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MECHANICAL-INSPECTOR RECORD DATE ID/SIG.COMMENTS OWNER BUTLDER DETARATION I hE*r tIftE uda Frr, of Firr dr I a a.oF tm tlt. Cod.dm tite lry tutE 6lb$il le (56m!l.J Acu{ ad Ptot-i@ cod.): Ar} cirt o cdny *nih qoi6 . FEi to orin d" .la. iry.ovc .tulili d i4.i ey ioctlrc Fbr ro n. isla.. .t E$i6 rh. +pliqd for uh F6i !o fiL . rirr.d rr@r $d lE or d'. b lic.6.d pE$d lo lt. Fliir of rb Cdt .ro.! Lia..d rrw (clr.F.r 9. CooEdiEs etn Sdrio! 70@ or Diyti'i I ofo. &.iB lrd *rDt io6 C.&)q $n b6iEi q.!,l rba6@Ed r hi 6r rlE.&r.d lraFir. A,y ebhihofs..ri, mrl.J bydy llplicld flr ! pcnn lobjcr. lb. Wlic&r to . civit FrIy of 6t lle rh& li6 h@drd <lotl-! (3t00), _L ! lffi of dE FoFrn d 6y apro'6 wib rq6 r rlEi Dk drEd.in! ril do lh. Nt tn ti 3lgc i, Dr i'rad.d d olEi.d fG EL (Sc.704,a. &!ir6 ed ?rDfrrirN C6& TIE Cofi.dd r Li.E Ls d.- Br +ply ro & ouG ol lh. FDFty wlF boin d ilt oE tlEEi\ dd eho &6 st wh hiElllor h6Elf or lfuDuab bn q lE om dpbt6, poviLdft. lrd iryud & 'br iiEd.d aotuld 6. EL lt lEw. tlr hfirit â‚¬ i!F@!rs ir bLl eiL @ ra ot.qqbb.. tb oi{E Duilda si! h.G d!. hr*a olForit rtl b ( iE dd d{ hrild 6 i!g!E dE F!Fi, ftr lE FrDc of _1. ! ow olrh. FDFrn D aflndy ofidie *ih li6.d @ itr6 ro orElrd rlEFli.r,lsc. ?044, &@ dd tioldd Cort: Th. Conr.cld . Li..e lr* dc tur tpply ro e ou- ofFlFry rlE buiL!. d iiprov6 lhao'! &d vlb conirt 11 6r ru.n FDj<l! wirh i Co n lo(r) lta..d pu@,n to tb. Conhirofr LtC@ Le). _l 6 sd9l ulda S.di,q_-- E- /t P.C. 6r tii ren lrrt. ()rmr \tolu(rk\' (htrPl tsa'I toN DICI.A&UIaI I hsch!.llirmundd pcnahyof p6J!0 oncolrh. lnlhrinBd(larari' r _lbEnd*ill id.b.ccrin r.ofcodro Sdfifu! ft.atd MFErit\ ! Fovi&l6r byscrb! lru) ofrt Ldoi Co<k fe th. Fltrl@ 6f 6c wt tc stti.t rhc FEit i iluod. -lt E Ed siu Di,Ilb Btd colEcrir i!.!e... Gqiird tt Sdi.E 1700 of rlt t Do. Cod., br lb. Feda.oftu wr f.r qtli ttbi Fni i i.!d My6ta .!rr.ion tre it rd poli.,@hq c -l (dit $d i! rh. FfM. of tt *orl tu wn dir Fmn s is!4 I r&I Dl slpt y oy Fn ir u, 6.6 s . ro bco6 llirl ro llE rdta oed6 t E otcdifo6i.. .!d cc lhr it l .lblld hclc $tixr !o $. w a Nmpo!.rio! Fovirio6 ofscrion 3700 oflh. t bor codc I rhl! bnlNio @!pl, *nh tho. FD6iod. WARJ1rNG: r.ibr ro G4 std @dp.irb! @rsl. ir oLstu! id rh.ll nbjar n dploF ro ailid rdrir.d civil 6.6 !p 16 6E hulrd ubusd.blL'r (31m.{m). ii.ddnbi ro rlt.or of @np.osio6. ddr6 r Fovncd toi E Selim !076 ol tlt lrto. Cldc id@l .!d .truryt fa6 lcEB$&-CA!trXaCIqa DlCBAAIlqtr I I'a6, dlm @dq p@Xy orFr'ly thr I D licdcd @d. Flvii[ orou9lr 9 (@!!ttE!s witn S<db! 7000) or Divbb! J of rlE Eui6 Ed Poild(a Cola tn 6r lt@ ir b tull firc nd ct[*1. qallarcuq!.lJaulG-agElcr I h6*y .lEE u,r& Frny ot Fiury lhr dE i!@dtu rih Eldir ..dy fo, dE Fli)fllto. of llE wt 6. *tth lh6 pnil il i6u.d (S<. 109?. Civ C.). ATIIJCAII.OECIJAAIIOU I hqd, rftD udd ]E!l, of Firy c or $. blbsi.8 &.l-riE: I).bhi.. P66i$Arb.r6 llorifEdin Fa(b.l RcguLtitu Ollc (,, P!l6) -R.qgftn rara of Nod6.ibd I (diLrr llli ih.1.\lorl,rrtrl. \rxk'L,trJn,!.trliar\r,tr,\rlJC,rrtfl\rr'11'n'rhrr!!.rr -I.r tdr I l$r lad dn +&ain d !1r. r dE6w ilrEr i(E idr.d.I lEloondyrit.llciy.nd Csr, ddiIr,E !d 9r. t,s Elta lo bildiB 6rnDdi,., d hE6, rrnode EgldriE offiir Cay d Couny lo d6 'ror rlt .lov. 6d'don d Flpdry for i perioi F,poc APPlid d 4d siatu:- liances laz Metal Fire Place Evaporalive Cooler Furnace Compressor Misc uipment Duct Work Pre-lnsulalion lnsulation Smoke Detectors lnstalled Rough Ductwork Vents Toilet Room / Clothes D ryer Residential Range Other Hood Type I Hood Type ll Hood Grease Duct Fire Damper Openings lnslallation F,D. D rop Test Above Hard Lid Above T-Bar Rough Mech. Final Test Meter Release / FINAL ? /?/ ///,v APPROVALS m Notes, Remarks, Etc. Poliry N@ba:_E I@' - --- ----T------ =