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PLUMBING{NSPECTOR RECORD <br />APPROVALS DATE to/stG.COMMENTS o*ra-Build6 D..l.nri@ <br />I hcrcby rffim urd.r p6il9 of Frju/ lh.t I I exall$ fdm $c Coilr!.loB' Lica!. L.w for dt. follo*iii r..s bc.?O | 5 Autitst <br />ed Pofdrioi Cod.): Any Ciry or Co6ty *hich rcauir.r . p.nir io co.rt!.r ilcr. irnprot. d.frolish or rcPlir uy tttlcnft, Pnor o iB <br />ir!@*, lLo Eqund lh..pplicMl f6 flch p.mn !o fil!. riFcd fimni $.r h. d th. i licot.d p@uxl !o th. Proviiio of$. <br />Cont .lE! Licd!.d ki (ChrPr6 9, C.modn8 eilh S..to ?OOo of Dvki6 I of dE B$ind -d lrcfdliot C6d.) or rni hc or <br />rh. ir adA thdfton ed $. b.rh lc th. .tl.r.d d pli6 .Any viol.li6 ol Sedo. 703I J by xy .PPli6t fc. Fhil !!bjca! dE <br />.pplicst b . civil Fndry of no. tle lhD fiE hu.&.d dolttt (ltoo). <br />_l, s oqi oa $. FoFry, or ny 6ploy6 pith *!ss s $.t sl. @mr!.!niotr, will & th. *ort ed th. trtuctr it rct i.rad.d <br />or o6a!d r* !al. ( se 7oaa. Bsin6! &d Prca6id co<L: Th. coteff! Li@. bq do.. not .pd, ro e omd of $. prcFny <br />who buil& n imF.vB lto@, url who &d rEh e!* hitrt .lf cr har.lf d rlrdlh hit d ia M @ployq.) Fovid.{ rlrrr et <br />inprcvddu e tol intadcd d oficEd ln r.lc. li howcvli, 6. buildinS d imprclmot it tol.l wiinin dc y6 or cdplcd6, Uc <br />Owi.rBoil<k will n.v. tt. burd.n ol provin8 t.l h. or rh. nol build o impN. for dE pu.pot. of iik) <br />_1, s M.r of !h. pr.r.ny,6 *clBilcly c6E&tin8 eilnli@.d @rer6 o @tud lhc projer ( S.c 704t, Bqi.4 6d <br />Prolcrcion Cod.r Tt. cont .1dt Lic.N l, d6 nol .!ply ro E oMa of gropcny who builds d imFovs 6co . &d who <br />co.ntu lor luch prcj..B with a cdF&ro(, lic@d Puruer io fi. coht&rors Li.aE L!w.). <br />_l 6 .xhpr 6dd sc.ri6 .B. & P.C. ru rhir @6 <br />WORKERS COMPENSATION DECLAIATION <br />I h@b, rflim udr pcralty or pdjury on. or lh. folloqint .lccla.nonll <br />_l h.v! sdwiU m.inhin rCarifid. of C6rar toSdtlBurc fq w id'cohP.ntd6, a [@vid.d fo by Saii@ 1700 01lh. <br />L.bd C!d!, ln $. p.rfmD@ of rh. wdt fd which lh. pmi ir isucd <br />-l h!v. ud willmlntu *6tcr'' .ohpcn$ri6 i um4,! rcquiEd by S..tion 3700 ofdc L$d Codq, ror$. r.rfono@ ofln! <br />vork ltr which $is pmir ir i!ru.d. My voi(6i' cmFnsadon inlt e csic -d policy hunbfi 4. <br />Ohn &clion rdd nor b. cmpld.d if th. pmn i! ror On. hundrcd doll4 {$,00 } 6 lB, <br />,"d,6.,"-i ${ in rh. psfol!'ltnc. of th. wot fo. which lht p6nil ir i!!u.d, I lhtll <br />l.* of cdilmir &d.Erc 0t{ if I <br />rn. Llbc cod., I rhdl, f*rhwirh <br />WAAMNG: !6iluF b rew qo*6r c.tnp63rri6 mployaro dmin.l FnahiB..d civil <br />fir6 up to @c hud'cd douad &llc! (tloo,ooo),in e.tdiiid to rh. <br />rhc L!!d Cod.. inld6t &d ro crt fet. <br />B proridcd fd rh. S..ri6 1076 of <br />IJCINIDD.CqNIBACIIIBIJECIdBAIIAN <br />I t@!y rnifr ud.r p6.lty of prj6y rhd I m lic.ucd udd p6!iti6 of ch4iq e ( <br />tllc Bwir6 !d PrcrdiN Cod.. &d lny liclM ir h Nl fo.c. rrd .fe! <br />I h@by dlim u.d.' pdslty oaFjury lh.l th@ h . c@ruc{on <br />i$!.d(Se 309?, Civ. C.) <br />. F fomM@ ol rh. {ort lor vhich thir plrhir ir <br />AIILICASIS.DICIASAIION <br />Dsnoli!'o P6hiE-&b6t6 Notificlio rcd6.l Rcaulniou G .40. hn O <br />_ R.qotld L.n6 otNoli6cnioi <br />rcmovll e iol.rPliqblc to rhi3 <br />ro @mply wirt .ll ciry rd cou.ry <br />of rhi! Ciry ed CMy to 6rt <br />!bov. marim.d prcpcny for inrFclid <br />UNOER GROUND <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 />Lawn Sprinkler <br />Sanitary Sewer/Cap <br />Back Flow Device <br />Rough Plumbing EXPIRI :D <br />Meter Release FEUUI tul9 <br />SI MC 8-43 20n <br />FINAL <br />Notes, Remarks, Etc, <br />Waste & Vent <br />Water Service <br />Final Gas Test <br />I <br />-----r----- <br />--+-