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APPROVALS DATE ID/SIG.COMMENTS
<br />Appliances
<br />Metal Fire Place
<br />Evaporative Cooler
<br />Furnace
<br />Compressor
<br />Ivlisc. Equipment
<br />Pre-lnsulation
<br />lnsulation
<br />Smoke Detectors lnstalled
<br />Rough Ductwork
<br />Vents n
<br />Toilet Room / Clothes Dryer g'^g-ls x,.w\A)
<br />Residential Ranqe L)
<br />Other
<br />Hood
<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.
<br />Final Test
<br />Meter Release
<br />1-t7-tv v"W'Jt)
<br />Notes, Remarks, Etc
<br />MECHANICAL-INSPECTOR RECORD
<br />OWNER BUILDER DELCARATION
<br />I lErchy amrn undcr FMlly of Friur, fial I m .rcnfl froo llE Co rer66' Lhcn$ l,w aor lh. following Easn (56.?0l l.t
<br />B!si.c$ ..d Pr6lc$a6r CodcJ: A.y Chy or Counly *hich EqriEs . pcrmn to onslfucl. dl6, idrorc, d.nolhh o. ep& tny
<br />srructurc. prior b ns nsuane. lko rcqutcs rhc ltpticsnr for slch ltrml ro frlc o rign.d sn|ceni thtrl h. or shc is licn$n purtunt
<br />b rhe tmvkions olrhc Conlslols Li.cned ttw (Chaptcr 9. Conmncing wirh Scction 7m0 ol Division 3 oflnc Busincss 8nd
<br />Pmf.ssions Codc) or rhrr lt or snc is cxcq,t rhcefmm and rn basis fo! rhc albged .xcqnk'n. Any tiolnri.n of Scdb. 701 L5 by lny
<br />applic.nr for s p.mir sbrets rh. spllic6 lo a civil l,cnllry of tur mie rhM nve hundEd dolLrs (Sr00).
<br />-1,
<br />!i oencr 6f rh. pEFdy. M my cmplor.s wilh *agcs .s tct $h cohpcnsrion, will &, llr *oli dd rlr intl@ is mr
<br />inre.d.n or oficrcd for $lc (Se.7044, Busituss and Profesions Codq Thc Cd.rturors Lkcn$ lj* &ca nol +Ily to 0n ovrcr of
<br />lh. pftFny wh. buildsor in{mres rhc@r md aho dfts such wik himsclaor hcscltor rhNush his or h.t owncmtloyc.s.
<br />prolidcd rh.r such itr{,D(E.h @ @r inlcndcd orolTcrcd fo. sh ll towcK. rlE h{ildiu or in{,olcft ir soD wnhin nnc rsd
<br />ofon{,btion. dE Owncr Buitls *i[ hlr rl* blr.kn ol pDvins rhd lt or ihc dil ml hriu or iqmE lh. pmlsly for the !!,IEe of
<br />I.,sovkrofrhc ro!.ny, !mexclusilcly contracring qith liccnsd codrr'oFk, Lrn{flcr rh. tmjer (scc 7(x4. Auiircs
<br />!!d lt,ar$ir Codc ThLC.nrd.roi \ Li.cnsc L,w docs fl r,,plyto.nosncroltropcnywhobuildsorioP$vcsrhqcon.
<br />rnd qho ontruds rbr suchrmjccc wirh 0 ContrNrffl9 licctr*d pr6u l b rhc Grnro.rols Li.cnsc tiw).
<br />I lmcrcm,l undcr Srctiotr . B. & PC. ro hs rcaon.
<br />ulratr[Bs:.c0utENta.rroN
<br />DECTATAIIAN
<br />I hcnby ralirnrunder lEnulry or !.rjuiy onc ot rhc lnlbwi'ig dc.l,rdrnnrs
<br />-l
<br />lrvc iodwillnuiirain!Ccni6carcoICon$nr r. Scll ltr\ur. hr workcn mnrlcDsolion, a! Imlidcd ld brS..rbnlT00ofrhc
<br />hbor Cdlc.lbr thr,crfonmncc olthc sork ntr *hict rhc p{nnil i\ i$ucd
<br />_l hd\c Jn,l$ill trr,1rdin worlc^' .mnlctr.Jri.n inrdrafr..r.quncd b, Sstion 3?00 of rlE tibor Corlc. fo. tlE ,,sfdm(c of
<br />rhc so* tor which rhi$ pcmit n iNrd. My wort6 6 insuruNc caricr ud Fnicy Nhbd ecl
<br />I.diryrhar in rhc l)..formncc of lhc sork ntr vhich tht Fi,nit i\ isslcd.l rh,ll nor cnDloy dny r.Non in ony'nanmr
<br />$ us ro bceflE subicr to th. *o.lc onp.nsrrior lassofcalifor.ia. dxl !8M rhd ifI should ntom su$jcc o rtE
<br />*o o( corrFnslrion !ruvision\ of sccrion 17fl) ot thr ulr, codc. I sh,ll. tunnwirh onlPly wilt t|,e povi\ion*..
<br />WARNINC llinn. b sc.u'c workcri onucnsrrit,n i\ unlnwful. dnd sh0ll nrhjet !n cmplorr lo oidiorl pculri.r ,id
<br />addirn,n tu rhc .osl ol conlFcnstion. d.nEgcs !s povidcd for rh.civil fincs up to onc hundrcd rhouend dolhrs (
<br />CANSIBIJSIIqUIENOIIC.{GIUII
<br />I hcrby sffirm und.r p.nrlry oi pnjury lill llEE h o onslMlion LndinS !€!ey fo, rlE fcrfo@ of llE worl for *hhh this Itmn i!
<br />irsu.n tsr. 309?, civ. c.).
<br />ATPI X:ANT Dlr(II RATIoN
<br />I tri!.t y rflimudrr NnrlryorFrjury onc olthc folb*nr8 dNhralnnrs
<br />D.Dnrlirn r PcirnirsAst eos Noti,icornnr ltdcr!l RcEUhrn'ns ('lirlcll). Pn6)
<br />-Rcquncd
<br />Lcrlc. ol Norifrri0n
<br />-l
<br />ccnilylh0t Ihc rUtrol rcrul|l ions toaa lin8 r\l,.i.so.r,!tr| ru nor.lpli.nhlc Io rhis,'roJ.cr
<br />-lcdilyrhar
<br />IF,rcrc rhhlpplicdnnrddnlrcrh rhc nh,vc inturnuriotr is .otrr.r I aBE lo $mply wirn lll Cily rnd cnu.ry
<br />ordimn.cs and Star. bNs rclrl buildin8 conndcrio'r atd hcrct y luhori4 E!rcicnlarivcs of rhis qry Md Counly lo cnlr lpon lh.
<br />ahorc mmbn.d pn,p.ny fot
<br />^ppli.ror
<br />or a8cfr sttrrru D/z?//e
<br />Duct Work
<br />FINAL
<br />II
<br />--------r------
<br />--------r------
<br />O*n..
<br />ucElsgrgN:I8at3)B
<br />DECI.AAA.IION
<br />I tuEby rmr6urd( !.mlryotp.rjury th|t I !n licctrsd undcr previstnr oichrrlcr 9lconrmncing wirh s.dhn 7m0) olDilhiotr l
<br />ol rhc Busimss urr\Pru{.s\i{,ir C.dc. dt oy li..nr. i\ in tull br.! u19rr.
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