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PLUMBING.INSPECTOH RECORD
<br />APPROVALS DATE ID/SIG.OI!NER OT]ILDER DI]t,('ARATII)N
<br />I lrrchy allirn unlcr prtr hy of Nlury rld I nm cx.mpi rnn rh. co.akk^ Licctr* bw fo rhc n,lhwitrE rcJv)n (S!.70.11 t
<br />llusin$s rnl Plolts\iu C&lc): An, Ciry ot (nunr, shi.h to!.luirus r Fnnir k' $n(ru.r. rllfr. ir.p(vd. dcnDli$ u cNn M,
<br />{rucrurc. Itrtn ro its i$n!ncc, so rcquilcs rhc rrplicanr ntrnEh pcnni n, filc! \iEn.d "rarcmcnr rhxr hc.r\hc t liccnscd ttrnxmrt' rhc |x)vnions ol thc cotrrrrcrofs t,iccnscd l.!N lch{rcr 9, Comnrmir8 wirh Scctiotr 7uD oa Division 3 of rhe Btrsircss rnd
<br />Pmicssionr Codc)or rhlt hcorshc hexcnDl rhcr.h,ndnd rhch$i\ rorrM ill*ci crcnDrion. AryliolulkrnolSccri,,n 7(r.ll5 byant
<br />!p,'li(nr lirr 0 !.!nil \ubjccr\ rhc !!plicinrlorci!ilpcnaltyofnormrclh!.fivchundrcddolhr\(S5n0)
<br />-1,
<br />!s owEr of rlE FoFny. or my .nlPloyds wirh w.ge &r rtEir sh onFnsrion. wil do rh€ *ort &d th. st rEr@ k mr
<br />inldn.n do,IeEd lor sL (s6 704.1, Buiiftss dd Profcasions codc: The conrtclds Lim{ t w d.rs mr .ptly ro an owM of
<br />rhc rrcFriy wrb biikri or impbB lh.mr ud vho dc sh eDrk him*li or lErslf or tt@ush his or ltr om olplo'€cs.
<br />provjdcd rhar leh inpormnr. e mr i cnlcd oroM rtr sh. li howE 0F buil,ilg tr inpmwmnt h sld wilhin om )E
<br />of.orplcrio.. rhc Owncr Bl ds will harc tlE bll{ko of pmvinS lhd l* or slr dil bt blild or in!68 dE FDpgty for t rt'orlrs ol
<br />-1,
<br />as owrr ot rhc porc.ry. un €rchsivcly .onrering sirt liensd .ofleroB ro .oosocr rlE lmir (Se. 7044, Buircrs
<br />lnd Eof6sion Cod.: Th. Conln€rols Liccns. Llw dms not {,nly lo m owncr ol FroFny wlF buildr or imp'4. th.@n.
<br />a.d who o rad. lor su.h pFi..!3 wilh , Cofit!4io(, li..ied pu^umr lo rlr Conln ror. Lier* t!*).
<br />-t
<br />u cxenfl !.da S*ion- B. & P,c. for fii! @en
<br />lvoBrES[tautBrArx,N
<br />IIECIAAAIIO!
<br />I hcrcl,y otrtrm undcr pcaalty ot ncrrury orc ollhc lollowine d(h.lions:
<br />-l
<br />h.vc.,n *ill @inrdr r C.nifa.rc of Con*nr ro Sclalnsm for smlm oipcn$rion. as ptueid.d lor by SNrion 3700 ofrtrc
<br />kbo. Codc ror ih. p6fo,mm of lh. mrt ftr ahich ihc ponlt is i$u.d.
<br />I hrv.rndsillmlinrrin sork.rs com!.n\rri.n i'rorancc. r\ rqtrncdhtSNrb.l7m.fih.L or O)d.,Ior rhc Nrli,nnin.c ol'
<br />rhc work hr which rlril,l.rmir ii issncd. Myw.rkc^mpcnsrion in nnc. sricr nd policy nu'ntEr rc:
<br />l.rnify llur in rhc tdfonmn.c of rhc rm whkh rhk p.nnh i1i$ucd. I shallflot cmrloy un! pcr$n in a.y lnNndr
<br />$ !x ro tB)m subj*r ro thc q,rt(s'cohpcnsrion hus ofcslifomis. !.d aBrec rhat ill should ti.om shiFi lo lhc
<br />*orkol comrcnsltion rovisions otS€dion l7l)0 oI rfic Lltu Codc,l shlll.lbnhwirh.omlly whh rhos pmvkioni.
<br />WARNINC: FailuE lo scuE *orkcra
<br />civil li,rcs up lo om hundrcd lhousnd
<br />is unhwful. Dnd shall subrcrr on cnqrottr h dninal Fmxis and
<br />eFni',i.n
<br />d{mecs N rv'dcd ro'
<br />'hc
<br />-(/
<br />of-rhc IiIrtr CG]. intcr.tl
<br />lr LI"r'7-lIi(L B.llltor
<br />I hcEby llfinnudcr pcdlryofpcrjrryrh l an lidn{d uod( pori\ion or Chrl)ld 9 (ontmnci.S with Scclion 7iI)0) ol Division l
<br />oI lhc Ausircrs and Pmfc$ions Codc- atn my licen$ n in full tole ud clTcc!
<br />( ()NS l ltL (.I lo\ Ll\l)lN(; \(iI:\( \
<br />I h.nby alIrm und.. Ifnrlr, oi pciury $.r rh.rc n a .onsd.rion h.din8 nsen.y for rhc Frfomncc or r,t work ror whkh lhh Firnir is
<br />i$ucd ( s(. :1097. cil c ).
<br />i UPUCAIIDEELLB{IION
<br />I tmh, lllinn undcr rnully of rErjury ooc olrhc r'olbwnr8 d6_lrraln'ns
<br />Ocnsllion P.flnnsA\b.{ s Norificdion FL{cnl Rcgxhriotrs (Ttlc.lO. Pnn6)
<br />R.qutcd IJr$ of Norifi (arxr
<br />-l.cnilyrhd
<br />rh. lcdcfll rquhlions rcAtuilirs r\L*sl.s rcnnvrl ar. NI rppli.lhlc t, rhi!tn,j.cr
<br />I.cnify rhrr I h3{ rcndrhi\ rpJ,li(rri,nr nnd {rrrrr rhcrblc inrrndiiD n.or..l Ir!r*toconrdywilhillCilyrn (innrly
<br />ordiMn.rs and Srarc Laws rclarhg hri n,! con{rurri,tr,. rtrd
<br />fi.vc nrtrlbncd pmlcny for ins
<br />ApDli.! l or Axcn( Sixnnlut:,:r/tl,I
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under lloor
<br />Gas-Underfloor
<br />Building Sewer
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Piping
<br />Rool Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />Ir/ain Drain/Pool Pipinq
<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
<br />Final Gas Test
<br />Meter Release
<br />FINAL v-7t.t6 4ztl )
<br />Notes, Remarks, Etc -7
<br />COMMENTS
<br />Area/Storm Drain
<br />Fill Line/Back Flow
<br />d* lft I t
<br />tJnJ.'', AJJ(\r
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