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MECHANICAL.INSPECTOR BECORD
<br />APPROVALS DATE ID/SIG.orvN I.]l !tu tLDFiR DII_CA RATtON
<br />I herch! Jffirm uD.hr nlnrlrr_ {,1 prrurr_ rhrr I xm crcN|r lionr lhc (ilnn.trr Licctrsc I rs lnr rhc lbll,,*ing rcawnr lscc ?0}l 5
<br />Ilu$ncsr r tl ltolcssi(ri Codc): t (iry or Coutrry *hich r.qrnc\ r p.nnir ro.on{turr, trlrcr. i'npnvr. dc x,li\h or rprr rtry
<br />rpnlicrrr rnr attnnirsuhjc.h rhc q'!li.JDrl. rclrilNnrxt(r rornncrho llv.lrtr.drcdiolIn(i5{xr)
<br />-1.
<br />!s owor olllE prupeny, tr my .q,lor€.s wirh wagcs N fieir slc .onFnslrio., siu do rh. wk .r'd tlE suErr ir ml
<br />inrci&! or olIcrd for sh (Se ,044, Busims and Pretu$hro Codq TIE Codn.rol. Lic.ns ljw dat not 'pply
<br />ro .n owmr oa
<br />thc pmreny Rl$ hoil& or inpoB lhcmn. un who d&\ sEh w* himsclf or tcrslf or lhoogh his or tcr oon .mrk,ttcs.
<br />pmvidcd lh.t sh impowE s @ Dr htcdcd (otrad for $b If. hogff. tF hiuinS o. inproEr ii$kiwilhinoeF.
<br />ofsrpletior lh. Owncr Buit-hr vill hrw tlE ttiko of pmvIg lhsr & o! dE dA rcl hild o, iirpDw $. p'trpqry for llE purlh$ of
<br />-1,
<br />n! owe, of rhc Folcnn am dchsively conrrad i.s wnn liccnsd .onrBcros lo onntucr rnc pn sr (Ss. 7or4, Burimss
<br />md PnEasion Codc: Thc Conrrmtols Liccnsc Ltrw des .ol apply ro m owncr of pmr.ny who builds or imprcvcs thcrcon,
<br />dnd who conrncrs for sucl poj.rrs *nh a conrBro($ li.ensd ,urs@r ro ir conrudoas Liccos Li{).
<br />-l
<br />amcrcmfl lndcrSdiotr- A. & P.C. aorrhis Elson
<br />D.rc lr*n.r
<br />]4!IBtrEB8.SI}MIE!!AIIITN
<br />DEII,ASAIIIA
<br />I lErcby arrm undcr lcnalty of prjury onc of th. aolhqing decknrioN:
<br />llrlctrDdwillnrxinrriniCcairirtrrcorConscrrhScllrln\ur.ritrworkes.onrF.{rrt,n.$,Bridrdinhyssrion.lT(x)orrhc
<br />&hn Corlc. ror rle r.nbrm'ncc ol rhc sork lbr whichth. pr nil is i\sui
<br />,\/h.tr(, L'i \'llmrNun tr.rkcr'!^i,ncn\. tr'n 'nvtrJn... r\ rcquirdbySc.ri.trlTmofrhctjhitrCodc.forlhcNrtnrnunccof
<br />lL,r{htrh rhn Fnnir n n{idfncr F/e-M, work6 .on,Ensrtio. in$re.c .micr {d ,x,lict numb.r m:
<br />do
<br />-!
<br />ccnit, rhal in lhc Frformmc of rhc $ork for enicn rhis ,'.rmn is hsucd. I .t!ll mr cmplo, rny p.Mn in d., nrnM
<br />e trs lo h..om subjel k, lh+ worlc*'coq,.nsalion h*s of Califomin. nnd a8i,e thn' il I shlll b.yo@ subrEr lo lhc
<br />*orte6 srlEnsrion lJmvtio.s of Serion lToo ol rh. L!b.r Code, LhaI. fodhwnh mmply *irh tb* ,mvisions..
<br />WARNING: |!'lrrc k, ccurc workcm comp-nyrri.n covcrr8c is unhNtul. rnd shrrl subje-t rn oq,r,,ycr r,, mmrn,l noJhic* ana
<br />civil fincs up to onc hundrcd lhousnd dollan lsl(x).([D). in,'Jditu.lo
<br />'hc
<br />c.\l ofco'npcn\aln,n. dnNses rs ploldd ri,r rhc
<br />i.rrrcd:mriorrv r f{:.\g g
<br />tl![NtEDji]Nrtacrga
<br />TIECIA8A,IJAU
<br />t hcEby atfifln undcr pcnaltyofpcljrry lhal I nor lien$d unncr nDvnbn otChaprcr 9 (cornnNing wirh S..rion Ttxlo) orDivkion.l
<br />of rhe $usircss otrd Pmr$sions Codc. md my liccn{ h in tull r'ore 0d cfiNt.
<br />C Zzo
<br />/X
<br />SANSIf,UIIIQIIENDIXG.AGINCI
<br />I hceby afro u.d.r Fulry ol Fdury lh8t r,'dc h ! @nsro.liri Ln<ling rgcfty for lh. Frfmmm. of $. Nort for wti.h lhis Fnil Ls
<br />issucd (Sec 109?, Ci! C.).
<br />alrttclNu)Erll$4llQ!
<br />I lmhyJllnnundcr nctrrhy ol pcrjury otr..1rhc nnbwinr lccl.nxri{nr
<br />D.nrrlirior lcrnrir\ \tr{o\ Norifi.di( Irrdcnl Rcguhrn$\ (Tirl.10. I)d6r
<br />-tcquncn
<br />Glrcr0l Nolirtalior
<br />-l
<br />c€nily rhlt rhc fcdcral rc8llark,ns rcBedinr asbcstos rcrmvalarc nor applicablc t, rhix pnjccr
<br />-l
<br />ccrrify rhar I narc Md fin spplicltion rrd srarc th0r rh. trbove inforNriotr n coftrr. I af@ to @mplt *nt all Ciry rnd Cou.ry
<br />ordinamcsond Sr6rc t ws rcldilg lo buildine c.nnDdioo. rii h.rcby aurh.nx rc,r.*.lalivcs o
<br />lhovc m ioncd,mp.ny ror inspc.rion
<br />Anfli.xnrorAg.nlSignxhrc m ':^dW-
<br />Appliances
<br />Metal Fire Place
<br />Evaporative Cooler
<br />Furnace
<br />Compressor
<br />lvlisc. Equipment
<br />Duct Work
<br />Pre-lnsulation
<br />lnsulation
<br />Smoke Detectors lnstalled
<br />Rouoh Ductwork
<br />Vents
<br />Toilet Room / Clothes Dryer
<br />Residential Ranqe
<br />Other
<br />Hood
<br />T ype 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.
<br />Final Test
<br />Meter Release
<br />FINAL 7-,8 l8 ,uil,q11 /
<br />Notes, Remarks, Etc.
<br />COMMENTS
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