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MECHANICAL-INSPECTOR RECORD
<br />olvNIiR B U II,DER DEI-C RAl'ION
<br />I h.rcny r,lirn, utrJ.r nc lry(nNUUryrhir I N1.rct)P f$nr rhc (innrr.rn l.i.cn{ lrN fu rhu tll,)eirr8 rcrsr lsc.?rr.ll5
<br />8u{tr.\s rtrd Prolt{sion Cod.) ADy Ciry o. Counry \hich rcarnct n t^_hnn ro.onnntr. r,lrcr. i'nPrrc. d. r,lr(h or rcDM atrt
<br />inrcxrc. Dri,,h irs i\\umc.. "l$ rcquircs lhc atrllrdnr l( luch Nnn[ h l]lcr \isncd inre rctrr rrN lro! shc is Liccnscn l r\tr3nr
<br />lmllrnnrlnrnNirnir$brcrrrl[rppli.rnrt,rcivilNnlryofnorixrcrhrnlivchundrcddoll6(S5U))
<br />-1.
<br />$ owF of ll[ prop.ny. or my crylorss wnh qas* ds lhct &h onp.oslior, wiu do fi. *orl dd tlE rmcm is ml
<br />inrcnd.d trofi.r{ fm sL (Sd,7044 BNim* dd BDh$ioN C.d.: T,E Contdcld s Litnc t s&8ml.I'plyloMowrof
<br />llE lmFny wb. b'iild! s inpoc thcdn. &d sln {tder sh mtt him$lr o. h.rslf or lnmugt hh 6 hc. oP. cn'ployG.
<br />prcvidcd rhdr iu.h iEpmEm s N mt inlcn&d nofcr.d for sl€. ,f.lhvcwi 0E t{ din8 or iipowmnl L, sold silhh onc rte
<br />of o,{,lction. rlE Oomr BuiB6 will hlE dE btrd.n ofFsving fisl lrc or slE did hl hild d inlha he ImlEly aor tlE Pltlns of
<br />-1,
<br />asowmroIrtc DmDcdy. an.iclu.irclyconr&lins wirh lienkd conlr4los lo mnsldcr rhc rmj.d (Se 7044. Bunm$
<br />!d PDf.s{h, Corhr Thc Conlroclol s Liccnsc Lla docs ml !fl)ly ri d oen( ot orop.ny who builds or inl,rcti lhcren,
<br />and sho contmr! fr ruchp,Dirk wnh . ConrEclo( 0 lkcnEd l,uuurlllo lh. Coorrlcl4 3 Ltcnsc Lrw).
<br />-l
<br />amcicmpl undcr Sel B. & P.C.lirrhis rcu$n
<br />-
<br />Orer
<br />w(lRl(ERs C(IIIPFNSATI(IN
<br />IECI.AXAIION
<br />I lrrcby amrn unds lcndr, of Fjury o.c of th. follo*in8 ddhmlions:
<br />Ihrvcdtrdsill nirlnn,nCrnificlrcofCoisttrrr.sclrlNurcnrrsotkcn conrpcnsllt,n. n\ Ir(,vidtdforhysccri(rl7(x)oihc
<br />ljbor Codc. tur lltr ltri,nnnrm ol rh. $ork ln. *hich rhc |Emir i\ is\urd
<br />Ih,vc&drillNinrahwo*crsomp.Naraonin.on.c,!srcquiBdbyS(tion3700ollhcLabo.C.dc.rotlhcI'.nommcof
<br />rhc wo for which thn pcmir is i$ucd. My .o.p.nsa,ion insumne caFicr and polic, nudb.r acl
<br />7-(-tq.
<br />-l
<br />ccnilyrhar in lh Frlormmc of rhc wori for shLt lhG pcrmn ir isslcd. I ih,U nor cnplor ..y Fson in any nlnftr
<br />$ s lo bccom subjccl ro lhc *o cr' oq,cnqrion lass ol Cdlia.mia, and aBEc lhll if I s,Fuld bcom ruhlrl io ttr
<br />mrkcs.on{.nsarion[ovisionsofScclion]700oflhcLihrCodc,I*lull.fonhwith.onplywilhlhocp(vhi.ns.
<br />WARIIINC: r2ilur. to suc wo cis' snnc.sarioi covcoac ir unlrwtul. md sn,I slbFcr !n cmdottr ro 6inin0l FNlti* and
<br />ciril n.cs up lo om hudrcd lnousrnd doltar$ ($tlx),od1), io addirion b thc cost ofcomFnrlriDn, dlmgcs !s providcd tu lhc
<br />"^,'?"?3-l< ^
<br />DEIIA.IAUAN
<br />I h.rby.llir ru ert'.rilly.lp.rjfiylhdIrmli.tn{dudotror(rtnofCh!PtcrI(conntu..i.!enhS..rio.7(](xJJoil)i!i1i(in.l
<br />ol rhc Bulilr\s,trd PorcsnonsCodc. md nrr liccn* i\ h lullfiEc rnd cfrc.r
<br />b 1
<br />c0llilalJcullN.LElDlNc-&GllNlr
<br />I hcrcby ulfiflnundcr rrnrlr, of,'.rjurr rhd rhLt h, coNrruclion lcnding rscE_y ror lhc pcrturrutrc ollhc {o,k rbr shichrhir ttrmn i\
<br />nsucd rslc 1097. Civ. C.r.
<br />AITLI!]ANLDE.CI'BdITA!
<br />llrEbyufinnrndcr rci,lry orpclury otrc olrhc ldbwnrS dcclanrrions:
<br />Dc xrirn r Pc nireA\t{ios Norincrlion Fcdcral ltc8ultrrit'ns ('rnh 41). Pan6)
<br />-Requtcd
<br />tdrcr ol Norilicrrion
<br />-l
<br />.drif, rhlr rhc a.d(rl reSrrlaliors ESedinB asb.slos rcmkl ar. mt apnli.abh lo thjs pmitt.
<br />-l.cnily
<br />rh{r I havc rcad rhk applicdion.!ld sllc rhd lhc ohrv. inn,muilion L{coBt.l rAm t, comrly enh oI Cilyaod G,lnry
<br />ordinrnccs and Sratc bqs Elding to bu
<br />abovc mntiorcd DoDcny lbr inltsri.n
<br />ieprcrnrarivcr of lhis Cily nd Counr, to cnl6 uton tlE
<br />Annliunr Dr Ascnt Si!nnrurc
<br />APPROVALS COMMENTS
<br />Appliances
<br />Metal Fire Place
<br />Evaporative Cooler
<br />Furnace
<br />Compressor
<br />Misc. Equipment
<br />Duct Work
<br />Pre-lnsulation
<br />lnsulation
<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 Ducl
<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 Belease
<br />FINAL ?l?/./rc -<-/d4,,l)
<br />Notes, Remarks, Etc
<br />\-.r_
<br />7-L3-ra
<br />ID/SIG.
<br />Smoke Detectors lnstalled
<br />ttnd6'sN.G:
<br />-
<br />DATE I rD/SrG.
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