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MECHANICAL.INSPECTOR RECOBD
<br />APPROVALS DATE Icq COMMENTS OWNI]R BUILDER DI'LC IL{TION
<br />I hcrcnr !flnr tr ln p<nrlr! ol pcrjury rhd Iocrcnrrr riom rhc (hnricur l-iccnsc tjs lor rhc hlk'*ins r.r$i (s(70ll5
<br />Busnr$ r l'rotc$i.n C c): Any City or Conrr, which rcquncs i.,snrir lo c(j\rrucr. lllrr. i'nrnrr. L!.n,lnh ,tr rrrJn Jn)
<br />ntucturc- !rn"ro irr i!\u$cc. !\o !.qutc\rhc rpnlicad lnr such p.orirx, ilc r \+ncd drrcmnr rhrr h.or sh. i\ h.(nrJ NFUJIT
<br />k, rhc pn)vi\tuns or r)f, Cotrkn.lois Lic.trscJ tr* rChrrr$ 9. clmn'.Nin! slrh s(rio. 70(Xr ol t)ivi\ oo I of rhc 3!\i'rs nnil
<br />rttli.dni l.r dltrnlir suhjrch rh. .mli.atrt h civilp.inlryol or rtrcrh.n lluc hllrdrcdd.llfs lS5U)).
<br />-1.
<br />&r osE ol rhe lblxny, o, ny .nplolec snh w!gc! &! rtEt $b .onpcnsrlion. will do llE vqt Md llE nnfiE ir hl
<br />inlcndcn or ofi.Ed for eh (Se.7044. Busiftss lnd Pmf.srions Cod.: TIE Conrmtols Li.u* L,* do.s nor ,pplt ro u owft, oI
<br />rhc l,oFny sh. lrilds or iqm6 tlitulr &rd wl& d.q tufi slt I'in\clf or hcftlr.r rhsugh hh r hfi own .rployc6.
<br />providcn rhal such inltmwmnls e ml inl.nd.d or ofcEn ror sh Ir. tbwEi llE b'li6in8 or inp,swm n sE widiin orc rB.f.on lcrirtr rtE O*ftr Auildc. *ill h.rc 0E bot(kn of tmving that ,E or slE di.t @r t{ild or inpDE lrE poFrly for tl* purlos of
<br />-1.
<br />as oqrcr of thc lJftrlcny, dn erclurilcl, .onradin8 wnh lic.ned .onrr.roR l. @nrrocl th. lmj.rl (Scc. 71144, B$ircs
<br />0 PrDftssbn Codc: Th. Conlnclols Licc.s L,w dGs mr 00plyto anowncr ofpolcnyvho builds or impbver rhcr@n.
<br />lnd who sntmds lor slch poj$rs wirh a C! Dcro(, licen$d plFMr to lhc Cr.n&rofs Lkco€ Lr*).
<br />-l
<br />m crcnfl urdo S&rion- B. & P.C. forfiii Easn.
<br />O*..r__ ,__
<br />IOAf,EBS:CPMIIIIAIION
<br />IECIdSAU(A
<br />I h..chyrlfilnhdcrp{nrlryof p.,juryoncolrhclbllo*iied.chr nn,s
<br />_l nrv. antl q ill trui'r ri,, r Ccn ilixr. ol Cutr*nr b Sclll n\urc tur $hrkdrr .. rlr {rion. N povidcd l hySc ion37UIofrhc
<br />Uhn-('ode. nnlhc Erfonrun.coilh. work ttr shich lhc p.rmil h islrn.J-
<br />Ehrr ar,i s'lltr, ,i tr unrlc^'!.rt tr\, trrrtrAurJ..,r( rcqutcd h,Sccriotr 37(Uoflh! Ijh{trCodc. nn rh. rigrortucc ol
<br />m!.nsari(,n insunnc. cMi$.nd Iblicy numhcr rcl
<br />0
<br />-l
<br />ccdirrrhar in lhc Fni,rmaec oa rh. work tn shi(hrhisFrntir i\ isslcd.l rhtrll n.r cnDby
<br />s as '. b(s'rc suhirt ro llr mlk6 coml).nsrion hws of Caliromi!, ond r8N lhal if I stslld bcoE subicr 16 llE
<br />mrt s mmFnsrlion l,DvisionsofSalion 3?fiJofrhc bbor Cod..I slull. fonhuilh odpryenh thos l,mvhio.i,,
<br />WARNIN(;| Failur. r. sric *orlcs' comp.ns.rbn olchlc n unhwful. d sh.ll subirl an cmplolcr lo qimind FM[ts and
<br />.ivil fiics !p b.nc hundrcd rhousand dullm {Sl0r.om), in rdditkr kr rhc.oil of.ompcnsrlbn, dom8cs 0s povidcd [, rh.
<br />Setion 1076 olrhc L rrCodc.in
<br />^'w u/eppnontA L-
<br />Ll$:lSl;lLgJXIXrlIlQB
<br />DIICLTIB,IIION
<br />oi rhc llu!Dc(s itr(lt'rolr{\i,!N Codc. and nrr- li..ns. '\ n tulilj)r.. xrNl.lri.r
<br />2-0 0
<br />I0XSIBIICIIONIENDIICTXiI;NCI
<br />I hcrcby 3innr uftlcr Ftrrlry olplrjury rhar th.r. n ! coniruction lclding !!cn., $r rr |xrturnrkr.lrlf, work tr shich ttn\ l.nnf $
<br />harcd (Scc.1097. Civ (.).
<br />AjTIrc]I.L)ECITLBIUAN
<br />I lmby a,iim un,lcr pcn!lry oip.rJorr" onc oftlt lolk,si',9 d.clrrtnnr\:
<br />Dc xrirnnr Pc nirr \h.{o\ Norifi.arion,icr,cr!lRcgnIrnnrs rTirlc 40. trn6)
<br />RcquncJ lrtrrrol Norifi. ri.n
<br />_! c.niayrhd rhc fcdcrrlrcgxlrri('n rugelnrS *h.do\ nnx,vrl rrc tror,ll)plid hlc h rhir [orc.r
<br />t[l(unilyrh. lrrtrc,c!drhtr.'nr'.r, ',,iJ {rrc rh]rrhc!h'vc irron ion i\coft.r lagcdhcoiflt*irhnllCiryondCouniy
<br />nrdi,'Jirc( Jnd Srrr I-,w\ trldi.A ro $nil,lir'p conqru!ri.n. atrd hcr.lry aur horiTc rcprcscnlarircs oflhi\ Cny anJ Couoryb cm$ q,,nrrr
<br />Aprlicer or ABcnl SiSndtuE
<br />-
<br />Ddc::
<br />v
<br />(
<br />,vl{t/lt) ( tq/4r-
<br />v?. or. ff
<br />Appliances
<br />Ir/etal 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 />Rouoh Ductwork
<br />Vents
<br />Toilet Room / Clothes Dryer
<br />Residential Range
<br />Hood
<br />Type I Hood
<br />Type ll Hood
<br />Grease Duct
<br />Fire Damper
<br />Openinos
<br />lnstallation
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Rough Mech.
<br />Final Test
<br />Meter Release
<br />FINAL
<br />Notes, Remarks, Etc
<br />.+
<br />Other
<br />Above T-Bar
<br />x
<br />atbrc m.rioncd prcpcny ror insle1ion purposs
<br />tt
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