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PLUMBINGNNSPECTOR RECORD
<br />APPROVALS DATE
<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 />POOUSPA
<br />P-trap/Drain Line
<br />Main Drain/Pool Piping
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Misc
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbing
<br />Final Gas Test E/\rll \Err,
<br />Meter Release r ,nlq
<br />FINAL SAMC 8'43' I lg0, s66, 66
<br />Notes, Remarks, Etc.
<br />OMd-Bulilr D.dr.lim
<br />I h@by .flim @d.r Fadty of Fjury ,lar I D cx.mF fm 6. cdlr&tos' Li@s Llw fa lt. follNi,a tq@ (8.?03 ,.5 Bain@
<br />ed Prcfeid cod.), Any ciry d Co6ty *hiclt quid a pmn 1o c@Etc! alt r, improe., d.inoliih q rcpair &y ltudw, Fic !o ia
<br />is@e, ol$ rcquiB dc qdi@t fdlah pahn b fiI. . lign.d i.ldan thd h. d rh! B li6$d pwur ro Ih. t6vij@ of ric
<br />Co.!&tG! Li@i.d try (Chllta q C@dr8 wi$ SEri6 7oo0 of Divirid 3 of th. Bail@ erl Pofdi@t Co&) d dl.l h. r
<br />!h. i!q pr th@fiw ed {r. bait fa tl,! 8IGs.d aaflid .Any violllid of S@d@ ?031.5 !y &y 3ppliot fq. p6trn subj.cB dE
<br />.rplicet l. E civil Ftulty oftrol hdc lhd 6* he&cd .Lru& (1500)
<br />_1, a oMa of rhc FoFry, d m, mployG rirh wag6 a rhcir !ol. @mFBand, *ill do fi. rdt od dr 6Eucrfr ir nd inr..d.d
<br />@ of.cd f6 ,.1. ( Sc.70a4 B€i.a &d Pof6id Cod.: Th. Cdt &rtr't Lic4. t- do6 o.. apply ro & *nd of {E pmF.ty
<br />who buil& d inFoe6 $.@r. ud $ho do6 leh *6t him.lr or h6clf d lhr@d hb d hr oM cmploy6, F@id.d thar su.h
<br />imFovml,Enoli.trd.ddoflcrcdfds.lc.Ilhow.v6,lh.buildinsdinprcmalirsoldwithhdcydof@plaion,lic
<br />Owna-Build.r Bill h3v. $. burda of Foving th.1 t. or sh! nol build 6 imprcv. fq thc prpo6. of 3.14.
<br />_L a oMdof th. prcFn , m dcluikly @nc&rini wi$ licoa.d 6n!de b 6sEud 0'c rojer ( sd. 7044, BGins ad
<br />!Df6n@ Cod!: Th. Con .!or" Licd. l3w &B mr .ppl, ro d oMa of FoF!, who bsn& a imprcG $o@ , od *io
<br />6E&l3 for $ch Fojds qiln ! cdat.1o(3) li6cd p$@r to lhc C6tr&1or'! Licm. k*.).
<br />_l m a.hPt udd SetiM
<br />-8.
<br />& P C fc this @d.
<br />!4BTEBICAMIIdIAIIOIT.DECLABAITAN
<br />I h*by .ffim uda parlty of pqjury @. ol lh. lollowinS d6l-.d6r:
<br />I l8vc &d *illnaatdn. Canli.{G ofc@6r ro S.lf-|ro@ fd *dt B' cmFuarioq a povi&d for by S..tid 3700 of ti.
<br />Lalq Cod., fG th. Frfmcc of dt wort for whid lh. Fmil it ilsu.d
<br />I harc md oill rEnt j! vdt6' @mpaEali@ iBum@, a r.quircd by S€dor 37OO of th. rrbd Cod.. fc dr. p.rfdfuc of d:.
<br />wd* fd whicl lnt Fhn is i$ucd M, *s*6' mpdsarion incuMe cdid ed poticy nmb6 ecl
<br />?olicy NMbe Erpic:
<br />(Thk scdioi nad nor b. cmpla.d if Ih. Ftrit ir fd on hurH dolle lll0o) s16)
<br />_l eniry dr.! in th. FforM@ of lt! qott ra which d!i3 pqnit i3 is@4 I 5h.ll .o. oploy ey DElw in ay 'lled $ a io
<br />bclm iubj€r b lhc qdta ' @mp.i$dd l.s of Cslifdi!, &d aE € 6d if I rhould bccoft sbjcd lo thc wat6'
<br />cdpd&tion psvi3i@ of S..ri6 !?00 of {r kld Cod., I .hall, fdrh*i$ ffiply pnh th@ Fwisie].
<br />wAilllNc: F.ilr 10 ie@ s6k@' ceFns.lion @v.a8. ir ul.wfu,, dd 3h.1, dubj..l & @doy6 10 qimir.l Fdd6 ed civil
<br />6n6 up ro on. hurlrld rhowd dolln (l I00,000),iD .dditi@ io th. .61 of cmFuad@, &nag6 a prwid.d f6 thc ScIio 3076 of
<br />thc tihc cod., inrdrr ed 6nm.y's fd.
<br />LTC'NSEI' CONARACTOnI| DECI-AiATION
<br />I hcb, .tI,m uda pa.lt, of Fjuy th.t I m li6!.d u&r prcvirim of C'tar(.r 9 (ffiaci.t wih Sedd 7oo0) of Divirio 3 of
<br />$c Bulincg &d Prcf6li@ Cod., Dd hy lir@. is in tull fo@ ed .fi&r.
<br />t -za./a /
<br />coltrBuqtrolrDlDrtcrctNcr
<br />I h@by ofim und.r FBIt, of Fjuy th.l th@ tu . cdEfucrio l6dir8 .96c, fd thc Frfmre of Ihc w*t f* wtich $is pqnit ig
<br />isu.d(sc 1097,Cie. C).
<br />AIEUCIITL:DECI4BAIIO!
<br />D.mlilion Pnill-Asb6rG Nori6c.ri6 F.{Ltrl R.8ukri6 (Tid. 40. Pan 6)
<br />_ R€quiEd ktt rof No1ific.ri@
<br />_l ediry tnal 1h. f.dqrl E8ul.lids EBadinS sb6b @oval e not appli@bl. !o thi3 prcjrI
<br />_ I 6tify th3r I h&vc Md thi! ap?li@rd ad sta. $ar th. o6ov. inlnEtid h cdMl I .Ec to @mply ei$ all city dd Couty
<br />ordiMG &d Si.!c La$ Eldlng lo building @muucti6, od h@by etoda rcpGdtaliv6 of lllis Ciry md Couty to cnid upon th!
<br />abovc mntincd propdty fd inrFcri@ pu?G6
<br />^prian u aats;s.,
<br />-
<br />Y z - p.,..<--/.', /
<br />tD/stG.COMMENTS
<br />fT
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