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MECHANICAL-INSPECTOR RECORD
<br />OW'IIER BTJILDER DELCAAATDN
<br />I hcrcby amrn under Fnrxy.f Frjury lhll I m cx.nDr 6tro lhc CotrlEclou Lixn* L3* for lhc folloqing Elsn (5.c.7011.5
<br />Blxincss a Profcssioi Codc) Any City or Colnl, whth EAuies s I'rft! ro cons@r. dlo. jnorcv.. dcmlhh or rcpair any
<br />stode. pr!, t, irs isloam. alo rcqlits $c ,l,plic lor .ucn Fm ro nk a siemd slrr.mnl thrl lF or shc is lie.sed plhua
<br />to rhc pmvGions ofttr aonrrmld s Liftn{t ljs (Ch!flcr 9. CommncinS wi$ Sedi6n 7000 of Diti.ion I oi tne Busimss and
<br />ftofcssions Codc) or rh hcorshsi.excnqrhcrclrooa.drhch{.isforrhcallcgcd.r.morio!.A.rviol0rionofs.dionT0ll5byuny
<br />dntrapc i subjNk rhc aptlic r lorcivilFtrdl',.rNr oororhi.livc hundrcddoll&st$500)
<br />own$ofrhc pmpcdr, or my.mploy.rs wirh wlgs * rhcn sb con{.nsarinn, will.!o rhr sort 3!d dr n.r.lE ir ml
<br />or onir.n for solc (Se.7044. Businc$ md Professions Co<lcr Thc Conrt.cror's Lietr* tis do.s nol aprly lo s o*flcr of
<br />rhc pNFny *tht ilds or inpbB tr@n, &n wth dmmhmd hams.lf or hcrsllorlhmugh hisor hcrotu cnll)l{'yccs,
<br />ptotidtd rhar s!.i in\a)tornrs @ tur hrcndcd o.oiTcrcn forelc.lf. ho*ercr llt hiuins or inphtd.r h$ki ehhinom Fd
<br />ofc,npkrion. rhc O*ncr ltuitld will haw 0E b(ldcn ot8rviiB thlr lrc or shc dit mr l ild or irqhk ft. p6Fiy fd rrE purF$ or
<br />-1.
<br />( o*ner ofrhc rmpcny, amcxchsivcl, conrracriry *irh liccncd co.rmcb^ t'
<br />o.d ProLssbn Codcr Th. Conrrrols Liccn$ riw docs nor rpply lo !n owrcr of
<br />r qho c.rr \ li,r rich nrcJcc( wirh J (inn' ch(, licrn\u(l ftr^uxtrr k,
<br />-l
<br />dckcmfl undcr Stclji* zf rcfr t
<br />DECLAR TTON
<br />I hcicby alfirm unrlc. Foali, 6f Flu.y oE of lhc followine .tc.laotiors:
<br />_lh!\clndtrillnuinkin!CrniturrdoiConscirhscltltr\r'cn,*.rkc^'.o p.flsdrion.NfolidcdforhyS(rnrn.l7 )orrh.
<br />L xtr Codc.lor rlk lrrr'onn rc ol'lhc wolk nnNhich rhc Pen l is hs'cn
<br />-lh c and {ill mainrain wor*c6 .om,coiarbn ior!6mc. {r FquiEd bt Skl ion l?m of lhc l.,bor Cd.. fo, thc Pc.fornee of
<br />rlE ed. tor ,hth Oh Fmn i! is{cd. My *ort6 .orp.nsrion iosumm. .Mir ed policy Nnb.r scl
<br />irrlh, nrrhc r.rforrorc.oflh. worl for qhichtht p.rmn k isucd.l sholl nor cruloyunyl.Mn in,nyn ncr
<br />so N k, lEcom suh]cd
<br />'o
<br />rhc ro.tcrs contcnqrn,n irqs df Caliaomi!, aid .sN rhd if I shruld hc.onE sunjd lo rhc
<br />workcn'comEnsarionnmvisinsorscc!i(,n17fi,orrhrlf,hnG c. t \hall n'nhsirhonlPly qith thoe povni,ni
<br />WARNINGT Frilu,c r. snrc {olkca comD.ns ion
<br />.ivil finur u0 (o oft hundrd ihousnd dollns (Sl
<br />t
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<br />ConlncloP-
<br />A.ITLIIANI,IIOABAIIAN
<br />I lrr!'hyrllinuklcr lf, hJ olpcrluryoncolrhc loll,rwirra dc.hflr ion\
<br />l)cn$liri(in llcnnirsA$cnos Norifirarn Fcdcrrl Rrgularn,n\ lTirle,l(,. Prd6r
<br />Rrquncd l.r.rof Mnili.didr
<br />I c.nilirhrrrh.lt&rrl
<br />h compl, wirh lllCirydnd Cou.ry
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Appliances
<br />Metal Fire Place
<br />Evaporative Cooler
<br />Furnace ,,/'
<br />Compressor l----
<br />Misc. Equipment
<br />Pre-lnsulation
<br />lnsulation
<br />Smoke Detectors lnstalled
<br />Rouoh Ductwork
<br />Toilet Room / Clothes Dryer
<br />Residential Ranoe
<br />Hood
<br />Type I Hood
<br />Type ll Hood
<br />Grease Duct
<br />Fire Damper
<br />Openings
<br />lnstallation
<br />F.D. Drop Test
<br />Rough Mech.14ldRm
<br />^b\a/n
<br />,)
<br />Final Test UI
<br />FINAL rr9lrf T 'ez )
<br />Notes, Remarks, Etc.U\
<br />lb
<br />Duct Work
<br />Vents
<br />Other
<br />Above Hard Lid
<br />Above T-Bar
<br />Meler Release
<br />ucuNtED-c(2Nr&IltaB
<br />DIEI.AM.IION
<br />I hcrchtrlllrnrondcrpcml(rolpcrjrryrhrr I rnlrci{dundcr Fn,lis nolChr0rs9l$nrnEncinstirhS&ri,7ID0)tiDni\i 3
<br />ol lhc ltusincss.nJ PmicssnnFCod.. a nrr li.cnsc is ir llllln&udcrrc.r
<br />co! x.ucuoxrENllNclliEu.l}
<br />t hcrch, trt n. undcr Fnaliy ol pcrjlry rhar thcE s d c.nsn.ri,n LndinS aScncy for lhe rcrlbmh-'c of ll8 uork for whtch rhh Fmir k
<br />hsucd (Scc 3017.Cir. C ).
<br />knJ.r. \rnr.
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<br />L.n&r,t AddEsr:
<br />Aa.>
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