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APPROVALS DATE ID/SIG.COMMENTS OWNBN AUILI'ER DAICARArION <br />t tdtb, .lrtu ui& Frr! of Frqy rhr I d aorF elo lb. Cdrr.(t6 Uc.c l,w for tlE followt rani (Sd.70! t.5 <br />&!ina alrl a.of6.aon Cod.)r A!, Cny or Coury wilah Equi6 . Fnir lo o'tnr*t .hd. idp.ov.. <l6olit d EFi rry <br />rltuclw, Fid io itr iula!,.lo Equirc lll +tlior tuscnFBilo fiL.!t!drroE t lEd$.ilid F ur <br />ro rll FlvibB of rlr Cofi-rdi LieEd t * (CluF6 9. Co@nB eit Sdb. 70O of Divbbn I of rh. Bqir Dd <br />Pbb.n Co&)d lalrdirbdd rhddod!d tb. b.ra forrlEdh.d aanFion. Any violaid ofsc,rion 7011., by &y <br />.ppli6r ro' ! Fmit rubicr ln. .prlicDt ro . civilp lr,of er mE rh& fRc hu!d,!d &U,G ($0o) <br />-1. <br />a ffi ofllE FltEly. a Ey o4lorq vni $e6 . tlEi ih oo!6dio!. wil do $. wdl !d d! nrdc it mr <br />ina.Ld or ofr.'ld rd r.L (5€.7or4, Buin... &d Pro&sioN Codq TIE cmltd'i Li(@ L* &q tut adt to - olE of <br />dEFrtrt, *lb htiLl d iry.6 ltaaa d *lb d6 rrn rut ii6.lror hdrdf d tbudt hi d ha om.qL)d... <br />FoviLd dlr st irylEat c d na4d dolE d tu.L tt lblrtc. $. toildr d i|lqocEr il FE wittr @ )6ofoEplabtr dE ol,E Eoil& si[ trE rlr hrd.. oaFovins thir L or ,E (ln ht h.iu d iw!€ d. Fopdr, 6. rlE tuFG of <br />-1, <br />o ocG ofrh. F$Fly. d q.tuliv.ly cooEi.riry wih lico!.d co'nEd@ ro oritod rll Flixr (Sd 704.1, &!!B <br />.d Eiirin Co&: TIE Co|nr.<rd.' LiccE Lr* d6 dl +ply ro - olG ol FoFry *lb tdiLh d ihFo6 lhootr <br />.rd *te @!rEl3 for Et Firrt wilh ! Co|irrid(t) li@.d Fsun h rh. Coi{n.rd . LtoE t w). <br />.E!8f,E85:CAAI[E!IAIIII! <br />!ECL68Ar&U <br />I h@by .llm udlr p6Eny of pqiury om of llE tol,owinS &(l!dh6: <br />_l h.t. .d rill ui rb . Cdrifrcr. of CoeI b SdfnBe frlr wkd @r'p.@rio.! ! provid.d for t, Sdbi l7m oliE <br />r.bo, Codc br rh. Ffffi of dE srl h. rtth rlE Fhi ir ibld <br />-l t E.!d siU Ei,lri! e,Idt .omp@dion iMtuca s r.qund by SElion !r00 otth l,nor ( od.. fd llE Ff!ffi of <br />$. !o.t fq wnth lhi! Fnn ir isld My *dtdt otuFEiid i,6lltEE *i, .'d ,olky @Ebq te <br />Potir N6b: Eri-: <br />_l c.nify th.l in $. Fftllrler of rn rcri fd wnth rhir Fnn niEu.d,I ihil mr d?loy dy Fbn in.!y ffi <br />m a !o b6m xlidl lo th. wto onp6tb. L{ of C.lifo6i. rd tc rh, if I ilbdd b<.8 uti.d lo llE <br />srl6 cohFs.lion FDvilbE of Seliotr l?00 olllE lrta Code I rh.ll fonh*nh omtly wnh lh.* provirb6.. <br />$^tNltc: FdlG ro GtG F a' orlocio! o16r. i' ub$tl &d *.ll elitl a qroF b Ei 'd drrb -d.ivil fi.- Ip lo oE hq!.d dDE-d &lbt (tlQ.o@). in .ddnb. b dE or of oDr@diotr. dar.Br r Fovid.d for rh. <br />S<lbi 1076 otthc tdor Cod., ilracn &d .idBr'. fto, <br />IJCE!$DSqdISACIqA <br />TECI4IAITO! <br />I hqlby .ftE u& F.&y otFjBy rtr | 6 li.ar.l @dr Flvhid orch$a 9 t@tltlEila eio S!6b! ,@) oa Di!..i- I <br />or th. BGb6 &d Frofai@ Co& .d D, lt c a h tufl bc.i.ft t <br />l-i(6. ( l&<:-Lic6. Numb{: <br />lr(c Co.l,..lor <br />co!sra!cuo!.rt!!t!{ilcE!cr <br />I hd.tt JTm u!r& Frlt, olFlry lhr tts! i . odnarbn laiiie t8d, 6r tlE Ff.ffi of th. wl 6. $tinhir Fdt a <br />isrd (S<. lO9?, Civ C ) <br />L,nd.ir Ntm. <br />lptt ratlYr htcl ^rllliotl <br />I tct, rfte ulda pody orFi6, om otttc blkviii dctriirE: <br />Dilohbn P@i!A.b.d@ NoiitEaio! F.dad t rlhiE (Tib rO, Prt6) <br />-R.quiEd <br />kn6 of tlotihni <br />-l <br />.diry lhr E lind.l Eglld.rE Etldilt ahd6 l6e!.i E m! .rdt.bl. lo fiL FDld <br />-l.ditthr <br />I iac rad lhir F li.nior.n tl. th, dE.t c infotubtr i.md I..Erooqlyw .I Ciytld Cour, <br />ddin.6 dd 9r. L.6 Erit to hqild4 odlarb.. d tE $t rdo.i4 r?.6lriva of i!i! Cit, Ed Coury lo ola Wo. dE <br />.boE @lion d FoFr, for nry.cth Fapo6 <br />Apola! m Arsl Sfunnc: <br />l'm enME(rnnr) <br />Appliances <br />Metal Fire Place <br />Evaporative Cooler <br />Furnace <br />Compressor <br />Misc. Equipment <br />Duct Work <br />Pre-lnsulation <br />Smoke Detectors lnslalled <br />Rough Ductwork <br />Vents <br />Toilet Room / Clothes Dryer <br />Residential Range <br />Other <br />Hood <br />e I Hood <br />Type ll Hood <br />Grease Duct <br />Fire Damper <br />Openings <br />lnstallation <br />F.D. Drop Test <br />Above Hard Lid <br />Above T-Bar <br />Rough Mech. <br />Final Test <br />Meter Release I I l1 ll <br />FINAL Iol lXl?l DNqt <br />Notes, Remarks, Etc. <br />MECHANICAL-INSPECTOR RECORD <br />lnsulation