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APPROVALS DATE ID/SIG.COMMENTS OWNES BUII.DI:R DEII'ANAT|oII <br />I h6.b-.mmu 16F lryolFtrlNtt I m d.flqr nom <br />'h. <br />(dr..ld Lrd.la for rlE folh*i.A .Er. (s<70rl5 <br />Bdn6 !d ProfBion Co&) ,{., (ir! or Cou <br />' <br />uhi(h..qun6. Fni ro N'tftcl..t6. iop?.!q dqmlirh or i+n o) <br />srddu., Fnr to ir! ismc .lo Gtun6 rh. rppli.er aor 3uch Fflni ro 61.. ii8.ai nr6d thd lE or dE a licdrcd pufun <br />ro rh. FolsioB olrrt ( onlra.loir Lic.nEd hw {Chafld,), (inmd.inB wirh Sdbn 7000 of Dirllion :t ofrh. Bcind ud <br />Pma6ioN ( rxj.) or lhd hc or rh. k dmpl lh6.nom ed th. tsb for rhc dks.d ddrrn,n Any vnndio. ols.<lhn 70115.r" M, <br />r!pli(&r tu.Fn tuhje13rh..p9li@ ro !cirilFEh!.f.or mr.rhri fi{. huid.r, &l!r. I l5ml <br />-[. <br />otrG of 6. FlFly,6 oy oqlorE lifi *Ba. rlEi -L @ordbc. ril & lE rut tn $. itat i |u <br />nd.lql dotu 6r.l (sc-7q& &!iE -d Plo&iq! co{c TlEcdrr..td r Li<@ l*.b6d +dr b r o$E or <br />dEFlFry $lD hlilll ( iq!€ lldu! r'd *ib &a rdt Lql tiN.lf or ta.l,or tED'rri tn s h6 om arbye <br />provi<!.d dd rdr nq.r€ffi G rbr itllrtd.d dofrqld 6r{]. lt fo9!€. rlE toil&g d inFDi@.d i Fld wtli. d )- <br />of.oqriird. rOwc BuiE- will hrEtln hdaofFovtgtr ltortr. did 6t hrld orntFlEdr FlFty brlt F4o*of <br />-1. <br />Go*€ olrh. FFty. E q.l!rcly..di'a wi[ li€..d @drrdro (.elrl rb Fri.l (s6. 70a4, ErB <br />nd E!ti.co&: Ti.Cdtr66t Li.crr.bc 6t Atlo -otGotFoFryrto t il6 d bF!!a li.Etr <br />Ed rto @dI6lb.adF!intwill.C.dr6o'(r)t.acdF,D- roil.cdrn rd r u.@ te). <br />I an(.nrfl u6dd Saiion ,Il & P( idrhs remn. <br />Drrc orn.r <br />\\ oRt(l lf\' ('ot\t IErisATtoN <br />u;gJaauo! <br />I h.r.t \ lmrnru.&r p...h) orp<r!'\ oEoIrh. fdh\ inB d.{Lr.ri)N <br />-l <br />htw -d *ill Eirhh ! Cdiftd. of CoEr b SdHM tu 6l6a 66Fqi6n. 6 FoiiLd 60r b, S6liE 1700 of llE <br />Lltor Code for lh. Ffotrrc of rlE wo r which llE Fhil i is.d. <br />Iha\.a,l{illnri, .in *.A.r! crn'ro3!ri(,n insu,an(r. N rq rd h} sr"non r7rx|ofih.l-ahrr c(ld.. turh. Fn\nnuc.oI <br />t!. url ft. *hih dtit p-En i. brd M] rdra @Ip@drn 6|rc 6b.d,olt, .obq c <br />,l* r n<orau c,e 6 fc-( o|Ihe u:c€ <br />\ ^,*,"^nlngD<OSOt/7'S-D I ton O7./a8/z ,,' <br />-l <br />c6rii, rh.r in tt. p.rfotuir. of rh. mrl 6r lnkh rlil Fmh i. is&( I .lEll mr dph, 6y p6Dn i! G, llllrE <br />s a lo trore .ubjer !o rh. mrtd' .oeFrrion h6 ofc.litoFi ard .8rE rhr ir I rhoull 6...e .uur€r !o th. <br />Nrtd' orqalIid FlvtbB orseriD !700 otrh. t &r Cod.. I trlt bnhxih onpv rih tto* Fovib6 . <br />Nl frG 'q lo c h6d,rd rhdlrd dollE tll00.0@1, <br />Sadoo 1076 oflh L&rc.d.. ix6tr ed.ndEy rt6 <br />ol orEs!.rioc d.ttt . ForiLd 6r tlE <br />|JC!!64j4[I!ACTOAllcLtArlo! <br />I trqllyeD o!& F*yorFjrr lb t a lica..d l!& FDvlb. ofctB.9 (@i{ wit Sdb. U}) of Diviin t <br />of lt a6iE dl PtDlid.E C.d., d Dy [c ir b 6[ ,o.E dcft4 <br />#70 <br />\ <br />COIEIBUq&IJ.IIOIIG.ACIICI <br />t hatby .rfti 'e pd.Iy of FiE, ttr UE i. . oiriEt-. L.dh! {Ey for lb F6.G ordt sdt tr {didt tlt l.ri i <br />iN.d (SE. 1097. Civ. C.). <br />AIIIJCAIIDECIaaI\UO! <br />I breblrda F.r, olFiry cotdt folbsis&clrbn: <br />Doohb. PrEiD&t r6Notif..i,n s.(b.l R.suti,n (Iilc4o. Pi6l <br />-R.$i,!d <br />lar.,of N.dfcrih <br />?;lr lh{ rhe lnldrl,u!tr|. tr\,.!rr(l,( rn*r\ . i ^, . r, r.q,|l !Jl.l. L, rl,. t!,r.1r <br />rh, I ls,. ral rhi +plaa6n rllr rh..lbe. hbnl.b. bMBl l.gEro @dply sti.l Ciy..d Cosdy <br />rn h4!, .rlni, rqerriG of $i. ci, a.l Coqry b .da '+o. rt <br />^,orf o/uq <br />Appliances <br />Metal Fire Place <br />Evaporative Cooler <br />Furnace <br />Compressor <br />Misc. Equipment <br />Duct Work <br />Pre-lnsulation <br />lnsulation <br />Smoke Detectors lnstalled <br />Rough Ductwork (i-7 -2t \l-11) <br />Vents <br />Toilet Room / Clothes Dryer <br />Residential Ran ge <br />Other <br />I <br />Hood <br />Type I Hood <br />Type ll Hood <br />Grease Duct <br />Fire Damper <br />Openings <br />Installation <br />F.D. Drop Test <br />Above Hard Lid ./ <br />Above T-Bar <br />Rough Mech. <br />Final Test <br />Meter Release 11l <br />FINAL l^'1-?) <br />( <br />MECHANICAL-INSPECTOR RECORD <br />NSler.8etre4!.E&- <br />I <br />+- <br />L-7o ,/ <br />k/..----