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APPROVALS DATE ID/SIG.COMMENTS
<br />Appliances
<br />Metal Fire Place
<br />Evaporative Cooler
<br />Furnace c lrz lq ,W/6,
<br />Compressor nard /o>
<br />Misc. Equipment
<br />Duct Work
<br />Pre-lnsulation
<br />lnsulation
<br />Smoke Detectors lnstalled
<br />Rough Ductwork -t /r,/,a
<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 />lnstallation
<br />F. D. Drop Test
<br />Above Hard Lid
<br />Above T-Bar
<br />Rough Mech.tln lq
<br />Final Test
<br />Meter Release
<br />FINAL '7/c,iln Da.trFe /o,
<br />Notes, Remarks, Etc.
<br />MECHANICAL.INSPECTOR RECORD
<br />OWNER BUILDER DEI'ARATION
<br />I hd.by d,Iun und6 pquXy of pajlry rh{ I s qonpl ftD'n lh. Colnrtclda Lic. . Law aor lt fouownlg rten (sc.70l I t .
<br />BBi.63 ,,!d Pro&sion Codc) Any Chy or Couly wtich rcquiB . pdon io cotrllrud. sna. imFov.. da&lsh or qatr uv
<br />3uu(@. Fior to ii3 isMc4 stro r.qun6 rh. ,p9li.el for $ch Fd b 61. r !i8n€d sldffil lhi lE or {E i! lito!.d .!@!s
<br />ro rlE FovGioN of [E Comrlcioir Li@i*d L.w (Chlpld 9. ConE.ncrs {ilh Setion 7000 of Divilaon 3 ofrtl Buind ed
<br />Pbf*ioB Co&) or thr lE or 3h. n cx.opt fiac&on &d lhc ba3! for rhc dl.s.d d@plion Any virLliod ofs61io, 703 I 5 by my
<br />.p?liel for ! Fmir subjcl3 rh. appli..rr to s civil p6ahy of not morc $d 6!. hun&.d dolls (1500).
<br />-1.
<br />s o1lc of rhc proFny. or by dploy6 wirh v!s6 s th.i, $1. comp.cdion, will do thc wod ad llE stdE ir ml
<br />idod.d otr(.d ror elc (Sd.70,14, Bsins Md PrDasiod Cod.: Th. Co t.cld ! Lic@ kv &6 ml @ply lo @ ow oi
<br />th.FDFI, wb. b{iih or imFo€ th@c dd sho do6 sh s,t hi@lf or lEs.lf or llmush hi! or ha oM @Ployc.
<br />Fovidcd rhn such idprovn@B e ml hlon d or o,r6d tor et li r!ow, lbc ttrildi8 or inlpo6Ei it eld *ihi. oe )qr
<br />olcompkior th. Of,r6 tt{il& win hrv. th. hmLd ofFoviiB lh.i lE 6 CE dit rcl hild or it4oE lh. FtFl, for lh. F,!o.. of
<br />-1,
<br />s oq6 of th. Fopoly. @ .r.l6ivcly €onlrrclin8 with lic6E d coirtdoc ro codrucl lh. pojct (Sc 7(,4, Aard
<br />Exl Ptbfrsiod Codc: Th. Conr..cloC! Licas. Lrw do6 .or apply ro o o*.d of propd, vho brild! or improvB lh6en.
<br />&d who otitkrs rDr such FDj*r3 wirh ' conrdo(u) lic.tu d p6@r to lh. conrn.,loas Liw L!v).
<br />-l
<br />e cx@p !rd6 scrio. .S.&PC aorlhi! r.Mn.
<br />llaxf,!f,f-co!,lEdtarlar
<br />DECI.AMIIIA
<br />I hd.lr, .mm undd p6rlly oaFjury onc oath. tullowhs dc.l&!tioc:
<br />-lhaw6rdpiumi
<br />ain.Cdtifi..ofcoBdltoS.lf-lMforworkdaonP.ndio[sFDvil.dforb,Scti,rn]700otlhc
<br />Ld.r Code for lh. Fftucc o I th. so for wl cnrh. Fmn i i!su.d.
<br />-l
<br />hav. and eill nEinlain wor{.B .onp.Nltion i^tllmc.. s r.quir.d byS.(io.3700 ollh. kbot CotL. tor thc Fa(y1M.. of
<br />p.rnn is is.d My wo*6r comFMioi iN!tuc. .uid ti Flic, nunbs s.
<br />DI Ol
<br />I cdiry rhat ii th. Flolr@cc of th. *ork aor whkh lhis p.m n isucd l3t llnot sPloy.ny pde. i,&ylI,lrc
<br />e s ro b<om. subjd 16 rh. mi{a' ompqErion L* ofcalilomit od lsr rh.r ir I slDuld heo6. ebj.tr ro rlE
<br />ert(6 co6F.!.tion pmviekrN ofs6lion 1700 ollhc Lstor Cod.. I lrdl fonh*ilh otrtply $ ilh lhos povilio6
<br />IVAR]\ING: tsiluE to su. wort6' comp<Edio. colE 8. t unLwtut, ed 3i.ll lubjdr m @PloF to siniDd p6tlti6 Md
<br />civil fu6 up ro otu nudrcd lhosld dolln (t10o,000). in .ddnion lo lhc con oa conpsslion, dsDrs6 6 Prcvid.d lor lh.
<br />Codc, i.rs6t ed rtror*y'! f6.
<br />cL
<br />UCINiEDSqNI8ACIOI
<br />DECIAEAIIO!
<br />t h6cb, dtr! u!d6 p@!ty oapqjury lbd t E ti6..d uldd Foviio! of CfE,rE 9 (@MinS *ith SErbn 7000) oa Divition 3
<br />of rh. Buir6 dd PDfB3ios Cod., ed oy liG i! in tul lo@ td cfrot.
<br />L
<br />qQli BUqUANIIjNDI!Ij]rC!!CI
<br />I h.r.by amrm undd lEnahy of p6jury lhal lh6c is a conerucrion lddui!almcy aorrhcp<romuct olrh.$otk forNhichlha ptnn i!
<br />Esued (sr. :1097, civ ( )
<br />AITLI(ANLD]ICIAAAII(}ts
<br />t hdrtyallmond( D,Lnalry oIpdrury on ollh. aollo*ins dch.dio.s
<br />D.molilion Pmirs-Asbdros Norifi.alion l'.d6!l R.rulations I InL 40. Ptn6)
<br />R.quircd t.trd oaNorifi c{ion
<br />-l
<br />cdit rld dE fcd6al r.sulalioB r.endnU ab6r$ rmovrl e. nol arpliclu. lo rhb pbjel.
<br />I cdliay $d I t3v. r.ad lhis &d sr c $ar rhc ahov. infotuion n corcd LsrG to comply unh !u city dd cou y
<br />ordnH rrs rtrJ Srnr.l x\s,. ir did hd.t y auhoriz. r.pras !liv6 of rhb Cny
<br />I4L4,
<br />Grease Duct
<br />71q Lo*
<br />.((\)
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