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PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE tD/slG.COMMENTS OMa-Build.r Dcclmloi
<br />I hacby .flim uidd pallry of pcrjur, $!r I .h cxorr fm lh. C@n*rdr' Li6* kw for $. followin8 @d (@.7031 5 Busin6s
<br />rd Irltdioi Co<L): Ary Ciry or C@ty which r.quin! . p€nir to c6!Erc! .|i.i, imFrovc, d.Dolilh or rcp.ir ay intcrurc, prior 16 i$isuc.,.lk rcqui@ dlc appli@r fs lud p.frir to fil...iFd tr!lc!6t lh.r hG or shc b li@i3cd puRuur ro $. pDvki6! ol$.
<br />C@r.crdt Lic€B.d Llr (Clup.6 q Cmna.iru wirh s6don 7000 of Dilirion 3 of lh. Buin6r Md prcfdie! Codc) d $.r h. d
<br />sh. h qeh/ thcftoh ed lhc bBi! ftr dr. dlcS.d .raiprior .Any viohtid of Sc,rj@ 7011.5 by &, ,ppli6r fn . p6nn llbjccr $c
<br />.p?li6r ro . .ivir Fdry of trd !t@ 0E firc hudt d ddte (1500).
<br />_1, a (M.r of rhr F!r6ty, d my mploye with *.a6 a lh.ir sol. cdnpar.lio, pill& d. wdl dd lh. mduc is .or im.ndal
<br />tr otra.n fo 3.1. ( S6.?0aa. BEin6 sd Profeid Co&: Tt. CdE .rd'. Ucdc i:w dq .ol .ppty to d om.r of d. prop.ny
<br />who buil6 d imp.o?6 lh6!oo, fll who &. ruch *61 hiru.lf or h@lf q 0rqsn hs q hu own oDloyei Drovi.t d fial lch
<br />iEprcv.1Ml! e nol intcn.Ld d orf.rcd for !.1.. Il h@ffi, dc biildiry d ih!@vtur is rold wit,i. oc y@ of @mpldion, lir.
<br />Owia-Build6 will h.v! $. boik' of Foviig thsi t. q th. nor build or imForc fd lhc plrps! of s.lc)
<br />_1, a ou6of 6! FDpaty. e crclcilcly dr&ij.8 wirh lichtd dri&ro6 bcwEucl tic pojar ( sa 7o,aa, B6in6 d
<br />Pmr6i@ Co&: Tn. Conr..(d'! U@* L.w dc nor !rp, ro & Mc' of prcFty sho b!il& 6 inrrovB rha@ , od *ho
<br />@inr.1! fd r@h prcj.dt ein r c6rald(, li.a..d pEur ro rhc cdrsldt u6s Liw ).
<br />_l e .xEnpr udd S@ri6
<br />-8.
<br />& P C. for $h l!.o
<br />WOII(ENS COMIf, NSAION T'ECLAIAIIOII
<br />I h*by ltfid urd6 Frlry or Fjury @ of di. followil8 d4h!.ri@:
<br />_l h3v. Ed eillMinriii 3 Cdrin€r! olcolMt io S.lflBG lor edLd.cmD.Drcion, s Fovidcd f6 by S*r'o 37OO of lh.
<br />kbd cod?, r60E F froe of thc pdt for which th. Fmit i! i!su.d.
<br />_l ha!. ed will roin6jn wat6' @np.tu.lior iNuoe, 4 ,.q!ircd b, Sedoi 3?OO of th. L3bq Co&, for 0E p.rfom6c. of $.
<br />wort fd whid this FDn ir isucd. M, wdrd' cdp.Ertio iM.c 6ir ad poli.y nuhb.r el
<br />iolicy Nmba ElDtE
<br />zr^",,^
<br />nor b. mpla.d if th. pdtnn is ad Onq huMrcd dolla 11100) 6 l6s)
<br />thr pqfonoc. olU. eork lo which lnh pm't is ilsuc4l rhilllh.,rtd .mFs.rio lai of Crliamis, 4d !a@ lhc if I
<br />compot i@ Fori3ioM of 3700 ofdlc kbd Cod.,I shdl, fditpid
<br />/(--o
<br />WARNING: F.ilurc lo 3ccuE worl6' c6F.3.rion @!.89. is un
<br />fin6 up to oc hu.ded $oued &llc (ti 00.000),in .ddid.n b tn.
<br />ln. Labo! Cod., inr.qt ad.nomcrt fc6.
<br />a .mployd ro cimiial pa.lli6 d;vil
<br />@r of.ohF.,sdion, d4.36 B proridcd fr rhc S@rio 30?6 of
<br />I h@by .mm und.r p@.lry ofpajury lhat I m li@r.d !nd6 p,oyisi6 oa Ch.pid 9
<br />6c Buins ed Prcfdion! Co&, &d my li@r. ir in fltl tftc ud.ffdt
<br />44to
<br />mdcr p6dry oa prju.y lhd $fr is a co$Eucrio thdin8 68acy fd rhc cc of lnc wort for ehich thb p.f,i isI isEd(scc log?,Civ C)
<br />APPLTCANT'S DECL{N.ATION
<br />Ddohio. Pmilr,&b6tdr N6rifiqri6 Fcda.l R.sut.tiffi (Tid.40. p.n 6)
<br />Rcq!tr.d lrtla of Noifrcarid
<br />.bovc hdtimrd prcpcny for ingP.ctio
<br />City and Cou'ty ro 6rd upon $.
<br />{r-a)
<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 Pi ng
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />Ptrap/Drain Line
<br />Main Drain/Pool Pipi ng
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Misc
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />trx I'IRED
<br />Rough Plumbing
<br />Final Gas Test r E,fl - r (ut:,
<br />Meter Release SAMC B.4i l, 290, 556.)67
<br />FINAL
<br />Notes, Remarks, Etc.
<br />POOUSPA
<br />Gas Service
<br />L----t
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