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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE COMMENTS ( )$N tiR strt t,t,r:R Dt,],cllt{A ( )N
<br />rtflrr r lor r lltrnir \uhF.r\ rhc iflrl'.drr tu r.n1lt)cNlryolfrr nxtrr rh{n lnr htrndrcrllollx^(t5(x})
<br />-1.
<br />rs o$ncr ol rhc n!,Fn y. .tr
<br />'ny
<br />crnrh'lcc\ $irn $!scs r\ rhct v,l. conrFn\dri(,n, $ill do rhc wolk ,xl rlE slnf,lu k nol
<br />i[.kl.d oronrrd (r ek (SLr 7O]{,Ilu\imrs and Pof.\non\ Codc:]'hc Conru(ktr s Ltcnr l.w der n.r q,Ily n' nndwncr oa
<br />rhc pmFnr who hitts or impro\$ rhcmn, dd who dfts such sorl hnn\clfor hc6clfor rhrough ht.r hcr osn cn,floyc.s,
<br />F)rnbd rhlr sn.n imnn)Enrnls arc rxn i'rrc .l{l or onircd ntr $h lt tx$cttr. rhc hui[i'r8 or inDmk ttrr h $U wirhr onc ]trt
<br />ol con$lcli)n. rh. o$nc. suilds s'ill hrvc llE budcn of pmvirg rhd h. or shc li1 mr huiu or irryn,E rh. pn,rd, lir rr* puqrM or
<br />-1.
<br />!sowncroirhc popcny. r rcrclusivclycoorrucring lnh liccned conrncror x, con(rucr rhc poj.cr (S* 7o,r4. Bu\inc\\
<br />ifii P$hs*im Cndc: Th. Co.lmcroCs Li.cnsc tlq do.. nor oprrly ro tr.o*ncr ol p..rcny *h. $uilds or inDmhr rhcmn,
<br />drd wlr, .odrucrs for slch nNjc r warh ! G,l E.ro(r liei*d Nr\urtr( ro rh. Coitodols Lien$ tir)
<br />-l
<br />am crcnlpl undcr S*lio U & l'C lnrrhi\ rc {)n
<br />ljlaf,EBs:coMfENtauq!
<br />DECIAIAIIIIN
<br />I lErcby ilrfo undf pculry ot pcriury oE ol rlE followhE d6&&rioos:
<br />lrfir(i ..li'.r[.plrfornJ(cof rh.$ork i(n$hi.irhcllnnir i\ i$trrJ
<br />Mh r n,lq ll rtr r a,rl.^' (innr.tr\rr'.tr n {trirtc, r\ rcquic h}Sc.rnr:l7lx)olrhclihorCrdr.nnrh.pcrrormmcot
<br />rlrc q.lk tu shi.[ rhisFnnii i\ nnrcJ My*.rk.r\'.o rt,ctrr.innr iNurrf.c.rnicr r ro]icynun$c!nrc:
<br />'. frr: Co.af LLo- rwcst
<br />l,l"-lu*,*, r. bYLVf oqfu(l@ t7
<br />I.cdify rhnt ir rhc pcrrormnft rfrhc work f.r whkh rhi{ p.rmit h ii{u.d. I rhollnor cmnloy ary J"'"",*'
<br />$ r\r)hcomsuhjc.ltolls$o crr cnmncns io lnas oi (.nlilorni( nnd l8ruc ihri irl shoul,l hcco r\uhjccrhrl'c
<br />*orkcrl conlNn\ irIn,visionsofSccrnrl7 )olrhchl G)dc. I tull. lonh\rith conDly wir h rho* nnrvtions..
<br />WAnNINO: Fail,rc ro $dr. {o*crs @npcnclri,m ov.tusc is liln*fxl, rnd snrll subF.r ar cmrlo}r. io 6imin.l F.rxts md
<br />civil fitrcs trp b onc hx*]rcd rMxsind doudB (Slm.mo). io nddnion iotr. dduss is lnridc, i)r rhc
<br />DECbAAIIQ!
<br />I hcEby alfirnr und.r p.nrllyofFrjuryrhar I !m liccnan undn,,rcvnion olChorrs 9 (ommmin8 virh Sslion TUjO) 6tDitisi.n:l
<br />of rh. Bu{err lnd PNr.$ionr Cod., ur! m, li..n\e n in i,ll t*.! olll cllrr
<br />c t
<br />I h.at y !finn u c. IEn,lly of perjury lhd thcrc is ! consldclion lcdiry o$ncy r'o! rh. D.yfornancc of rtc sdrl rnr whi.h rhil Fymi! ir
<br />issu.d 1S... l{t97. Civ. C ).
<br />d-tfu( NfDEcLralrIQN
<br />ItErht dlinnu .r |En.lr!!ll{ijwto.colrhclirll'tr\$pd..liniions:
<br />D. nnIrr] PonnNA$.{or N.ri,l.iri, Ftdcnrl RqrtrllrnnsrTflc.l),Prn6]
<br />-Rcqunc
<br />L.rrcrolNolili.!!ir
<br />- l.rrirJ r',. r1,.1,11..,l'.!ulri,ar n.!r,lirg LJ\ ,^
<br /><Jl.{r'rj rt,I h,rc '.Jd r\'Jnrl.Jrr{r.trii Jrt'rh. rrr'
<br />rcnnxil s. nor Epdi.dl,h ro rhi\ pmlrl.
<br />inaomrion is .(rer. I 3gr ro 6nply sirh lll Ci
<br />.din0tres ond Sial. L!*s clllinS !o buildinE ourh.rir EprNnlalircs of lhn CI, and
<br />trh.vc mnrion d F)pcny r$ ir
<br />L.t/
<br />Waste & Vent
<br />WaterUnder floor
<br />Gas-Underfloor
<br />Buildino Sewer
<br />Area,/Storm Drain
<br />I nterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Pipino
<br />Gas Piping
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P{rap/Drain Line
<br />Main Drain/Pool Pipinq
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbing
<br />Final Gas Test
<br />FINAL lo 7 t///DWwv 7
<br />Notes, Remarks , Etc.
<br />ID/SIG.
<br />UNDER GROUND
<br />Meter Release
<br />L a,lr"\ Nrmr
<br />I. ,t.,\
<br />^JJ,r..
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