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PLUMBING.INSPECTOR RECORD
<br />OTVN !]R tIUIt,DER DFJI,('ARATX)N
<br />I hcrrht flnm uidrr p-ialry ol Frrury rhur I n drc'nnr fx,n rh. Cd[d.(ri l-].cnsc hv lor ihc lolloring rcrq,n (Sc.1].115
<br />Busirrcr\ rtrJ Pdts\n,. Cod.): Any Ciry or Courry $hiih rcqun$ r |tirnir k' .onsrn,cl. trllc.. impnNc. tlcm)lsh or npd ,ny
<br />tu rlr Ilnn nidN of rh. C.fta.nrt tjcc.{d trw rchlltr 9, Co ncmin8 *irh Sccri.n ?(XD ol Divhion I ol rh. llu\i.c$ and
<br />llollssion\ Conr)or rhrr hcorshc ncxcmnl lhcrcirotrr d rhcbu\i\ lor rhc rllcged cicnl]]rn,n AnyvinLrn,nolSLtri.nT0:ll5hrrtry
<br />rmhcrnrfurrFrmir\ubrcrrrrhc{fli.rruacililpcnrlrrofnorn{ftdidilvchutrdrildollrml$5U,
<br />-1.0\
<br />o*ncrol lh( Jn)I,cnt. ,tr n,y ctr,Ilotcc\ qnh wrg$rs lhcirqrlcon,pcrslri{,i, silldo rlt$1nk, rh.{tu1uru i) mr
<br />i .iddl or oficrcd tur qlc (SLr 7IX4. Busim\{ xnd l"ofc\!. \ C(xld: Tlr CtJ ticu's LNnrc li* docs nol {ply b an owncr of
<br />rhc pnrFny who huiklr or iDprx$ lhcNn. ul *lm do.\ \uch worlt him\cllor hdsclld rhn,uEh hh ot h$ o$n cmpby.cs.
<br />ln)vidcd rt r\u(h impn'vcnr \rrcnornfceLrlorolfcrcdforsrlc Il. hoFcvcr. rh.hoiliinEor tnnnNnrnr i\ n,ld wirhm onc ,tu
<br />ol (mplcri('n. lhc osncr Btrildcr will hn( lhc burdcn ot F)vinr lt h.or\hcdil or huikl.r m{ro\t rhc lr,tdy for rhc !u4!r{or
<br />_1, aiowtur6frh.rftFny. rngclu.iv.lycolll,ering *irh Uensd @dEdoB ro.on(ruc n pmid (S(. ?044. Bu\ift*
<br />ud ProlNion Cod.: 'rh. Co.rEdols Lkc.sc Llw dms nor q'ply ro u owM o, propcny eho brilds 6r improv.s 'h(.on,ud *ho offia.ls for slch l)ojccrs wirh o Co 6.10(9 lic..ed nursut ro rlE ConrBtoar Lkcns tiw)
<br />-l.
<br />cxcdfl lndersecr
<br />Drct -&ut0ti
<br />-l
<br />hIr udwill mi.tlin rCcnificrrcotCon\cir rosclflnsurc ft,*orlc^ corptns lion, ns providcd nrbySEliotr:17iroolth.
<br />tjlv Codc, for Ihc pcrf{mrncc ollhc $ort lor vhich Ihc Faorit is hsucd.
<br />_l h6r aid will minl.in *dt6 conpcostion inrmrcc. a cquied by Serio. 3'100 of rlE L!6or Cidc. lor lh8 pdfomfte of
<br />tlic aort fo, {hich rhis p.mil i! il$en. My wort{C srilf,Nrion i.suM ffirud nolty nnhb.r d.:
<br />I hcrciy affirdxndc, pcnllry.hcrJury.nc
<br />, c.nily thi nr rh. Il.rfornrri.. ofrh. $ork for qhicn Di\ p.rnrh i\ is\ucd. t shrllflor..rfloy loy tE6on in !ny nrmncr
<br />{, nsr' lf,(,M nrhjccl lo rh. wnrtc6 compctrs.riotr Ilw\ o, (..lilnrnia. md r8ru hlr ifl \hould t{rom r!l,F.r h rhc
<br />u.rkcr'onrrnsrrn,n,'rcririonroiSccri,,r.170('olthctilxn(i c.I \hdl. ronh*irhconll'ly snh rho{ pnvkoN.
<br />WARNINC: t'rilurc ro scnrc workcr\ coflrDcnsnlion ..vce-!c is unlislul- !n.l \hall \ubAr M cmpnDrr b di'ninal FIulri\ ntul
<br />€ivil fincs ur lo om hundrcd rhousnd
<br />S(rion 1076 ofrh.lltnr Cdlc inrercd
<br />DESIdSAIUI
<br />urd.r novision of Ci0pl6 9 {conmEi!3 vnn Sddon ?000) of Division 3I hcrcby oflirn xnd( p€tulry of !.rjury rhat
<br />ol lh. Busircss md Pmfcsions Codc, ltd hy liccns h in tull fore aM efer
<br />!olila!Ell0lLlNllMirllili!(I
<br />i!{trlrs.. 1097 ('lv (-j
<br />ATILICAILDECIJAAIION
<br />I I'cd,y strm unds pcnaXy of !cr$!y om of rhc foln)wing dftlr,ar io.rl
<br />Dcmlirion P.rmik-Arbcsros t{orilicorion F€dcrrl RcSrihriors (Tirlc.r0, Pd6)
<br />-Rcqutcd
<br />l.rlcr of Nolilicnlion
<br />lhc lcdcru, rcBuhtions rcsadinB srhcsl{'s rcnnrul rc n.l alrtlicablc ro thii pojccr
<br />Ihrkr.irhisrtdicrirnnRlrr(.rhrrh.rh)rirn)nnnrii n.drc.i I i!r.c tJ ..nrfly slrh al { lryrnd(butrrv
<br />*n'ariKsoarhis Cilylnd Colnryt6 cnrd uF,n rhc
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under f loor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area,/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Piping
<br />Roof Drain
<br />Tub/Shower Test
<br />Rouoh Water Heater
<br />POOL/SPA
<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 Plumbing q Ito/n.IM >r)
<br />Final Gas Test I J\ \
<br />Meler Release
<br />II 70/tfl T (s-l)
<br />7\-:Notes, Remarks, Etc.
<br />"*,-)f
<br />FINAL
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