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PLUMBING-INSPECTOR RECORD
<br />Own.rlluild.. Dcclarrr'otr
<br />hdcb, alnm!trdo Fnalry ofp.rjlry llut Ianrc{.mptfom rh.ConulcIoE L'ccisu l.iq ror r[. tol]oqlfE rcron (s.c ?0]l 5 Btrsif.s
<br />imi P'!ic$'oi Cod.) Any Cnlo' Counry whichr.quir.s a p.m roc.Dirud. ir.' 'n,lnov., d.nrlish.r l.lln lny rruck c.r)for(rirs
<br />i rini.. rkor.quircs rhc 4pl'cinr lor\rcl pnm rofilcasgncd ar6.nlnrJrh..r$cnlccnscdptr'luatrrtol[cM'vu'on!ollh.
<br />Conr.crorj Lrc.nscd LN(ChiDi 0.CommcncrnswnhScctiotr7000dfDirislonr.lrh.B0s,n.$inJr'rui.*'.n!(-od.)o'r[dh.or
<br />slE r.x.mprnrc'lnom.nd rn. bsis ior rh. rll.B.d.xc,nprion Any \iol3(iotr dfS.crotr 70:ll s hy ary !r)r) ici a.r iD.mrr subiccarlr
<br />rpplic.or ro !civilNnihy olnd mor.lh.n fiv. hu.drd doll$ (1500)
<br />t. xr ownd olnrc propcnl. oruy cnrrloy.es wirh *ats.s as ([cr $1. co'np.nsiion, * lld!nrc qorl ]dr[.nruc'urcsrornncn'lci]
<br />or ofi.r.d ior s!1. ( scc ro!4. Bu!i.$ and P'.f.$'ons Cod. Tlrc Co ador's Lic.nr. L!* Jo.t nor ipfl! ro ri owtrcloirhcD,o,E'l,
<br />wno builds or rnproy.s rhcr.oD. Jnd qho docs such $ort hrEclfor h.rs.lld IhouSh Iis or l,.r owi.mrlotc.s. !ro!'d.d rhrr such
<br />mpov.rrctrB ar. nor inrcnd.d oroiLrcd tu 1. lf,hoq.!.r,ri.bundiisorinp'orctrr(rr snnd \1r[ r.tey.r] ot.dnrdcl6n thc
<br />Owtr.'Build.rwillhnv.th.buddofDrcvinsd,cr[corshci.rburLdorrmprovtn,i[.]'u],o!colsrlcl
<br />l.sown.rofrh.Plop.ny.an.rclu$\.lycontrcr'n88 h lrccns.J coitrnvs rocdfnrucrrh. pqccrr Slc 7r).1r. B$ .sinJ
<br />ProL$ronCodcThcCorrrdo'sl-iccnicLawd..snor.pplyrornownsolDorJ.nrwhoLrldsorrDuovcrlher.or'nrdwrLo
<br />onrocb tor such r)r.l.crs qrrh r contncl.r(, licenscd pururnt !o lhc Conracri \ L cctrsc l,r! )
<br />_lanr ercmpr un,l.rs.cnoi
<br />-.a
<br />& P C for rrns 'cx\dtr
<br />\\'oR(ERS (1)NlI'f,NSt ltOr DI( l.An,\l lOll
<br />I l,oc,v rliinntrrd!' l)c ill].it\.1tr'),rc.ilhcf.llo*'naii..h'1rtr)ns
<br />ll,rvc i dqill Dnnii.iCcn'ficatol(oDsc ros.llri\ur.ior$ok(rr'qnrtrsrr(n'arl!ouJcdlorbys(rotrr70!oir[.
<br />LJlsrC.d.,iorrh. &rLnr:!,..dfrh.worlfoi uhrchrhcpqnnrrsBsu.d
<br />*dIi. *tich rlr ( D(mnl s 'strct] My workets conrxNr on *urricchdld rnl ln,]icJ tri"tu, rrL
<br />irh>,ton n..d tu{ lEcomr,'d.d 'rrh. r{m B ro' oic hLnorc'ld.llrr itrl!,v
<br />./ I.cailr lhar
<br />'n
<br />rl.. pqlonnrr..lh. sork'or *hrch rl' s p.rir 6 65ucd.l rhJll
<br />hccahc ruqccr b fic worl.6 comr.nslton la*t or Clliromia. and 38n. $!t ir l
<br />.omp..srion prcvisio[ of S.crion ]?00 olrh. Labo Codc,lshll, foihrilh
<br />D.€l-,)=24a4 lppr,cJ rr\-
<br />lirr.s up b.n. huful'.d rh.usrtrd dolldr {1100,000).ir llddtru k, rl,c
<br />rlt LrL.' Code. id.r.( i.drno'n€y ! r..r
<br />m.8s a p!ovidcd lor lhc Scdion 1076 ol
<br />r. r( f Ns r: D ( o N] rr \( 1 ( llrs !ttcL1]!!l lI)l
<br />I [o.b, lmnn undcr Dcna]ry oipcrlury rhdl I dn l,ctis.d urdd p!ovrlon oi
<br />rhc Bunn6s md Pn,i.$rons Cd. rd my lrccnsc rs rn lullf(dc ind.f.cr
<br />Llccnrc C 165 __
<br />o",,\ >'Zq-oL
<br />I hd.b, aifim und.rpd3ty ofpc!urt rhi'
<br />'ho.
<br />is !connruclion
<br />6su.d(S.c 1097,Cn'C)
<br />fom c. olllt work ror wl,rch rhE p.mn B
<br />APTLI'AN 'S D€('LARATIoN
<br />t).aroln,on Pc,mi15 Arb.nos Norific.uor F.d.r!l R.30larions ( l,rl. t0. Pr'.6)
<br />R.qur.d L.t.r flNorifio i.n
<br />_l erify rhar $. fc.lml rcsulatio.t rc8irdiie Bb6'6
<br />_ , colify lhar I havc rcld r[ii.pplicalion Mdsl.ri(h en[lv wil] r l (',rY oJ a.unr!
<br />lrlns (
<br />'() lrJ Coutrr, bcDrc' upor ri,cordrn cc5,ndShk L!{5.clnrhgtoburldrnS
<br />ID/SIG.COMMENTSAPPROVALSDATE
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Underfloor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarifier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Pipeing
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />Ivlain Draini Pool Piping
<br />Fill Linei Back Flow
<br />Pool Heater/Gas Line
<br />M isc
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />E1,b !l !ri
<br />Rough Plumbing
<br />Final Gas Test EEE;I 20t9
<br />Meter Release
<br />\MC 6,4J. El,U
<br />FINAL
<br />pon,i',cc nam. (pnitf _-
<br />) -Lc/-
<br />Back Flow Device
<br />Notes, Remarks, Etc.ol
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