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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE tD/stG.COMMENTS
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area./Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Water Piping
<br />Gas Pipinq
<br />Rool Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P{raplDrain Line
<br />Main Drain/Pool Pipino
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />t
<br />Rouqh Plumbinq / /zz/n ,*/q \
<br />Final Gas Test ,.\ _l
<br />Meter Belease h
<br />FINAL ls- ll -/'1
<br />Notes, Remarks, Etc 'rv
<br />Q*411pe6a t'hueh -/o/t 2,,/tt -rl*s h
<br />OWNI]R BUII,I)I:R DI]I,CARA'N0N
<br />I hrrct'l rliirnr uNlcr penrlly ol p.rjury lhr I i crcnu rron rlt C.Dtrictts Liccts lrtv for rh. n,ln,wi',A rcxsrn (s.c 70.115
<br />Bu\ircsl aNl Piofc\\i{ Codc): Aiy Ciry .r Cou.ry {hl.[ ruquirc\ r pcr ir k, co {nrcr. rh.r. nn|r'rc, dcrnolish .r rcnrir my
<br />{dclurc, lrior b ir\ kuimc.0lso rcqnncs rlr lPtli.int li'r $.h I).nnir b filco slrncd srilc'rEnr rhd h .r shc is liccn\cd prr$mr
<br />t, rltr pn)!isi,,n\ of rhc Contsckr'r l-iccn\.d lls (Chrnrcr 9. (nmnr'rin! wirh Sc.rn,n TUXI .f Division I ol rhc llu\inc$ and
<br />lpplicnnr ntr n p.nnir $hjcclr lhc rDplicanr h a (ivil rcMlry .l mr flor. lhitr filr lrndBl dollrr I S500)
<br />-1.
<br />Ls owfl.r of !h. poFny, or ky .mplorts *ilt Mg.s as .h.ir sh otrp.nsalion. will do ttE wk ltd llE slixl@ tr mr
<br />iireidcd or otrcEd for slc (5&.7044. Busincss lnd P,Df.sshns Cod.: Tnc Comrdols Lkce kw dei ml r0sly ro rn owmr of
<br />ll* FstEly sho boiur 6, inp.oq tE@,!. ard who d@s .Bh s* hin*ltor h.Bll or threu8h ni. or h.r own employrcs,
<br />provided fiil such imFo@nls m f,ol inlcd.d or oflqsl for el. ll lEwE lh. hildiDg o in+rowm is sld oilhin orc FE
<br />of.onplclbtr rlE O1rB BuiE r will ha* llE l,nt4! oftovins lhll h. or $!ic dn rul hild or atrllr@ tlE prDFry for tlE purl[s of
<br />-1.
<br />as osncr ofrhe Eolcny. rmciclusivclyco mrins *irh liensn onra.roN ro.onrlrucr 0E r@iccl {SB. 7044. 8ulinss
<br />md hD&.sbr Cddcr Th. Cootra.rols Li..Nc tlw der nor aDr,ly ro ,. osner of pmD.ny who builds or inprolcs lhcrcon.
<br />rtrd who NnrEcN for such pmjers wirh a C.nrdro(s) lk..s.d pursu.flr ro rh. Conrrutols Lic€n* L,u).
<br />DECI,AAAtrON
<br />I hceby trffirm undcr F@hy of !.rjury onc of lhe followi.g d.cld io.s:
<br />I hrvr nrd q ill 'tuiiirin rC.nill.rrcol Con\cnr b Sclf l,Nrrd fitr sorkcN ronD.nstuutr. di pn,vnhd tu. hyScclion.lTlx)olrh.
<br />Lthitr Adc. ftnthc p.rformanccofrhc {or\ rur *hichrhc prrnir n i$u.d
<br />_l hatc and ,ill mainrain wo*c6 ompcnsotn,n insursncc. !s rcquicd h, Sar ion ]700 of rhc Libor Cod.. ror rh. lcrfom.cc of
<br />rhc vo lor wnich rhis p.mi is irsucd. My workcB sq{nsarioa inruaE.eiefud ltliy nun$.. m:
<br />_l edily ihar in rhe f.rforron* ollhc work for which rhi. Fmir il is{.i. I shall nol cmploy my f,cson in any ronrcr
<br />m N ro ltom subj..r lo rh. norksl sq,cNrtion l.vs oaclliaomh. and !Br. rhrr it I shoukl o.{om $bjct ro llr
<br />rc ec 6mt'.ns0lior pmtisionsofselion 3700 oflh.l,hor tuc I sh.ll. fonhwilhcomply *irt lho* pnatioB..
<br />WARNINCT FliluE ro slre sorkc$' odpcnsrion .ovcagc is lnlawtul. o.d shall .ubj.yr M cnpLye, b cnniMl |Bdlli.u ard
<br />DECI,AAAIION
<br />I hcrchyomrm undcr pc.alty of !,crju!y that I am liccncd lndcr fnvisn n oaChryrd 9{conmeins {ilh Selion ?0m) orDiviiion -l
<br />oi lhc gusincs ond Profcsions Codc. !trd my liccns. is in rull rom un cffLrt.
<br />Li.cns. Cd$;-Liccosc Nun$cr:
<br />Drt.i Cotrtmro.
<br />CAIiIXIJEUANIIINIIIN!.4IjINII
<br />I hrmbylflnntrndcr p.iilryorl.!trr!lhDI rhcr. nnc.niru.ri.n Lndnr8r8cn.yror rlElrc nnmnccofinc$ortlorwhichrhnFrnriris
<br />is!rcd (S( .1o9?. Civ C ).
<br />ATTIICANLDECIASAIIO]I
<br />I hrby oiinn undcr pctrrlly of pcrjury onc oflhc followinS dlrhr.rions:
<br />Dcnmlition Pcrnrirs-Ash.{los Notilicalion l;cdcrll RcAuhtn,.s (Tnlc40. Pfi6l
<br />-Rcqutcd
<br />Gltct ol NoilEnlinr
<br />_t (nilrrh{r rhc l'cdcnl rcgllrii.ns rcgartlitrA a\hc{os [m rn nor npplic$!. r. rhis !roj.cr.
<br />-l
<br />cfiify $a1 I have @d rhic lppliddon Nld sarc thar lh. lhovc infom0rion is .o,d. I lgE lo omply *ith lll Cily und Colnl,
<br />urdnnn $ rtr{l Srarr In$\ rclarii! r) huildiig.on{rlcri()n.rhk Ciryrnd Cou.ryro cnrq ul[n rhc
<br />rhrvc
<br />'ncnrioncd
<br />ptr,pcny for ?- tc. rpApplicnnt or Agcnl Slgnolure:
<br />A/-fur
<br />uUll
<br />B.qPc rnr'hnEa$n /
<br />,^,, ?-tt-l
<br />lII'TtrE& OMTENSAI]AN
<br />14 tR$il
<br />Waste & Vent
<br />Miscellaneous
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