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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 />Misc. 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 Ranqe
<br />Other
<br />Hood
<br />Type I Hood
<br />Type ll Hood
<br />Grease Duct
<br />Fire Damper
<br />Openinqs
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Above T-Bar
<br />Rough Mech.
<br />Final Test
<br />Meter Release
<br />FINAL 2,4-11 vili{.I{}
<br />Notes, Remarks, Etc.
<br />oWNDR ATIILDI.JR DEI,CARA I(}N
<br />I hcrch, rlnrr uid.rprnrlry(,frrjryrhdIurcrcmpll^)nrllrcC.nlrr.n,r'l.icci{,:*r{trrhc(nl'qin!n:r$n'(Scc:70j15'
<br />au\ir.\\ rnd Piinas\nr C.dc)r An, Cil) or CouDly shnh rcqunrs r n rnir r, .or{rucr. rlrcr. nn|novc. dcN,li\h or rpxn rn}
<br />{ru.rurc. priq (' ir! i\n'$cc. rl\. rcqun \ rh. {!lic n nn {k r |tnn( h) lilcn silnc{l {arcrmtrr rhrr hcor \h. I li.c.\cil !trrsui.r
<br />t. rhc ,vol\ior\ ot lhc Crnrncttr r l.iccn\.d lnw (Chlprcr ,. (bnimcncing sirh Sccrrn ?(Xx) of l)ilisirr :1 ol rh. tltr\inr\\ sid
<br />I'roli\sion\Cod.)orrhrr h!or \hc krl. rtr rh.tufn lrd rhclrasi\ forrhc rllctcl cxcnrpri(nr. Anyvn,hri,,nofsctonT0:ll 5briny
<br />rpplicrtrr tur, lcrmir iuhi..rsrhc {tli.rntx'!civilpc.rllyolnornrcrhrnfi!chundrcddollnrs(S5(x))
<br />-L
<br />!s owmr of thc prlpcny. !! my .tr{rlorEs wirh wae6 I tlEt $lc ompcnrdhn, will .lo lhc frrl od ltE srnrr@ L, rcr
<br />inr.idcn or ofiercd for slc (Se.7044. Busimss rnd Profssions Codc Thc ContElm i Li.cn* Llv .ioca ml .pply lo cn o$rcr of
<br />rhcl,mFdy wno hiikt or intmts tltotr .!d whb doas sh *orr hircll or h.rrclf o. llmush hh 6r hcr ow..nPlo,€cr.
<br />Irbrid.d rhd sucn irpm\trnt c ml t dr.!.d ffo,t rcd for $L. lf. llMlq. rE boilding or itrplMmnr is FU eithin oft t@
<br />oaohOktion, rhc Oqml Buildd wi! lurc ltr hrd.n of prcving tlEl lr or shc dA d hoild or inpNv€ 6c pep!fly fot dE P!tFE of
<br />_t. es o,o.r otrhc popeny. o crclusiEly .o.ra.ling wilh liccned conrErou ro .o.rro.1 rlf, p,nitl (Se ,044, Busirc$
<br />a PDfLstD Cod.: Th. Conrscroi s Lic€nsc ll{ d@s nor !!ply 16 an ow.{ ol proFny wto builds .r iiPrcvcs rh...on.
<br />lnd *no conrrers for ilch piojd. with a Co.rdto(O lhcnsd pursunl lo thc Conlrclols Lkcn* taw).
<br />I uncrcmor undcr Scclion .B &PC forrhrr6on.
<br />l,rlr ()$nrr
<br />}IT$EBESQIIf'NAITON
<br />DECI.Af,AIIII!
<br />I h.rch,rffiirnundf Ilcndryof ,crjuryoncof lh.followingdcchr ions:
<br />-l
<br />havc ud willminlain a C.na,lcarc ofconscnl lo S.ltlnsuft for workcs mn!rcn ion, &s pr6ridcd for byS.clion 3?00otlh.
<br />tibor tuc, for rhc Dcrfolfuc of the eoil f6. whhh rhe p.rmir h isu.n.
<br />_l havc adl will mintain eortc6' mnlll€ns ioninsumncc.!s rcqfied hrSc.rioo 370) orrhc llhor Cod.. for thc FrformB of
<br />rhc *orl lor whi.h rhh pcmil is nsucn. My *orlcl coqrcnqlion inslmmc cuic, sd tblhy numtrr a.:
<br />-l.dirt
<br />tld in rhc p.rfoirmmc oflnc wort for whicnlhn permil is kucd. I shail nol cmPloy lny rEson i. any nemr
<br />$ as ri' bcmrc suhict to thc *ork6 @mp.n$rhn lr*s orc.liforni.. md !8N thd if I should b..oE sublrr b !h.
<br />sorkcB corntc.sltion pn,visions oaSla1ion:lTlroorlh. L,tsr Codc,l shull. fonh*nh comuly *ilh lh.spmlirions
<br />and shall sublc.l 0n cnr!,oylr ro cri'nindl F.trllirs otrd
<br />.os ol onFnstion. d.m8cs rs provilcd rot rhc
<br />LICEISE]LCANIXAgIAA
<br />DECIABAIION
<br />I hcrcby aafifln undct letuh, o{ IEryury rhd l rnr lienlcd und.t t ovision of Chrprcr 9 G\,m,ftfti63 sirh SL\ri,n 7(Xx)) oi Dilision l
<br />ol rhc Busircss$d Prufc$iorrC.dc, dd nryli.cn{ h in rull fttr.c nd cilccl
<br />Cro r"3)t/3
<br />3
<br />(aISIAISITNIENDIII].{GTNII
<br />I ncrcty aflion hdrr FnllryorFrjuryrhrt rhcrc i\, onstrudion lcMiDE racncy lnr rhc tf,ironn.mc ollhc *ork tn *hichrhi lcnnii i\
<br />tsu.d (Sc..l(})7, Civ C.)
<br />AfILI(ANI.DEII,A8AIION
<br />I Er$y lfm undcr pc.alry ol n .ju.y om of fic followin8 dalnnl ions:
<br />Ormlirion Pc.,nn$tuh.slos Nolificlr ion F.ncral RcEularions (Tirlcl0, Pan6)
<br />-Rcqutrd
<br />Lcrrs of Norifraion
<br />-l
<br />csrify rhar rhc f€dcrul Eslllrbn\ Egarding.sbc{os Enovrl m mt arplicdk lo lnii pn,j..l.
<br />-l
<br />c..riti rhar ! h,vc r.ad ihn orplicarion ud shle lh.l thc abor. infomukrn h coded. I sErE lo co'ryly e i'h all Ci', od Counly
<br />oi{l nrnc.\ rtrtl Srric l-n\r\
<br />{bow ftnri{rncd oml.n, for
<br />r anl hcrcby lunoria cprcscnr0rivcs o'::"';'ul);--
<br />II
<br />III
<br />lnstallation
<br />t idd'r N.G:
<br />-
<br />o.Cz.u
<br />I
<br />tt
<br />I
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