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PLUMBING.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWNER A!ILDER I'I'I.CARA'I'IoN <br />I htr.by illtn und.r pcnih, ol pcr.Jury rh.t I .m cx€nrtl fnnn rh. Conrndor'l-rc. s.1.r( f(tr rlE follosin!..ai'n (S.{7llll5 <br />lrusinc$ xl Profes{on Cod.I Any Cily or Cornry slr'cl r.quics r Fmi b constnrct. .kci imrole. dcmltl or qtrtr anv <br />{n'crurc.,rn.r kr trs issBm.. nho rc+r.i rh..pplcnnr for Nch !.nn b il.. ssnd slar.n rnarhcorsh.6l'..n\.d puN. <br />ro rh. prcvG'onr oflh. contrcror s Li.etrsed l..r (chrri.! e, CornmcEiry \'irh Sc.rion ?0orr ofD'rson I ol'th. Buen.* .tu! <br />Itotcs{on{Codll orlltrr lEorsht ir.r.ml rhcRion and lh. basis 16rrh..ll.scdcxcnrlltrn Anyv'olrrionofSccri.nT0ll 5hv..v <br />amlrddlorir.nnilsuhl$rsrh..ptlimntto.crvilr.nillyotnol'er.rhdnnvchundredd.llih(s500) <br />l. ., owner of rhc lnrlEny, or my cmlloyei w,lh wi3.s ,s rhtr rnc comncnsrrbn. wll no rhe wo* and ttk studuE N ni <br />'nifrlcd orolf.rcn for slcISE 7 4. ausins.abd Potasrcns C.dc lhtaDnlnctds I rc€nkl.a*do.s.olnPplvIoin.qMrol <br />rlicpmpcny wno tunds or ionn,ycs rh.6[ ad wl{ &'s sc[ ultrk hnns.llor hertlrorrhftnsh hf or her osn.rnrlovces. <br />prorid.dthrrsochihrotmnFnrcmt'nrc.rlor.fl&.dloreGI[hotror.rtf,tudnrnSornnpm\€nEnr($klsihinnEvd <br />.i conrrkrnu rhc Owkr Rurlder sill l[E lt. bun n ofPm$ns rh.t lr or ctre J an huild or inDmw Ih. pmPdy lili lhc puqxr{ of <br />l. iso*nerolnrrrmrcny..m€xcluqv.lyconticr$Ew[i licens.dcontr ckJNr)con(rucl rh. nN]ecr(Scc 71M4. BNinc$ <br />. l Pmliacnncod.:lh.ConkacknsLi.€ns.l,awdo6*,arnlvro.n.*n.rotntupcnvuMbu'l.lsornDnror.irhcrnrn, <br />nd wlN conlBcc fo! such rrrrcrs wnh . Commclo( n licensd DuNu t' lhc ( ofiicktrt l-E.nse l-!r') <br />woRKtlRl' coll, PltNsarloN <br />llEcLAsarlq! <br />I her.by lmrn und.r n ndlryofp.rjuryon ofrlE folhwmS del,rtrion.: <br />, lwe trd sill Dainr,in . Ccnifc.lc ofcdn*or ro s.lf_lnsurc for *orleu onrp{s0tion. ar i,nrvidcd for bv Selin 17rn nf rhe <br />Lab.. co&, fo. rhc prf.ms. of rh. $ott lor s nich lh. ,*ft ii kscd <br />rlr. \u litr*hEh(hLs|tn rs6scd ltly*o'lsE (n,ndrnr( N xDr. rrrrc. runl Fni.'" nunrh.r tc <br />I'01'c! Numh.r-Irl <br />-l.cnirylholi.rhcpofolmNeofrhcworkforwhtrhrhisp.rmnhis.d,I3nallmlemplov6n,p.mninonvndcr& as ro b.6m. sbj.rt lo lhc sttd' oDp.n$l ion Lss oacdlitomi.. t d lsr lhal if t rtbuld b.sm sbjcct to li" <br />worlcF' onpmtion pmri ons olsorion l?0O oflh. Lsbor C.d.. I dDll. fonhwnt 6q,lv with llne pmvllioN <br />\YARNINC l:rilurc ro *cnrc tr6.k.is' o ,ffntaro ..\tm-{c r\ unl3thl. md d$ll snbJ.cr !n .hpkrrcr l. smiml nt lrie and <br />cNil fines un roonc hundrel rhoustrnd (lolla( (Sl0lr,lr(r01, rn addtr!'n h rhc c.* olcon'pcnsriotr d'nuses r! l,n'r rl r'rrhe <br />sdtrn 1076ollhe l,rlx,r cdlc, mrctcs and,tunr!'s l!$ <br />Drt.:_ Appll".nr,- <br />I rcl'NSliD C()N Ill'{cIoR <br />lll:cldSalra! <br />I h.Ebv lmm under,,.Mhvofpertrrv rhar l0h licen*d und" pmvisio' ofcluplE 9(c'hnMcrnS wilh scctk'' 7000)'tllivhion l <br />ol rhe Busi..$ B.d Poa*sions Codc, !ftI my lic.nsc ir in tull loc mt elt cr <br />I enJc''( A.l.l'c$ <br />- <br />AIIUCANT.!}:CLAEAIIqX <br />I h6tlry.flim undd p.n.hy olp.rjuryonc oflh. followins dcclaix.ns: <br />D.nmlirion Pcrmils AriElios Norilicatio. l;cd.ol R.!ul.ridF ( f nlc 40, Padr, <br />RcquiEd t..rr.r of Notic.thn <br />-l <br />ccnily thdr llr ted.ral re$htiods EE.rdins ashcitoi e6.vsl 6r. not apnli.abl. ro rhis fmi{t. <br />-l <br />c.n iry rhor I lEt. Esd rhir arplicstion .d Bral. rhlt fi. .iove infonMlion G comd I 6sra lo mmPl, eirh al Cnv and Colnrv <br />orli.rrc* nnd Slar. tj*sElrint ro l,uildins @n{tuclio .nd h.r.nynurlnrir. r.pr.s.rx.rir6 oflhis C v t d C.untv to trl6 {l.n rrE <br />,tnc mdio..d tmFny for iqdion lulxB <br />Appllcrnr 0r Agcnl siqn,rur. <br />P.mllc n.n. {Drltri)r- <br />UNDER GROUND <br />Water-Under floor <br />Gas-Underfloor <br />Buildinq Sewer <br />Area/Storm Drain <br />lnterceptor/ Clarifier <br />Waste & Vent <br />Water Piping <br />Gas Pipinq <br />Roof Drain <br />Tub/Shower Test <br />Rouqh Water Heater <br />POOL/SPA <br />Ptrap/Drain Line <br />Main Drain/Pool Pipino <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 />Rouqh Plumbinq ///q///fuort /oz- <br />Final Gas Test <br />Meter Release <br />FINAL u/9/rf rylDA //n <br />Notes, Remarks, Etc. <br />Contrt.lorl <br />cQllr8llcrl0N-trNluNa{;-ENcr <br />I hccty amrn undd p.nnlry of p.rjury rh.l $ft is ! on(ruc1nrn kndmS .8.my for fi. pdfom.cc of th. sork frn sti.h lhis pcmir ir <br />Bsu.d (S( 309?, Civ. C ) <br />L.r.i!.is )rrmc <br />- <br />Waste & Vent <br />TOP OUT