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MECHANICAL.INSPECTOR RECORD <br />APPROVALS DATE tD/stG.COMMENTS oIYNUR uU ,trER Dtlt,( lRATr()N <br />i, rh. ni{,vi\i,rn\ oi lhc aotrrrrctr'\ l-ircn\cd hw iChrlrrr 9. Com'n nLiriN wirh Sc.ridr TUxJ ol I)ivi\i,D I ol ihc h'si'x\\ r J <br />rDplrrrrtrr pcnnirsuhFcrriho rpfl'.rtrrn, arnilp.trrlr)_olmr ntrrcrhrn lirc l[rdrcd dollir\ (S5rxr) <br />I <br />I <br />L as os*r of rhc pml'ny. or my cmplore€s wilh wr8.s 0s rncir sh so{E.$lion. *ill .to rlE qo* .!d 0E rhrrE ( ml <br />inrcndcd o! o,Icrcd tor slc (Se.?044. ausincss ud P,.fc$ions Cod.; Tl,c Co.rdors Lic.n* t w 6cs rct lpt y lo atr o$ner ol <br />rhcpmFdy sh.t ikls or hntmEF thcmn. ard who dc srch qfi him$I, or h.tslfor rhotgh hh or h$own cq,loy*s. <br />proridcd rhar slch impohftnh e nor anr.rd.d or ofieftn ror elc. li howcw, rh. hilding .r irymwE ir eU wilhi, onc ,!tr <br />oacomplclion. E Ovmr BtriUs *ill haE rn€ hdcn ot F,ving rhar lE or shc dij nn l{ild.r inorcE Ur popdy for lhc pu4ns of <br />I. as owmr of thc pmrEny. mcrclusirlyconrrdins wirh liens.n onrEro6i(,@6hd tlr l'.iel {S1r. 1044. Businc$ <br />lnd Ptnlcrsion Codc: Thc ContrlcroCr l-i.cnsc kw d6ci nor dpply io ,n owncr ol prcFny who blilds ot imPdv.q ihc..o6. <br />a.d who 6n!h.N ror .h rrcil1r wirn a Conrtrto(O lienscd pursonr k' rhc Corr6.rr'i Li...s L2w). <br />_l am .xcnpr ud.r Scdion-, A. & P.C lor this Eason <br />ItaxrEB5laurEtlarlo! <br />D&g.AAAIIAN <br />I h.rchy alfirm undcr Fnolly of,'sjury om oflh. followinS dsldarions: <br />Lftor (irlo. ln' rlr pcrtu'inN rlrhc q tur qhl.hth.l'cnnir n i\\u.n <br />-l <br />h,$ .nd will msinhin wo cG coqr.nsolion insumrcc. 0r r€quircd by S.crion 17m or the hhor Codc, for llE l,cdoMcc 6f <br />rh. wo* for whkn rhh pcrnir is hn n. My wdtds sq,crsdion insuhnce .@tu 8n |b$cy numb.. @: <br />_l ccrrifythrr in rhc lerl.rmne or rhc *ork torwhi.hrhh r.rm t nsucd.l shlll rei cq,loy !n, pcNo. ina.,nMrcr <br />$ N ro 18.ft iubif,i ro rh. mltc( comtcns.rion laws ol Colil'ornia. lnd ogrc rhd it I sh.uld h.om subtrl lo lhc <br />wo*cn contrn€iio. po*ionsofsclion 37mof$c t t rCod..I shnll. ro.lt*ilh mnPly wnh rho* Pmvisios.. <br />WARNINGT Failnrc t *nf srkc* ompcns.tion co\rm8. <br />.n'l finc\ ur n' n* hunJi{ rhousnd dollm llluo.olljl. <br />'nsdion 1076 ofrh. rjlnr Cod.. inlcrc(lnd lllomcy's accs. <br />domScs is proridcd tq rhc <br />I ncEby nltirn undff pcnally of pcrjury lh.t I an liNnsn uder Imvhion orchiprq 9 (.ohmmin8 wilh S€lbn ?000) of Divhio, l <br />or rhc Bu\i.c\\n d Pbrcs\n,N Cod.. md myliccnr t i,rfull lorcc md circcr <br />t h.rh, drlnn undf FDdlry ol pc'juy rnrl lhcrc isacoNlruclion b insua$cyli,rhcpcrto m.oirhc*orktuwhichrhi\p.nnr i\ <br />i$ucn(Scc .loe?. Civ. C ) <br />_l c.nify rhsl rh. fcdcrll rcSublionr rcBedins asbcsros rcmvsl rc nor aDltnbh ro lhir pmj.rr <br />-l <br />enrtyrhlr I heve Eadlhi.applrsrionadsrar.'har thc I rEte ro.orvly sirh rll cny and colnr, <br />ordi.!rccr lnd Surc lrws rldinB lo bu i ldinS .onstdcl ioo. <br />rhvc mnii.md pol)cny lo.* <br />Appliances <br />Metal Fire Place <br />Evaporative Cooler <br />Furnace <br />Compressor <br />l\rlisc. Equipment <br />Duct Work <br />Pre-lnsulation <br />lnsulation <br />Smoke Detectors lnstalled <br />Rough Ductwork <br />Vents <br />Toilet Room / Clothes Dryer <br />Residential Ranqe <br />Other <br />Hood <br />Type I Hood <br />Type ll Hood <br />Grease Duct <br />Fire Damper <br />Openinos <br />lnstallation <br />F.D. Drop Test <br />Above Hard Lid <br />Above T-Bar <br />Rouqh Mech. <br />Final Test <br />Meter Helease <br />FINAL ,L/'qAb )'r.'6cl <br />Notes, Remarks, Etc. <br />"-,-"*{ <br />l.odci\ Andrcs <br />- <br />Ats,{ rr'ANI DECI..RATION <br />I h$hy lnlnn u Mcr |)c.ahy of pc,Jlny onc ollhc l'ollowin8 dccharionr: <br />D.nFlirnr Pcnnir!Asbcstos Norilicarn,n Fcdcrd R.Bulrrions friit ilo. Prn6) <br />RcquiodL.n.rolNorii. ior <br />P:z/qff\' <br />-t---+--- <br />tt <br />tt <br />I