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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:
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