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PLUMBING.INSPECTOR RECORD
<br />Omd-Build6 DehdlioD
<br />Ihd.byafftrmu ldp. lty ofp.dlry tiit I u qchlt fom tlE ContrldoE Li@ns. Lw aor rh. followin8 .60, (sc 70] 1., Buin6!
<br />tnd Prof6lion Cod.) Any City or Couty which r.qun6 r Fmir to 6N!ru4 rltd, irr,or, dcmolirh or rq,!n.ny n udu.. p or to iu
<br />nruM. .b. r.qut6 rn. .pplism lor rlch pann to fiI. . 3i8n d lElm.nt ih.r hr or !h. i. lic.scd pu*et lo dE proviiioE of thc
<br />Corhcrorr Lim.J L.e (Cllpra 9, Conm..cirS wirn S@Iioa 7000 ofDililior I of dE Buin6 &d Prcfs.ioN Cod.) o. fi.l hc or
<br />rlt. i. dcnpr 6a.non rnd lh. brn for (h. rllcB.d dcnprion .Any viohtior of S.dion 7o3l 5 by rn, rpptionr for ! p.mn rubj.cB th.
<br />lppliqnrb.civil p. lty ofnot m,. rh.n tv. iundr.d doll.B ($500)
<br />_1. !! osc, ol dc pror.ny. or Ey .Dploy6 wirh w86 !r dEir ioL @orcoerior\ eill do rh. *ork !d lh. !t uduE b mr i.r6d.!
<br />or olt r.n for ul. ( Sd 70a4, Buicr rnd Prorario.r Cod.: In. Conhqor't LieM kw doa mr lpply to u ogu ofilrc propdy
<br />wh6 blidr or ihpror6 ta@r, .rd who do6 reh worl hiru.llor hd!.lfor rtuolsh ii! 6, ha oM.dplolc, Drovid.d 1h!r ruch
<br />iop.oEncnt! ac rct iiI.id.d or ofi.r.d for la Ii how.ver, rh. buildina or inprov.m.nt n sEwirhh orcya,of 6hpldi!4 Utc
<br />Ownd-Buildd *ill hrE th. burd.n olprovine lhlt h.ot eh. not 6uild or inpr.rc lor thc purlos. oa r.l.).
<br />_1. !! oMd of th. p.oD.ny, rn qchsiv.ly @nhdins wnh lieN.d @nhcrou !o @Bto.. d6 ,roj.d ( Se ?044, Buinsr .id
<br />Pble$ion Cod.: Tl'.Co drols LieM L.w dG @t.pply to.rowd ofpopsty vho b{ild! or improvd r,r.ron..nd *ho
<br />.onr,rcE for rucl' prci4 wih . conhcto(, Iic4.d pu4u lo dE conrtuto* Lierrc t w )
<br />l.6.remfl und Sc.tion ,B &PC lor lhB,oso.
<br />WORKERS COMPENSATION DECLARATION
<br />I n.r.hy llfirn unde, rcmlry ol periury on. of rh. followins delrdioN
<br />_l h,v. ind ull mrinllin . Ccnilidr. oa CoBnr ro s.r-rBur. for work.tr comp.aaiio'r ,s p,ovided for by S.clion r70r of lh.
<br />Lbor Codc, lor Ihe p.fo,mn@ ofrt. wort for which tlrc p6oar ir $ucd
<br />_l hlv. lnd will trinltin wortdtr @hp.uton 'nturiM, a r.q!n.d by Sfttion 1700 oarh. bbor Codc, for orc p!,fomie offit
<br />sork for whrh rhts,.rm B Nu.d My $o' t.R' @mD.nrtron rnruBnc. ar I '.r ,nd pol'c, numbd r'.
<br />c!,,i., Etzr.rt Nla{,-^a. I I
<br />WARNING: Frilu! ro tu work$ conpc@tio! @rGr.B. i. sl.wffil, iid !h.ll rubjer u .mploFr !o dinin.l P.Elri6 rnd .ieil
<br />finB up |o one hundr.d rnou!.rd dollu (ll00,000}ir rddition to d!. @ ot@op6Mtio[ d.dg.! s prcvid.d for 6. S&1ion 3076 oa
<br />lhe L.h.r CodG. intdqt ind rllorn.y i tB
<br />LICENSED CONTTACTORS DDCLAN TION
<br />I hs.by .flio undd pcuty of pajury rhlr I & ti@.d undd provi.ion of ChFe 9 (@ma.i.g eil1l S.clior 70Oo) of Divnirn I of
<br />rh. BBin.lt rnd ProfqsbN Cod.,.nd oy licc@ i! i, tull fore rnd.f.cl
<br />Li**ct*, ECbtL__
<br />D.,. +/r-com..6o!
<br />n
<br />CONSTRUCTION LENDING AGENCY
<br />I h.r.by rlrtrm und.r p.m lry ol pcrjrry thir th6. i3 r cosrruction l.dins rs.ncy lor fi. pelfo.mie of rhc eorl for whth l1li! p.,in is
<br />asued(S@ 1097. Civ C )
<br />AIILICANTIDICIAAAIIOtr
<br />Dcmlitioi Pnnl!,Arhglo! Notfierion F.dcnl R.subtioN (Tilb 40, P.n 6)
<br />_ R.!uir.d L(d of Notifiorio.
<br />_l cdily rnd lh. f.dd.l ,.8u ht io.s .c8rrding Bb6ros rmnlr. mr.pphebl. ro thi3 pr+d
<br />_ I c.dit th.t I h!v. ad thi, +plisri.n ud n r. dlr th. !bov. inforn io. ii @,ic(l I .gre ro @hply with .ll Cny lnd Counly
<br />o.diDnc .nd Sfic Llp! r.l.li.! to blilding .ouuuctio[ {d ho.by ruth.ria ,.pr4ruriv6 ol $ir Ciry ed Couly lo dtB uroi rhc
<br />,bov. B.ntior.d proFfiy lo, isp.dion puposd-<
<br />APPROVALS DATE to/stG.COMMENTS
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Underfloor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarifier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Pipeing
<br />Roof Drain
<br />Rough Water Heater
<br />POOUSPA
<br />P{raplDrain Line
<br />Main Drain/Pool Piping
<br />Pool Heater/Gas Line
<br />Misc
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbing .)l9 I tllN.-/
<br />Final Gas Test a I
<br />Meter Release
<br />I I ,lilh-.-FINAL t'l
<br />Notes, Remarks, Etc
<br />1\P6.mrt'lnspeclion Forms\Ptumbrng lnspocro. R€@.d doc 03 31 06
<br />Lucos tr/o//<
<br />Tub/Shower Test
<br />Fill Line/Back Flow
<br />'11
<br />OvG:
<br />r"riryN",u- 76@oo/3o1 /rl e*"*. at/z/tz
<br />(Thsdionrc.d mlh.@npldd 'f rh! rdhtr tr for Orc hundr.d dotLB {tlool or 16,
<br />_l e.tily rll h 6. psfordtu. of th. *ork for whi..h rhi! Fdhn i! i$!c4 I !h!ll nol eploy lny pslon in .ny ms uo a !o
<br />b€M. rubj.d lo th. M.ks @mp.nsrion L-! ofcrliforrir ild !s@ rhrl ifl iiould b.@e iubjer !o rh. world'
<br />@Dp.Mtion provnioB of Selion l?00 of rlE lrbor Coi., I th.ll. fonlNith @dply *ilh thc. proviiiotu
<br />,". 2/q/z ^u,'-*. Lr.o.L ' U
<br />?/4y'2-
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