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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OlVNER I'T'II,DER DI.:I,CARATIoN
<br />I lN.6! rlltnr u cr I'cNlr, of Frltrr r hdr I iN cxc'ntr fnn rh. CotrLd.rE l-i.ctr\c t..s nr rhc tullowirS rcr{n (Se?0.115
<br />Bnsnrc\\ r d Pnn$tn Codc): An, Cily or (,nn y trhi.h rclun.s. Itnnir ro.on{rud. (lrct. imnovc. dcnn'lish o! rcpin rtry
<br />(r!cnrc. t'liortu ir\ is\uaNc. rh. rcqtrtus rh. {p]i.nnr ntr \uch pcflnilt,l-rl.! \i8nrd {dcNnt rhal l[o! \h. i\ lic.n\cd pusurnr -
<br />n, rh. povijons or ric Conrrr.r{ r l,iccnscd bw lchrprcr 9. aomnrncirs rvirh S.dhn 7(xx) o, DivNion .1 ol rhc Busjnc$ 0trd
<br />ft.ics\nnr\Codc)nrrharhurshci(crdrnrrhcnfronrnJricba\i\lurhcrllcgc.lc.cnrprnnrAi!violdtrnolSc.rionT0.ll5hru]
<br />rpplicJnlirrr!.nnirsuhls.^srhcappli.rtrlbr(ivilNrlryofmrndcrhnnfiv.hrndicddollar\(S5m)
<br />-1.
<br />as owEr of ilE FDpcny, or my cnployrs wirh !!Bcs a rtuir $le .olqEnsltion. eill do llE wk !d rh. $mnG i{ mr
<br />ir .dcn or ofi.rcd for sk (Se.r044. Ausirc$ od Ptlfcsionr Cod.r 'l lE C..ralols Lic.ns Lrw des rct lpply to & owmr ol
<br />rhc p,bFdy sno hiiu. o. inyrbB U,asn, .!n who dc rBn trft hinr.tf o, h*lf o. rhouSn hi. or hr ow, cnployc.s,
<br />pmvidcd lh.l such itrlPmwmnls @ ml inl.id.n orofi€En hreL.lt howE( 0E hilding m itr?orcBrl !! sld vitltin oB Jr{
<br />ofonplctiotr dE Osno Buildq aiu hM $c hord.n of FolinE th,r lE or slE dii mr hiild or inProk thc poFny tur dE purpo$ of
<br />-1.
<br />rcowmroflh. [m!.ny. amcrclusiv.ly.oolreling *ilh lic.ns'd s rdcton !o mnsrN.r ttf, trej(l (Sc..7oa4, BNia$
<br />.nd EbLr\io C{dc: The Conx&rolr Liensc kr dcs mr El,ly ro m owns ofnrcpcny *no boilds or impoves rlEr6n.und wh. onkrs fm such pEjcdN wirh I Conr&h(s) li{nsd ,uBuanr h rnc Contr*ltr's Li.cn* L{*).
<br />-l
<br />lnrcxcnpl und.r S..rbn- I & P.C. forrhisrcnv,n
<br />o*E-
<br />loaf,E8s:coMfrNtaroN
<br />DECIdEAIIIIN
<br />I hcrchyrlln ru ricrN rlrvof Itrru'yoicof rhcrol[NirSdc.hnliinN:
<br />I hrvr xtrd*illnDnnri'r rCcnill[icolCon\cnr t) S.ll ln\uE lor work.r\ .o'lr|)ctrsrin]. a p(NidcJ firbySNrnn,.lTrX)otihc
<br />t-ntxrCqlc, turrhc pcrlonnan.c.r!tu sork lirNhichrhc pcrnrir n i(\Bl
<br />I hrvc rtrd will
<br />'nninrrin
<br />*ork&J .oirp.i\ariun in\uruncc. u\ frqtrtcd h! Sccr hn 1700 of rhc tlbor c(dc. liJr ih. Frli)mh-'c ot
<br />il hsEd. My sortdc oq*nsarion intulte drtu eld pli.y numhd m:
<br />6 o
<br />ft,..nur,n,.,n"*rorronccnlrh{tro*rortrhrhrhhp.rnrirnnsucd.lshrllnorcmploylny!.mn rtrym rcrr rs ro h!'nr \uhFd n' rhc { rlc^ rm,rn\or ii,n ln ws of Coli'orni( and lgR I hrt if I sk)uld tEcom suhjcct k, rhr
<br />$Ntrh..mncnqrrtrin[lnrtrion\nrsc\rinn17(rOolrhcLJbqcudc.l\lslln,nhwirhorlrq hrlF{prc!nons
<br />WARNING: r{iturc ro surc lor&cra onp.nslion cov.sSc i\ unh*tu|, md sholl subiccr m
<br />civil linci !! lo onc hundtcd lhou$nd dolhB ($lm.00o). in addnion ro
<br />'hr.ost
<br />of comFrsl
<br />.nll,loter ro diminal l*ml'ls .nd
<br />ion. &mecs I n,ovid.d ior rhc
<br />n 1076 of rh.litnrtuc inr.r.( andu-13- t6
<br />^d-', )OeK,.",
<br />II[(:LAA]}.IIO!
<br />of ih.llu\iuc\\ul ltolc\\i,nr\ Co(lc. (lmy li.cr\c i! i| lulltur(culcllc(.
<br />13
<br />(;-
<br />o
<br />11-t4 <cov.- Co ircI6r\
<br />IA SIBIJCIIONIENDIX(;J(iTNCI
<br />I hcruhy rfinn, trnd.r rcMlryofFgur, rhd rhcrc is a conNrucrt,tr lcndi.8 rgcncy ir lhc p(rirnuncc olrhc wort lu *hi.h rhi\ lrrn,ir h
<br />ilstrrd (Scc :l(})?. Civ C.l
<br />APILICANT!&CLABAIIO!
<br />I hod)y lnim !onq p€nalryoipcrjur, onc oithc rolbwirE dcclanlions:
<br />Dcmliri.n Pcrnrirs-AstEsros N.rificirion f,cdcml Rcgularions (Tirlc40, P0n6)
<br />-ltauircd
<br />Lcrrcr of No'ificariotr
<br />l.cnifyihd rhc fcdcrrl rcltlrri,)n\ rclJrdin3 r\hc(os rcnmRl urc n.rQplictrhh ro rhi\ rr+cr
<br />-l
<br />ccnify fiar I hlvc r.trd lhis rrplicalion and slak thd lhc obovc inr.mdion h cor.c!. LBre .o .oftrlJly wnh rll Cny .d Counly
<br />odinatres .nd Sllrc Laws rclnlinE ro huildnrS consrrucrion. o,i lpeb, rurhri2. EpEs.nr,riv.s of rhis Cny end County ro .nrer upon tl.c
<br />.hovc mnrioncd pmFny lor i,stEdion
<br />e
<br />(_-ttr
<br />UNDER GHOUND
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterc eptor/ Clarifier
<br />TOP OUT
<br />Wasle & Vent
<br />Water Piping
<br />Gas Piping
<br />Tub/Shower Test
<br />R ough Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />Main Drain/Pool Pipinq
<br />Fill Line/Back Flow
<br />Pool Heatericas 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 1-zo-|tr NW).)
<br />Notes Remarks, Etc.
<br />Roof Drarn
<br /><-o L(-o l-J6lq
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