Laserfiche WebLink
MECHANICAL-INSPECTOR BECORD <br />APPROVALS DATE ID/SIG.COMMENTS OI4'NER BUILDER DEL(AIAIION <br />I hercby llrm !idc. Felty of Friury rhd I m .xciu fmm lhc C! mtoB Lian* t w lor th. tolto*ing E.en (Se.7O3 LJ <br />Busirc$ ad ftof.$ion Codc): Any Cny or Colnty which fquircs r pmh ro onsttucl, .h6. idpmve rhmlish or r.p!r e, <br />stddur.. prhr ro irs issuamc. dso rcquirs rhc arpliclnt lor such Frmir lo tilc a signed {rlcmit rhat tE or rhc is licnscd puls@r <br />ro rhc tdvhio.s oftr Conrmroii Liensd L!* lchaph 9. CohNBing enh S*tion 7000 otDivkion 3 of rtE Busire$ lnd <br />Prcfc$ionr Cod., or rhlr Lor shc n.xcmF rlEehon dnd tlE hasis for rtE stkg.d cxcnlpdnn. AnyviobtionofSccihnTO3l.5byrny <br />apDlicant aor c Fnnir subjc.k rhc .nplica to a civil pcn,try.t mr mrc $d filc hundEn dotm ($5Oo), <br />-1. <br />s owmr ollhc l,ltEfly. d ny.tr'pk'F$ wirt erlcs .s thei sL onFr$tion. wi d. ilE wk drld dE sEEiE is hl <br />i.tcftLd or of.r.d fo, sh (Se.70{4. Bulifts* md ftsfc*ion. Codc: Thc Conlmciols Lic.ns Uw d@3 mt mDty to d oeEr of <br />thcpmFdy sho hiil& m iqroEs 0E8., sld who dcs $ch *o* hi@lr or hcetf o. thmusi iis tr lEr ovn cDployer. <br />Fovidcd ln3t such hpmrftil! dht hlcd.n Goftfd fdrslc.lL IDEE, tlE brilirg tr in+ioEmot n sU wnnnr orc )ruofoflptxirn. tlE O*rc. Builicr will IEE rlE t rdo ofnDvitrg rlEl lE m dE da d toitd or irprcE ll.tc lNroty fm dr ltrpoe oa <br />-1. <br />as o*d of rt !m!cny, m .x.loriv.l, conrE tins wnh lien*<t .onrado6 to @trdtuct lh. l'Diet (Sa 7o4:t, BusiBr <br />a.d ProfNion Coder Th. Conr.clor's Lkcns. L.w d@s .or atply to u o*ncr of propcny sho builds or iht,rcles th.rora.d who atuzcts for suct ptujcct! wirh a Co.lFclo(s) ticr$d pus@l ro thc Co Ecrots Liene tnw). <br />_l m€xcnpl unda SNdon-- B, & p.c. for lhis rcason. <br />woR(FRq, coltPFNsaTtoN <br />DECLAR-ATI(IN <br />I herchyll'itnr undcr Fn,hrof pcrj!ryo.c ol'th. followin8 dcclanrions <br />-l <br />hovc srn will minlli. a C€nifEatc of C,nenr ro Sclalns!rc for worl€6' snp.nsdioo. 6 poviEn aor byS6tio. tToO oflh <br />Labo! Codc, tor rhc tcrfomrcc ot thc worr ftr whi.h rhc pcmir is hskd. <br />_l harc lnd will miflain *orLn compcnsrion iEu.aftc, &s rcqui(n by SetioD l7m of dE Lnbor Codc. tor the perfortum. of <br />My pork.m co.lF.{rnrn insururcc ..ricr !trd policy numb.r dc: <br />B'ZL1tX I <br />-I..niry <br />rhlt in Inc pcrfoirmm old. work ttr *hi:i ttis ncrnrir h hsucd. I shall not erpto, any D€ren in any manmrb !\ ro hcom subjc! h !h. solkrn ompetrslion lnws ul califodi!. ond !-qN that if I should txcom rubj.d ro rlE <br />workcN comFnstion pmvhionsolScclion lruofthc ti|lrG)d.,I ihall. forlhwirhco.rrly whh rhos provirions.. <br />W RNNG: Flilurc lo $cuE qorkcrs' comrcnqtion ovcnec b unbwtuL lnd .hall suhixt d cmploFr to aiminsl Fnrhds and <br />civil fines up ro onc hundr.d lhoDr0nd dollds ($l$,01D), in oddnibn ro rhc cosr oacoh0cnsario., danBecs as providcrt for thc <br />Serbo .1076 of thc titrr l).].tt <br />LtcuNsFD C()NTR,t(:TOR <br />DECI,IMfION <br />of rhc Busincs rnd Pdisshns C.dc, md m, ticcnrc is ir tult t)ra d cii{r <br />CZL L6-Z ( Ld\ <br />,r., '') ' ( <br />( IINS'I l{t CI()r_ Lt,NDIN(; ,\(iIj\( l <br />i\{ulrs.r lo()7. ( i\ ( ) <br />AIIITANLDICI,AAAIIQ! <br />I ffiy i,linn ukrcr lrtidlrv olr.rjury otrc otrhc tullosnre dr.larirnrns: <br />D-nnllirn,n P.rnrirlAshcsos Noiifi.ddr F.dcrtrl Rquhriurs (Tirtc40, Prd6) <br />-RLlNidl <br />lx[.r of Norifrcation <br />-l$nilith <br />lhc rcdcr,l rcso llr ions rcsuding rsb.so\ rc.xrvrlnrc ml urplicnhlc b rhit pojccl <br />_l ccnify riar I hrk i.rd rhis,mlic0rbn 0!d narc rhar rhc ftrv. infi,'mlion i\ corsr.l tr8rc b.ooply snh all Cnyand Colnry <br />ordinlnccs and srdrc Lass rclalins to blilding consrrucrio hcrcbyourtnizc reprcsnlalivcs (,rrhis Cnysnd Counryto cnr$ upon rl[ <br />rtx,vc rrtrri(ftd ln,Itrnv fff in\ <br /> p!11.0r or As.nl Sisndu <br />\)pliances <br />Ivletal Fire Place <br />Ev rative Cooler <br />Furnace <br />Com pressor <br />tvllsc. Equipment <br />Duct Work <br />Pre-lnsulation <br />lnsulation <br />Smoke Detectors lnstalled <br />Rou gh Ductwork <br />Vents <br />Toilet Room / Clothes D ryer <br />Other <br />Hood <br />Type I Hood <br />T e ll Hood <br />Grease Duct <br />Fire Da r <br />Openings <br />F.D. Dro Test <br />Above T-Bar /-'l <br />Rough Mech.7-lvlE h.W:!1 <br />Final Test <br />Meter Helease <br />2_2t_tg fy,*ttt*lt fzi. <br />Notes, Bemarks Etc v, <br />Residential Ranoe <br />lnstallation <br />Above Hard Lid <br />FINAL