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PLUMBING-INSPECTOR RECORD
<br />DATE ID/SIG.COMMENTS OWNER AUILUER DELCARA'I'ION
<br />I hcrcby lififln u.dcr Nniny {,1p.rju.y rtrr I o cxcnrpr nonr rhc ConrEckE t-i.cn\c lj* tur rhu lilkrwins toa$rn (sc..?Illl 5
<br />Busine\\ rnd Pn,lc\lnrn C,ric) ny Ciry or Coui!, {hi.h tuqrnc\ a p.nnir b .otrirucr, dlr.r, nnpn,vc. dcnnnish .r r.nrn {ny
<br />{rucrurc. prinu rs rsuakc. irso rclum\ thc e icrnl lnr such pcanf n,lilc! si8ncd nnlcmnr rhlr hror \hc is li.cn{d NBusnr
<br />r. rh. Fn,viln) ofrhc (bnra.ntr s l-ncnscd t-.w (Chrpfur 9, Connndn.hA wirh Sccrion 7(II) ol Division :l ofrnc Businc$ and
<br />Pmfcssiur Codc)orlhrl hcorrhc iscxcnDl rhcrcl'ro.nand rhcbJsi\ for lhc rllqcd crcnDrion Anyrn,hrnrnofS*rn'n70ll5 hvntr!
<br />nprllicrnr ior rpcmir suhjechrhc arplicrnr ro ! ciril l).ilhy oa oor ffirc ihrn fitu hu trdrcn dolhs ($51D)
<br />l. o*ncr or rhr r(,Fdt. or nry c rtl,,ycd airh *r!cs * rhrii v,lc rorirpctr{ nnr. sill do rhc sort &l rtf, slMlurc i\ ior
<br />i .rk{ .rofcrcd tur s.lc (Se 7(Ll,l. ausir.ssrnd ltolission\(t c:lnca firctn \ Liccn\c liwJoc!nor rpplyrJtrnowmror
<br />rhrfn'|tny shohuiil\orn\n,!d\rh.tunr,andwhod,*\soch{orlhi' rsll or hc, {lf or rhmugh h i\ .r k(t oqn cnDloycc\.
<br />pn'vnlcd rhJr \uch in,lDroxnhr. nor inrcri.yl or oftcred lor elc li ho\,.!cr rh.buikling or i'npn$cnr nw,kl*irhin!'trrJr
<br />olcon$Lii(r lh! Orncr tluihcr $illhrv. rh. btrd$olpnvirg nu hc or !tu di,l nor huiu or iarlln)w rhc nn,ncn, nn ihe nurFi{.1
<br />-1.
<br />es owmr of rh. ,rcp.,rt, am crctusirety .onrldins rirh liana-d conrrdoB ro consrrucr tlE pmj..l (Sc. -1044, Busircs
<br />rn ADtu3im Cod.r fi. Conlmrols Li..nsc kw des nol alplylo u own.r ofltope y wto builds or ihprovcs lhcrcoo.
<br />dd sho .onrds for such trciris wirh . Conmc'o(i) lic.ned pusuni io rhc C.nM.l! LieB L.w).
<br />I aFcrcnpr und.r Sc.rion ,B & P.C. fordhrcasotr.
<br />laar[8li$aMlENlAIlAN
<br />DICI,AIAIIIIN
<br />I h.nby dfiird udd.r Foull, ol pcrjury om ol lh. followinS dc.lrotionsl
<br />-l
<br />havc dd will minlain ! Ccnafrarc otconr ro Self-lniuE Id rc*cB @np.nsrbn. s FDvilcd tor by Sdlior 1700 ol lh.
<br />L{bm Codc am lh. FfolM of llE *ol fG *hth llE Fmi ir i$ued.
<br />J har ond will moinrain eorkeB comFnrarion insuaftc. &\ EquiEd by Sccrion l7m ol th. L3bor Codc. for lhc lf,rfotljec ol
<br />the qo for wtich rhis pcmit is hn4d. My worlcF onncnsdioo insuiam ffir En lbli:y number !rc:
<br />E,
<br />-l
<br />cenilythat itr rhc pcrformncc or lhc sork for whichrhisI]. ir h is\n.d.I sh llnorcnrployanyFcisonin!flymuner
<br />s ,rro lx..nr \uhid ro rhc w.r*cs co mr.nsar io. laws ofcdlinni.. rnd oBrc lhal if I sh.uld t rotu $bicd ro rrE
<br />w.ikcrs mmr.nsarn,n pro rionsorsetion 37mof rhc tjhor Codc.I drll. fonhvirt aryly virh rhos povi\io.s..
<br />WARNING: raihrc ro surc $orkc6 Lom$n\D'nm dNcrssc is unl,wfnl. rnr sh,ll suhj.tt ur cmplortr lo simiml pcnuhic\ and
<br />.iril fincs up ro om hundrcd rhou\and doll&s ($lq).uD), in iddi'nrn lo lhc co$ ofcompetrsation. damoBcs a\ novid.d Lr rhc
<br />s(ltr.1076 0f rhc blnr orlc- inrdcd Md
<br />,"JIJN T 17018
<br />D[Ct B rloN
<br />I h.reh, atinbdcr ncinlryotp.rJury rh l trm li.ctrei und.r tmvhioo olChit,ls e(conurncins *irt s.ction 70tlo) olDiuision l
<br />o, rhc Dusincss und ProfcsioisCodc. ud Dy liccn* i\ ii ftll r{r.c ard cffc.r
<br />4.6-
<br />D'G:Jfl FJ--ll-?010 c".,r'ic
<br />C()NSIIUEX()NIINUIICTT(i]rI!:f
<br />i(sud ls( :rlr97.civ. c )
<br />AIILICANLIIDCLABAII!]N
<br />I tmb,:mtDu cr pcnahyofpcrjury onc 6frhc lhllowins dftlrdrions:
<br />Dcfrnrn,n Pcrnih-Asb.{os Norificdiio. Fcd.rol Rc8ul0lions (Tnt 40, Pan6)
<br />-Rcquncd
<br />br .f lloriarcali,n
<br />I ccnrlvrhrr rh.ledcralrcFhrr,F\ rcrudrne d\b€{n. 'rtu\al m nor {,tl*ahk ro lhs pmi\t.
<br />finrYno r*u n,O,nts rnDl(ornn rid {ar. rhr rh. !hov. inroinurion iscorcct.l aEN ro comrryqnhau Cilyand counry
<br />odiEncc\ xtul Srrrc I !*srcL in! krhuildin!.on(ircs oIlhis Ciryand Counry lo cnls utDn llE
<br />8borc nEnlio*d propcrly for inspc€rion
<br />AppliGnl o. Aa€nl siamlorc l 4. ,Q
<br />UNDER GROUND
<br />Waste & Vent
<br />Gas-Underlloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Pipinq
<br />Gas Piping
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough 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 0/lz-/c ))156
<br />Meter Release
<br />FINAL -{/tt/x \l\%
<br />Notes, Remarks, Etc
<br />APPROVALS
<br />Water-Under lloor
<br />Final Gas Test trhdo \ Addc$:
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