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PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNE[ AUILDER Df, LCAiAIION
<br />I hd.by ltfm udd p.Mhy of lrjury lh.t I m cx.md fmd th. co.n6clon Lic.bk Liw for rk followinr @$n (sd.?ol l 5
<br />Busincis lnd Pma.ssion Codc)r Any City or Colmy which rquire E tdnit lo o.srru€|, ahd. idtmvq ddDlish nr Eptn nay
<br />sltutu., prio! to irs istue, als ..quiB th. arpli.dl fo. $ch p.mn io 6le ! dr8.ed $ltff.t (h!t h. or.,E ir lic.trsd Pumanr
<br />to rh. Ixovi3ioB of llE Co r.cl4l Li..n.d Lle (Chafl.r 9. ConmBin! wnh Setion ?000 of Divisio. I of th. BudMr .nd
<br />Pof.shtu Cod.) or $d h. or !h. b .i.r{ rhcnon ad rh. nr3i for t}E allc8cd .rditl ion. AnrviohionofSccriof,r03l.5byany
<br />r il'c,m for6,.mil bjfls rlF al,llicmr ro s civil p.Mhy o I hl mr fiai lia. hu.&.d d6llm ($50l)).
<br />-1.
<br />&e own.r ofrh. Io|l.ny, or ny.mplotld wilh wag$ ar lh.n mk cor{E llion, willdo $. mrt md tlE.iru.tuE ir ml
<br />int n,.d or ofcEd fo. sl€ (Se.7044, AlsilH Md PmfcsioB Codc 'rh. Conlrclo* Licc* L.w &.i bl lpoly to u ow.6 of
<br />rh. I,.lcny who tuildr r iqmc lhssn, .d wls rtE sh wlt niMror tuelf o. llnou8h hi. or ,Er ou cmrloltfi.
<br />rmvid.d thd scn iqmEEn& eer ifl.rd.d or olM forsl..l[ howffi,ltE hlildns or inlftEntrr & $ld within ox )dr
<br />of@nplth[ rlE owftr Buildn wiu tEE rlE bunkn ofpoving drd lE or dE dl, ml hild or intmE th. p'olEly t', dt FulFs of
<br />l, asowrcroflh. pmp.nr, 6dclu.ively6ok0ding wirh lienkd onrrdoBrooddtucl rlE pol.d (se.7044. gusins
<br />and Pioft i,nCod.:1'h. Conr.lcror'! Lic.trE La* dcs mt applyto downd ofpmr.nywho hildro, iotiov$ lh.rol\
<br />and eh. @or6cti lbr flch p6l.ds wilh . Conlr..ro(3) lic.nrd ,uEu!,r ro rh. Conlnctois L&nt L.w)
<br />_l m.x.6fl und.. sd
<br />lr9!x[8s:col!8Ers4lr0B
<br />DISdAAIIIB
<br />I h.r.hy,mrnundcr Fnrlly of Fjury om olthc rolb*ins deladxoE
<br />-lhav.andwilln.inr.ioaC.dificarcofCoNorloScla-lNur.nnworl.Bconr!.n.0lion.tsFmvidcdforbrSdidnlT00ollhcLah.r cndc. hr the Dfl lom.*c nfrh. wo* nv qhich rh. n.mr 'q
<br />is,.d
<br />yl hak r..l w'll h nh'i wo*.R (onntnsrrit,n rnsmm., as r.qun.d by slcrnrn l?00 ofl h. Lnbor Cod., lor fi. pdf.mam. of
<br />ih. work for shi.h rhie D.mn i, irsc.t My wo*6- @mDcnsl ion ins..mc ctnrer a,Id Flicy tumb.r a.:
<br />c**, I Wt eLV,D 0@FArsUt'ttAL tt/Sul,+lee
<br />ON 310 1 06 zo
<br />I c.nify rnd in lh. r.raomE olthc wolt for s'hich rhi. ri.nnl k hs.d, I shrll mr cdtloy aoy r.B'n in tny Dstu.
<br />$ as ro l,€ee $bjd ro rh. w.!t6'omrlasrhn h* ofcalifodi!. tnd alG rh.r it I shuld h..otu subjd r. rh.
<br />wo*od smr..erion tmvhions ofser ion l?00 oarh. L.lnr Cod( I tEll. aorlhwith onply *ilh rh.* povirk B..
<br />WARNINC: laihc ro suE workdl mqlMslion svcms. is uiliwfll. dd shall flbid an.mplo}!r lo dihiMl ldEllig and
<br />ciail linc! !p ro orc hund..d rh.uerd dolhB (S100,000), i. lddnirn h rh..or olcomP.Mlion, dams.i a! pmvid.d ior th.
<br />Sdrian 1076 of rh. t,tEr Cod., i .ren dnd rfi orn y e f.n
<br />o
<br />Dl( l.AIrr\Il()N
<br />I h.ESy afiim lidd Fmhy ofrai!ry $!r I M lianrd und.r nmvtubn ofchapld 9 {oltwmins ,nh seaion 7000) .f Divtion l
<br />of th. BlriGs and PofdoN Co&. dld my lhm- i! in tull foE atd.lldr
<br />76G25 +
<br />l/zt / zo F€ L\F€ \.,
<br />(lJrsrB!1CIIl)LLIItrl}(itqriN(r
<br />LqdE'! Ad&*
<br />-
<br />AIII,TCAtrLIIICLABAIIO!
<br />I kret1, inilh undd tcful'yofr.rlury one ollh. nrhuins dccl.r.rionsl
<br />Dcmlirn'n Pemils Ash.str Norific.lon I'ed.ril Rqll.rnns(l irl.40, Pan6)
<br />_Rcqunrd Lder.f N.nfi orm
<br />/ lcdrli rhnrrhe f.dr','1 rc*DL''on eEml'ry a!h.n,tr'. nrnl.'e n.t inrr(.'hl( 'or\tnn,*.'
<br />-Ll cd'rj rh llan. rr.trl rhr onn 'c,r'otrrnd {Jre rharrheatnre rnlomxinn tr coftrd l.sreroomPlysilhallc(yandCounty
<br />odimncs.nd Sratc ljBs ELr"r8 lo huildnr8 conqrucriol dd h.r.ty !uiori2. rqiEs.nidiB oflnh City and Cotr.ty ro ..'d upon tlE
<br />rboE ,Bnr io..d ,,mr.ny fo. iNt crhn
<br />Appllcntri or Agerl S,RMlurc:
<br />P.rnfi.c nin,. Onnr) (
<br />"rrr+-e
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor
<br />Building Sewer
<br />lnterceptor/ Clarifier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Piping
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />P{rap/Drain Line
<br />Main Drain/Pool Pipino
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbing
<br />Final Gas Test ilr212il)I fuiW,{6
<br />Meter Release tt II /4
<br />FINAL 1ru,/a/0 {ufail 760
<br />Notes, Remarks, Etc.tl
<br />I hrr.by artrdundcr r.Mlty.f,,erjury that lho. is a Fnsrrucl'on Lndn* aEency rhr rnc psft'nEn.c olrhcsork lor trtichlhis n€mr n
<br />hs.d (Ss 1097, crv C)
<br />l.enrle''i\"m(
<br />-
<br />Area/Storm Drain
<br />POOL/SPA
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