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PLUMBING-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS orvNER BUll_tr[:R t)n,(ARA',lloN <br />I hcrchy rtltnr rnder llrilrf oi p.iuiy rh ln cx. rpr fro , rhc (,nnrrchr l-i.c sc lrs lorrltr followmt rcr\{r (S( 70:ll5 <br />Btr\inrss rtrd llror'c\ion ('odc) Atrj_ Ciry or Coxn', shich rcqtrnc\ 0 |lrnir ro con(nrd. !l'cr. ilrll]rovc. tlcnxni\h or Eprn rny <br />{ru.rurc pri*b n\ n{ri.c,ll.o rqondsrhr rtpli.rtrr tur \u.h nd,nirh lilc r \iEncd {rrrm.nt rhar}ror shr i\ li.cn{d plnhir <br />nprlica nn rFrn \unjc.r\rhc arpliclnr b r.ivllpcnalrror nor nFrcrnln lirc hundrcddollm lS5u)) <br />-1, <br />$ owffi of trE |'lFny. or ny.,ployes wnh wae.. &r rh.n sk orwnralio& will do 0r NrL a.d dE srBiw is ol <br />hlcrxlcd or oficr.d for sk 1Sd.?OU. Blsimss and 6Dfc$io.s C.d.: Th. Coffaclo.'s Licn* L.* drr.s ml lpply to owr of <br />It. pmF ly wt[ bdk r or irproB tlEotr,rn wb.r0$ ikn slt hiaclf o. heBllor thmulh hk or trr ow! ctrlphyni <br />,ovi&d th sah lq,rcl4ft se ml inrdidcd orotrcrd for nk lt lIo*M, rl! boihirS or inprortu k$Usnhhnne,@ <br />ololphriotr lh Oqmr Euihler will hrk ltr h{dei of prcviig $n tE or 3h. dil mt hild of iqrcw $c p,Dpdly fo. rlE pu.Fe ol <br />-1, <br />&s owmr ol rh. pmpcdy. .m cxclusikl, .onlBclhg *nh [ccr*d .onti.ros ro .o.smt rlE l!ft]r (Se. 7044. BujR$ <br />aid Brrlsii Cort : Thc Conlrrior'r Lkcisc Lr* dNs mr !pp,y ro m oeNr of p,opcn, wno huildi 6r impmhs ihcmn. <br />and *ho conrtrts for sh rlirrs *nh ! Conhcro(s) lirnr.d pu(@i <br />'o <br />rh. C4nr&roas Liccns L.w) <br />I hcrcby aanln u0dcr nrrulryorprrury o oa rtc n'llo*in8 dslaroltns: <br />-l <br />h.w ald will @inllh. Ccnii. c olco.*n to s€lt-lnire fd @t6 @np.Mnhtl e Drovith<l for by Seio.1700 01lll. <br />Lrho, Codc. for lh. l,crfotrlgG ofrt w* fr {hkh thc p6hir t isi!.d. <br />I haw and will muifliin worte.a comnc.rodon insu.arce. &\ equircd by Sdion 1700 olrh. Linor Codc, for the pe.fo@.e of <br />the wot ror ehbh rhh p.mi is hqrn, My work B ohpetudion i.$dkc ceier lid poliy nunrbc. ae: <br />! c.nif, lhar in lhc pc.formakc orrh. wor* r.r which rhk p.rmir is irsxcd, I shatl nol cnp,oy,nyp.non in eny mrnmr <br />s' as to bccom slbjccl lo llr worlcB ompcns ion llws oacrlir.hio. and a8rcc lh if t snould hccom slbj(l lo lhc <br />*o sl om!.nsolion pmvisions of Sccl ion 3100 of lh. kbor Codq I oEll. fonhwith omply ,ith ltFs polisions.. <br />WARIIINGT Foilu.. '. *urc *orkch .omr.osaiio.nhwrul. Nrd sh,ll subi{'cmploF b aiminol tEBhLs and <br />ion, damgcs as provilcd lor thccivil fin.s u,r ro oft hundEd rhoDsnd dollds ($l <br />I hcnbyoillrmundcr p.triry ofF lury rhtrr I d r {d undcr pm!tn'. ol Chnpr rncin8 with Sftlhn ?0{D) ol Divhio.l <br />o{ rlE Blsincss lnd Pmfc$ions Codc. lrd my liccrs is in tull forc on cfiNt <br />D.t.: (:onlrmlor <br />Il) SItrUEI]()NIENDINCr\(iIiN!I <br />Ihcrdbyrlfinnricrpcmlryofp.'jdr,ihrrrhrci\rcon{rucri,,trLndirslAcn.yf{nrhcpcorn,ncc.frh.w.rkl whichrhtrp.nn[ i\ <br />issucd (S.c.:1(D7. Civ C.) <br />APPLICANT DFCI dRATTON <br />I H,y Inirn u.dcr pcnrlly of lcrjury onc oflhc lolt'qing del!r0rions: <br />t).mlirio. Pc.mirs-Asb{sos Noritcarion rtdcral RcSuldion! (TirL 40. Pd6) <br />-Rcquncd <br />Lcltcr.aNolilidlbn <br />I ccdilyrhd I hr\c rcd rhi\r n)n rl n)rr rhd rhc finc ifktrn r on i\.otucr I agIN t, cotrDly wnh allCiryr0d C.u"ty <br />o,dnxn.sr sriru l..rv\rcprcscnlolircs of lhis CilY !fl d <br />al$r mnriokn pmpcny aor i <br />ArrDlitonl or,\,:ml Sllnrl <br />u I anz/n*or- <br />/7 <br />UNDER GHOUND <br />Waste & Vent <br />Water-Under lloor <br />Gas-Underfloor <br />Buildinq Sewer <br />Area/Storm Drain <br />lnterceptor/ Clarif ier <br />TOP OUT <br />Waste & Vent <br />Water Piping <br />Gas Pipino <br />Roof Drain <br />Tub/Shower Test <br />Bouqh Water Heater <br />P-trap/Drain Line <br />Main Drain/Pool Pipinq <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 Plumbinq <br />Final Gas Test <br />Meter Release <br />FINAL 9l,Aslft r1>^nr,r-ur,r'?' ) <br />Notes Remarks Etc. <br />POOL/SPA <br />I.eniiyihtrl rhc ndcmlrcsnldi,,F Esarlirs a\lEslos reN)ulIc tror lnrlicahlc io lhi\ rmJccr <br />I <br />= <br />t-- <br />I <br />=