|
MECHANICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OlVNDR BUILDER DEL('ARATION
<br />I h.eht rliiiln undcr lcnah, of pcrjlry rhar I m cxcm0l ri.n lhc ContucnrN Li(n\. I-rw f.r rhc iolhvir8 rca$n (Scc Toll5
<br />ournrs rrl Pn,Ic\\n,i Cidc)r Any Cny ur Cuunry *hich rcquir.r r |xnnir ro (onslru.r. lllcr- inll)rolc. dc i,li+ .r tolln iny
<br />snduq pnorto il1 i$uamc- aho rcqutcs rhc lpFlicinr i,, suchtrrnilr{, filcr \iAtrcd n .n$! rh.rhcor nrc t lic.n\cd pursurnr
<br />b rhc prorhnrN ofrhc C(r fuhls l,i.ctrsc{ l-rw (Chr cr9. Comtrrcncnr-q riih Sccli,'n 7(X)0 ot Divi\i( .l olrhc Busirrc$ i
<br />Pn,rc\si.ns Cod.) or rhir tr .r shc hcxcirU lhcrcliomrnd t ba\i\ lnrrhcrllcscd ct.,!ritnr (yvi{,hlnrolSL!iu70ll5hy! y
<br />,mlrafln)rrl).nnirsuhF.r\rhca|flicitrltorcivilpcnrhyolnolnxnclhlnfivcnlndrcddollnr\(S5m,
<br />LJr.nNrnirhcnmpcny.ormycmpbl.d\trirh$rEc\r\r[$(nr.oml(n\ari(r.{illd rltsolkr.d lht nuruc i|xn
<br />inrcndcd orollcr.J ri)r$lc(S( 7O$, Burilc$ rid Pturc\ion\C(xlcr'lhcConk rni\l,,cctr{l;Ndoc\norrptltt)tr o*ncr.r
<br />th. F)ncny whdh'ikl! riUrrtrt!rhcGn,,uxl*hoJm\n'.h$or[hi'nsclforhc^cllorrhn,ulhhNorhso$ncnrpl(,y.c\.
<br />ol$mnlcrt)n. rh. Own.r Buildcr will hrvr thc hurdcn.lpfl,vir! rld lror \hcdd frn hnikl.ri prorc lhc pn,Fny nrrlr,[rF'{of
<br />-1,
<br />as o*mr of rh. proI,cny. ,n.i.lusivcly .o.r.ding snn liftned .onlracloB lo mn(rucl ltF rrojecl (Sa. ?1X4, Bulinc$
<br />ad RDf6sbn Cort : Th. Conkelor's Lkcnsc L3s dms ml apply lo d o*ftr of ptoFny who builds ot inlrov.s lhcr@n.
<br />aid who conttulr to, sEh p6j(6 wnh r Co.rdo(, lcnsd pusEt lo lhc Codtudolr Li.ns kw),
<br />-l
<br />rn csnpl undcr Selion- B & P c, li, hir r.ason
<br />Doler Orner
<br />JT!.IBtrE&1IIJIIPJNSA.IPN
<br />DECI,ASAI]ON
<br />I hcrchy amrn undd I'.nrlly o, !€,ju,y om olrhc lollowins delarorion\:
<br />Ih0rcutvillnuinrainnC.nirEurcoiclnMnlloScllltrsulcturlorkc.onr.nqrion.rslrovidcdlorbySslion3?00oflhc
<br />Lnbd Gdc, ror rh. pdromRc oi lhc vork for whi.h rhc pcirnil is issucd
<br />I hrv.0.d qillmtrinr0in *orkcri rompcnsolnrn insuancc. fl\ rcqotcd brS..ri.n l7([ oflh. tibor Codc. for rh{ lrrlomncr ol
<br />rhc work fo. whirh thh pcrnit is tsucd. My qortes co'qicnsd io. in\lrtrn.. .anifi ud F,lic, nuhbcr m:
<br />Pnl'cyNu'nbcr
<br />-Erpirc.
<br />_l ccnilrrhar ifl r hc ,,crLrmncc of rh. woll t r whi.h
<br />'hh
<br />p96n is nsu.d,I sh0ll nor cmtloyonytcNn in any oantrt
<br />s * ro bcco'rc srbid ro rh. wortss smFnsllion lows of Cnliforni0. and lsree rhur if t *hould h..om subiecl lo th.
<br />workc^.om!.EsarionpmvisionsofScclioo3?0OollhctihorCodc.lslEll.lonhwirh.Dn{lrwilhrh.{pbvisioni..
<br />WARNINGT FailuB lo ww turkcB' .omrcnsaliotr @vcms. is uih*fu!. a.ti ih,ll bixl M .mt,brtr lo ainiml Fdlier ud
<br />civil n.cs u! ro om hundEd rhousnd dolloB (S100.0m,. in addilion n' rhc o{ or snpctrelion. &m8.s as Pmvitcd for th.
<br />Selion 1076 ofrhr l$or Codc. intcEsr lld lrtomy\ fes.
<br />LTCINIIILCONIIA(:IAA
<br />DECIdI^I]ON
<br />I h.ruhy Jrfin undcr p(trrlyofp.rjrry rhrr I r lirnqi undcr l)o!i\nrofCh.fl$ I(.oNmming trirhScclionTIXX)) olDivi$on.l
<br />or rh. surirE$rtrd Pmrisions Cod.. and my liccn\c i\ in tu||l(,.$micrlirr
<br />Liccn€ ch$r----=---Liens Numbcr
<br />Ihl.: CmtF.lo.
<br />grNra!(rtoN.rElDlNc-dcrliLr
<br />I hcrch, rflitr uid.r Ftulry or p.rJuiy rhlr rrko h r .on{fl.ri,n lcndiu agcncy for lhc Frlornuncc oi rhc sork ror *hi.h thh Frmir is
<br />i$ucd(Scc. l(r97,Civ. C )
<br />AfILIEANfIT!!U.8AII9!
<br />I hcrl'! niltm urtlcr pcnnhyotpcrjtry oru oirhc i.lbwins dcchrrrn,ns:
<br />,).mnirn)n fcrd,ir\ sh.no\ Norifi.irn,n r.d.rnl R.tuld$n\ ('Iirl. {0. Pd6)
<br />Rcquncd Lcnc. of Noliikalion
<br />-l
<br />enify $ar rhc fcdctul rcpldrbn. eg6.din8 urb.cl$ remval drc nol amlicabh b lhh pmj.{
<br />-l
<br />edily lhal I lEve @d lnis ,pplicllion ed slntc lhd lh. lborc infordrion n @ran. I rStc ro 6nply wiln dl Cily $d Counly
<br />ordinlres,rd Surc llwr EbrinS lo hrilding snnructotr,d h.Eiy authorize Epr!$ntarits of this Cn, ard Counry lo e r uF. tlr
<br />abore ftnrio*d nopcny lo, in Fdion purF$.
<br />AnplicMr or AEctrr Sisnnrlre:
<br />Pcirnilcc nlnE (r,rinl):
<br />Appliances
<br />Ivletal Fire Place
<br />Evaporative Cooler
<br />Furnace
<br />Compressor
<br />It/isc. Equipment
<br />Duct Work
<br />Pre-lnsulation
<br />Smoke Detectors lnstalled
<br />Rough Ductwork Nalr t "14,b/h-/tf\-,'
<br />7
<br />Toilet Room / Clothes Dryer
<br />Residential Banoe
<br />Other
<br />Type I Hood
<br />Type ll Hood
<br />Grease Duct
<br />Fire Damper
<br />Openinqs
<br />lnstallation
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Above T-Bar
<br />Rouqh Mech.*z/k f;ilyfr'-/€
<br />Final Test
<br />FINAL X/,v, lE Erf.l*ln --'-
<br />Notes, Remarks, Etc.
<br />lnsulation
<br />Vents
<br />Hood
<br />Meler Release
<br />lxnJr", Nin(
<br />tt
<br />=
|