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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />UNDEH GROUND
<br />Waste & Vent
<br />Water-Under Iloor
<br />Gas-Underlloor
<br />Building Sewer /,..,
<br />rq;ealS4orrn$rais lr-, at-jrlFt h&ttl
<br />lnterceptor/ Claritier Y' nY " ll/
<br />I
<br />TOP OUT
<br />Waste & Vent
<br />Water Pi prng
<br />Gas Pipinq
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />Main Drain/Pool Pi ping
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Gas Service
<br />Water Service
<br />Lawn S prinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />/,ttt xtYtX4Bough Plumbinq ln lb a I n-/
<br />Final Gas Test
<br />Meter Release I
<br />FINAL ll),tY dvqt* t n/
<br />Notes Remarks Etc.
<br />OWNII SUILDET DELC RATION
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<br />llutiftir 1n l\of.sii c{rLr Aiy Ciry or ('oudy rh.h Elun r . Fmi b .r{{d. !lr.r, ,nvrnrk, d(mlish or eF ..y
<br />lrdlE . Frr h {1 ir.l)ti, rk Ertonn rlE rt'ilixn n, rEh Fnu ro liL. rBEd (dcmr rndl lE or {E ! |ft.{d ,rlld
<br />n! rlE FovrIB of rlt Connxftr'r l-irnsn l,w lcn flc. 9. ('.mmBr8 *nh Sft[rn ]Un or Divrbn 1 nr rh. auriN .rd
<br />Pnnc{rio.s Cd.) .r rhrr h.or rlE r.r.nnr rhccfrom lnd rhc horn itr rh.lllcB.nGr.q'rion AnyrirnorbnolSdi,nT0.llahydoy
<br />Ellru.r for.IE.n rubFrr'h. ll,pli.mr ro.civilFekrormr mEIn n firc ho'nrd dolbl ( l5lgr
<br />-1,
<br />u wE .l lll FoFry. q iry cnpl,Fr ,an r.rd d rlEi -k o.Frrrta *i! 6 tlE kt d dE -ldE it d
<br />i,rqi.d dolldtd aor.L (S€.704a, BEiK.rd PmGBndC6d.: Tt C.rb.tur.t Lj.!c t ,&.ridTpl,16Do}cof
<br />rL FFq llE hudr r irTrDE tlEa &d yho d6 at &it hirelf d h.dlf or rl!@ln hlr d lE oM.nEbr*r.
<br />Fovld.d ftt ryt irFoccilcer ardiLd doeld h..t. ( lr*E, dE tet a nFo\dEn b ro! riri* )6o,.o!plrir, d! OrG & rin hE rh b& d, Flvit 0r li a lE dd |Dl bl! a h!.oc rlE FoFr, 6.lt! trF. oa
<br />_1. .. olffi of ltE FlFrr. 6.r.b!lEl, Nnurrtl' *n! l.tnl.d odr-r6 ro @rdiEt 0r FoF.r (5a. ?0a4 SEIBtn Ala.nE Cod.r Tll C.,r.Erd r Li.tr t, dd h..epl, to i orE ofFlFry rlb boiLr. d i,!68 dEe!
<br />.!n *to 6d-lr fd *t FoFt rth . Co0!rql, lbqEd F od lo rb C.drror'r Li.c 1r).
<br />lr . (rxk.
<br />ruaE3sl;rluMAsa.rlrJ.I
<br />uli(laSdJlQN
<br />I h(r.hy !lfi nutr cr NMhy or tE)r,y onc ol rlf, n,lL,* nrr (lNbr inni
<br />_l h.E rn ltl nh.h. Cdtif.r. of Cocn b S.lt-l6c fq iqta'q+.irtir. F.r&d h. trserbi 37& of rb
<br />t ad Cod. fo. rlE Fft.N ol rl! Et ft. *ici rb Fd i! i.d.
<br />-l
<br />hovc .nd sill .rlinrain worl.h conp.nrdbn iNUr.B-'.- .r rcquircd hy S6thn ll rrx) of t,E Lit or Cod., tu lh€ F,fomEkr ol
<br />llr sort ri, r hah rhir Fmn ,i !(ud M, r*ld on{Enrrin insrrN. !-eir . Fnay nuntE. &.1
<br />1..'tr\rhr rrlf,Nr[{nu,k(tirrri\iili,!r'xl,rr,.t\1 nr \,\!ril l.[l\lLr t\itr\trr!!rr]a\nrfNr
<br />e, .$ni r\r,n'r n'l'r\r i, rlk {t '1.'\ (rqrrN.(r[ l,'r!n l,!r'n,n',,.. tr|,,t,.( rh. rlI.lr,Ll(lh\lrr!rhf\Ir,rh
<br />ii ml,tuL .!n lul obirr d dpbF b ahid F.lir r,td
<br />.ddnior ro rl! &ir ot onFd.rio[ dmlEr $ FoviLd for rl!.Ml 6ftr up lo m hurtd lhorsi dol rtl
<br />srirtrr 10760r rh.lf,hr(iin cr.{ r d
<br />l-B-^
<br />D!;llraarla!
<br />I hrhyn,firmtrnJ( p.nrhyoln Uury rttrrIrr ifr$lu drRrnMolqpto'r(lrnrr.in**ihSa1i,.r((X)rotD!!Ni,.1
<br />fl rh. au\ft\\ ,nl Pr,a.stnn (ixlc. rnl nrv l(.nc n h r! ll ran! !'rl .frirr
<br />(:oNsTxuc'noN r FtDrrt(: a(:ENcl'
<br />I llrut'yamim[rt.r Fnllry f lrrrxry rhd rhd. ii r cnn(tocr htr lcndinS !s.Ny l'or rh. Isformn-c oI r,E smt lor rhkh lhn ,r,nrir ir
<br />i.t!.d rS$ .xre?. (ir C I
<br />A'PI ICI T DECI TRATIIIN
<br />I lEtr,lrm! lcr Fut y ol Frlury oE or rtr folbrin, d.<lfia6nr:
<br />I)cR'lilhn P$mik.Arh.Nor Norifi.{irn ttd.hl R.euhriont (Tilh 40, Pln6)
<br />-R.r|uircd
<br />L.rrd ol f*rildrr
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<br />I .dify rh, rlE ,inc..l EfuU, iom ErrnhS .sb.{o\ hmrvd e nI r0plr.hL h rhu 0mrn
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<br />.diry lnd I lrE rc.d rh! lllpli.di'n 1d d.r. rhd dE dr,r in,o.rdii n .on6 I(dirE.. .!n S[r. t,rr Elral
<br />.tiot iE i.rr.d ,,spdry ld
<br />Appllcdtrl or A[rnl Slltmlu
<br />trAC rvrt-n V
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