv. nld rhis rhi rhc !ho!c infondrio. h dorcd I osN lo .lBply eirh &ll cir, lnd Counly
<br />ordinones lnd Srarc L,e\ Elar
<br />Amli.ant or Agcnl SiBnulurc:)8',
<br />I
<br />Grease Duct
<br />lnstallation
<br />Lxndo i Nam
<br />-
<br />hndc. s Addrcs
<br />-
<br />,rppr-r:,rni oeciiiiffi
<br />I h.mby 0Jtim undcr ,Enalty ol rcrjury orc of lh. follosifls dehBl io s
<br />D.nrnnion P.,nik Arb.sr6 Norilicrliofl F.ncrel Rqullliofls Onb 40. Pdr6)
<br />_Rcquircd kocr ol Norifcalion
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