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PLUMBING]NSPECTOR RECORD <br />APPROVALS ID/SIG.COMMENTS O*n6-Burldd D.cld&rid <br />I hRby.fiim ud6 pc,.lty of pdjury !l.r I dn cr@d fa.h lh. Colr&ioB' Lic6$c Law ftr thc aollowin8 las {*c ?031 t B6in6 <br />sd Prof$ioi Cod.) Aiy City d CouDty *nich r.qliB t Fmir ro c@no4 .lla, imFov., dnolish or rcpli, uy sr^crur., pnq to iB <br />issu&@, ds Equid rh. rr9lidr for 3u.n Ffrit ro fi|. . .iiD.n sut.Mi t I& h. d slE is lians.<l puEuot ro rh. provitioos of lnc <br />Co.redt U@*d Llw (CiTr6 9, C.Mcing witn S&lid ?00o of Divirio J of In. Buin6 xd Pmfdsiss Cod.) q lhd h. or <br />sh. h dxdpr rh.Efim &d thc b.!i! ld $. .ll.8.d lxcmpiion .Any violadon of S.clion 703 I 5 by ary applicd fr ! pqmir subjccE rh. <br />sppliet !o . .ivil p.arlty of nd h6q tta fivG hundr.d dollB (t500) <br />_1, a (M6 of th! Fopcny, dmy mploy..! witn v.a6 $ rh.ir 5olc cdFtulrjq, will do th. work od th. smduc ir nol inrad.i <br />or oftc.<l fd edc ( Se.7044. auin$ &d Prcfdi@ C!d.r Tn. Cdmddt Lic.@ Lw dG nor apply to a ownc. oliE prop.ny <br />who build! 6 imFovB th.:@, ed wt'o dod iuch *o* hielf o. helf d 0'rcudt ni! d ltd o*n cmploy6. Fovidcd fill such <br />improvmE e nor inlddcd d ofld.d fd nlc. I( h@.vd, rlt. blildi.s n imprct.Mt is sold *i$in onc yd of @mrl.do., tn. <br />O*nd-Auild.r will havc lh. b{rd!fl of proviry lhal hc or rh. D.t build or ihlrov. fd th. purpos. oa sal.) <br />_1, a oMaof {to proFrly,6 dduidy 6rr&rin8 {irh lim.d @rde io cdltrrct tha prcjcd ( Se ?0a1. Bui.6 dd <br />ProfBrim Codcr Thc Cotr..lo'3 Li@!G lre .tG not !p?ly to u @n6 of pro'pcny who buil& q idFove rfiq@n . ud who <br />cofte!. fd !u.-h Fojell wilh . cot!.to(r) li@&d p{E6r ro lnc cnr..lqt u€t. L:, ) <br />_I e.xmprw&rS4f6-B. A PC forrhi! l!.s <br />WORKERS COMPENSATION DECLARATION <br />I hrcby aifim undd p.n.lry of p.il ury on. of rhc folldin8 d.€lorations <br />_l h!!. dd wil!minl.ii aC.nificlt of ConsorbS.lf.lEurc for vork@i @pasation, s proyid.d rd by S*lion lT0oofrhe <br />L.bd Codc, fd th. pdfffie ofth. sorl fd whi.! $G Frrit i5 i$u.d <br />_l hav. sd will minr.iD wqt6' cmparlrio. iBuMe. a r.qun.d by Serid 3700 of rh. tjbu Cod., lor !h. p.rromucc of th. <br />wort for uhich thk Fnir i! iriu.d My wqt6' corqEai@ ii5um@ qh6 Dd policy numbq {. <br />J/nt $d i ti. pal.-u@ ot 6. wdt <br />b?6mc tubld lo rhc worl?s MFtrd@ I <br />lm ehich rhir p.Dn it islcd, I sh.ll <br />.*s of Cdifc..i., sd a8'e Od il <br />700 olth. Lalc Cod., I shall, <br />WARNING F.ilur. to ec!rc wdt6' cmpoa.d6 <br />fin6 up to on. hundrcd $N-d &116 (r100,000).in <br />$. LalorCod4 i .16r od anm.y'r 16 <br />d!m8d 6 provid.d 16 dc <br />LICf,NSED CONTRACTORS DECI,ARATION <br />I h.Eby .mm un&r podty ol Fjury lh.r I 6 licd.d und.r p6vi3ion of Ch+i6 9 <br />lnc Bsins Md Pbfdioi Cod., {d ry li..E it in full fdc dd.rer <br />o <br />I hcrcby amm urdq pcn!]ry ofpajury $d thfr ii..@Eu.tim <br />issu.d (S( 3097, Civ C.) <br />of rhc *ort for which lhis p.f,il i3 <br />AIILISINIIDECIdIAIIID <br />Ddolitlon PmiG-Asbcsrd Notilic id rcdcral R.Suldios (Tnlc 40, Prr6) <br />_ R.quir.d L.nd ol Notifrdlior <br />I lgE lo conply wnh lll City dd Couory <br />16 of lhis Ciry <br />'rd <br />Cou y lo dtd <br />abov. m.niorcd popcfty rd irupetion <br />-<Uzzo(.\-\J - 7 -7 <br />77 <br />o <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 />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 />FYD IEtEN <br />lglgh Plumbing <br />Final Gas Test FEB O r 2019 <br />Meter Release <br />FINAL <br />Notes, Remarks, Etc. <br />DATE <br />Waste & Vent <br />(This sdion nc! nor bc @mpl.&d it th. p66n is t6 on. hundEd dolla l3l00l d le.) <br />-------T------ <br />= <br />= <br />=