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PLUMBING-INSPECTOH RECORD <br />APPROVALS DATE ID/SIG.COMMENTS ()WNl.lR Bllll-DI.jR Dl)-C.{RATION <br />Bu\inc\s xl P n.i\{on Codcr Atry (ity or Coufry +hich r.qutcs r p.i,ni r. .o \ru.I. rlrcr, irnprok. &nrilnh or tl3t rtrt <br />{ru.ruc, prrtu irs isn[Ec. rl$ r.quin\ rh.]pFlicrfr,nr \u.hNhnirnr lllc a sig.cd {irctEni rhrrhr.rshc i\ lr.cnrcd purunr <br />n) ihc tn,r^i,nF of r,r (tn ncr.l\ l,iccn$d l-aw (Chrpi.r 9. Co'n'nci.trrS \il Strrirr TtXD ol llivi\ion:l o, ihc llu(i'rc\\ ind <br />P(ni\(iotrsCod.) hrrh rhc or\hc tcx0nrpr rl[rrlionixnd rhc hrs\ tujIhc trllclcd crcnroion Atry!idrrio.lSccrionTOll5byiry <br />irrplicnnr knrncnlir \rhir.r\rh. at)J,liutrr k) r.irilpcndlry.lDor moc ll niiv.hu d,cddollr (X5m) <br />-I. <br />ar ow.( ot rhc pNpcny, or my cmployes wilh *s8!s as rhct sk clnqrnuiion. will do lh. wmk ud tlE shtlE b mr <br />i.r.ndcd or olftr.d aor sk (Se.7044, Busircss and Profcssjons Codc: Thc Conr|dols Li.ctrs tiw d@r nd alnly lo !. owncr of <br />rhc pmFn, who toildr or inqmB lhcmr drd vto d(B Mh @,t hituclr or h.rslf o. <br />'hmu8h <br />his o. hs o*n cqrloy..s, <br />rovidcd rhor ocn inpbrlmc G mr inlc.&tl .ftnn rd sE. lL lF*b. ir. hiBinS itr{,mwr i9 sld wirhin o* yw <br />or odpLrb.. tlrc Ovmr Buildcr oill h.w dE bitr&. of pmvin! rhll lE or $c dn d hiu o, i'r$ow dE p,DIEry fot rhc Fqbe o, <br />-1. <br />as owner o{ lhe pFp.dr. ar crclusivcly coouocrins wilh liNnsd conrado6 ro co.strud rh. pmj.ll (S( ?044, 8u{Rs <br />and Pmftssir Cod.: Thc Conltrloli Lic.ns. l-l* ddr nor dlPlylo M owmr of p,opeay wh. build! or imProv.s lhcr@n. <br />lnd {ho co'nB.rs lor su.h Imi(ls with . contnclo(, licrn*d poElsnr h thc cotulclols Ltctrs tiw) <br />-l <br />!n cxctryr und.r SelioD- B. & P.c. fot rhi! ,eesn. <br />IIOnI(NRS' COM'FNSAIION <br />DEII.AEAUON <br />I h.rcby oflirm uod$ F.aliy of pfijury om of lhc followi4 dcchrrrions: <br />I hr\. jxl sill irdsr rCcnill(iicolCon\cnr k, Sclfl'strr lor $orkor .omNnntrion. ,r PrcviJc,l lffhvScLlotr 17(X,.frh. <br />I nktr C, trlc. lnr ihc Frtunrrnrc ul rhc r ork lir which rhc runnir i\ is\uc <br />-I h& lnd will mainlah wort6 ohpcnssthn irsuraec, &r rcquiEn by Sdion 3?00 of lh. tibor Codc. fo, lhe lErfolmftc of <br />rhc vort ror *hah rhi pcmir is hs.d, My eorlcB' ohpctrerion iBlllnm cetr &d lDla.y mn!.r e: <br />! <br />-l <br />ccnily thrr i. rh. pcrfornumc.r rhc sork for which rhis pcrmil is hsucd, ! shallnol.nployany P.son in !.r 6uncr <br />$ ^ b h.com subfcl to thc wo*cs'compcnsurion laws ot Culiro neEc rhor ill should Lconr suhh.i ro rhc <br />lonhwnh €omoly wirh rhoe oDvliions <br />Wr\RNINC: Flihrc x, surc workcn ompcnsorion bj(r an cmployc, to dninal Fndlics end <br />civil finci up to 6nc huodrcd thousond dol co$ of.onpc6ation. domSct ,3 ,rovidcd for lhc <br />Dtr(L\U!!:!A!! <br />I hcrcby alfinn uhdcr p.nnlly of r.rjury rhal I am lirn$n undcr ion ulCh.ptr 9(.onnmncins sir! Slrri,n 70{D) oiDivision.l <br />oa lhc Busircsi dd PDtcssionr Codc. 0 myliccnFhinhi <br />Bt -ce5 Lfsl ?'/8 <br />8 <br />CoNSTRUCTIoN LENDINC A(IFN(IY <br />I h.aby lrfirn undtr Fn,hy oa Filury r hd rhcrc n ! conslocrhn lcodinr rs.ncy lor thc r brmncc .f lh. work lar shi.h thi\ rEnnil ir <br />isucil ( se. 1097, civ. c ). <br />APILICIINLIIECLABAIION <br />Ihorbytrlui undf p.trrlry ofpcrjuryone ollhc followin-! dNlarari.n\: <br />Dcmolirioo Permih A\l,cdos Norincarion F.dc.trl R.8uhlion\ (l irlc 40. Pfi6) <br />-llcquircd <br />L.rrs of Norin.rlion <br />I enily <br />'har <br />lhc tcdcBl rcsuhrio \x\h.no\ rcnx,v,lrc nor lnali.rhlc l. rhn projccr <br />-l <br />ccnili lhar I hrvc rcad thi\infomurioi isc.tur. l38re lo.omrlyqnh rll Cily !.d Counry <br />ordiMn.cs md Sralc L!$s rclaring r iurhtrlzc r.prcrnrdivcs of <br />dtDlc nEnrio,rcd !m!.ny for <br />I AppliGnl or Asent Sismlu ::{4tr <br />UNDER GROUND <br />Waste & Vent <br />Water-Under floor 8^/f/0 .z -'4tun e> //'+ <br />Gas-Underfloor <br />Building Sewer <br />I nterceptor/ Clarif ier <br />TOP OUT <br />Waste & Vent ,,lnln,--./.12 <br />/Water Piping 11( (o Iw ffT* <br />Gas Pipino <br />Roof Drain I <br />Tub/Shower Test \ll ltrfl'A171,r4a,5l .'1,)) <br />Rouqh Water Heater IT I U <br />POOL/SPA <br />P{rap/Drain Line <br />Main Drain/Pool Pipinq <br />Fill Line/Back Flow <br />Miscellaneous <br />Water Service <br />Lawn Sprinkler <br />Sanitary Sewer/Cap <br />Back Flow Device <br />Rough Plumbing tllT lr\',fuX"rre*xt'zY <br />Final Gas Test <br />Meter Release <br />FINAL 9-t3-n lZc-tst ,reao> A1 <br />Notes, Remarks, Etc. <br />Area,/Storm Drain <br />Pool Heater/Gas Line <br />Gas Service <br />Osmr <br />wo*6 corqrn*lion pmvisions of SElio. 1700 of lhc Litv <br />t-l <br />L.n,l.: ( Nrfre: <br />- <br />-------T------ <br />-------r-----