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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE tD/stG.COMMENTS OwNr]R BUILDUR DI,il,cARATlON
<br />I hcrchy 0ifinn uftlcr ncntrlrt of ncrJury rh l ,n cxtnDr in,o rhc Conrmcl,tri l-ic.n\c t-rs lar rh. r.lhwirB rcrnr (S.c 70ll 5
<br />$u\incss r l Ptr,fcsi{r Cdlt)r Any Cty or Counry whi.h rcquncs r ncnnir k, con{to.r. rlrd. mProlc. dcmoli\h r tl'rn rly
<br />dtucrurc, pri{tr t, its is\utrtr.c,,1$ rcqtrnc\ thc {!li.rnr ror \u.h t--nnii n, filr. \rstrcd {arcmrt
<br />'har
<br />hcor\hc i\ ti.en\dd pursumr r
<br />ro rhc n.ovnn,ns ol tl[ Conrracttrt l-icrnrd us (chatrrr 9. C.nnncn.ii! Firh Sccrion 7r)(n ol Divni,)n :l ol rhc lru\ircls nM
<br />l'mi.si,'n\ Codc ) or rhrr h.or shc ncxctrror rhcrcinnrnd rlrc hrlis ln!rhc alhscd crcnyrn A yriohrnrolsccltitr7l).rl5 hyxny
<br />llptli. d r(tr r rcnnir suhlccklic lpplicanr t, acivilprulrtornor frdrhrtr,lvc hufldrcd dolisrt(S5( ))
<br />-1.
<br />6 osM ol lhc ,roFdy. or my ehployes with w.Ecs !s lh.t $lc conFnilrjon. will & [E vo* an dr nf,rrE t rci
<br />inlcid.d d ofi.Ed for eh (Se.?044, Busiftsr tud Protcsrions Codq Th. ConlEcldt Ltens! Liw do6 mt q,ply to M otu of
<br />rhc p'Dpdr, who t{ild! or inpoB lh.6n. ad wlh doci s.h mi( hid*lf or lErslf o, tt@u8t ht or lEr own cflPk'fes.
<br />providcd rhar 3uch imrmwmitsm mr inr.idcd trorcEd for sk. lf. ho*6. tlr t{ildine or nl!,lErnl ir $ld *ilnin om )ra
<br />.f6,r?bri,n, UE OsEr Built r will hlE dE hlrhn of preyiis thll tl .r dE dil mt toild or inptDE dE pmtEly fm tlr Inqne of
<br />-1.
<br />as o*ncr ol rh. DmIcny, an cxclusikly conlr.clins wilh li.cnsd .onlrucloF to @n$!d rlr prc.iccl (Sa. 7044, Bulir$
<br />rid Pirt sb6 Codc: Thc ContEcror's Liccn* ljv dms mr lmly ro an ownr. ol proFny wl'o builds or ihtmGs lne,6o.
<br />and whD conrtucrs for slch poi.ch wnh a Commclo(r) lic.ned purrunl to lhc Cbnrlc1ois Lkcnc kw).
<br />-l
<br />!mcicmpr undr Sd'kr
<br />IAatrESLCAMIINSAIIOND[CttI8Aro!
<br />I hcrcby .mrn undcr pcnally oI psjury on. ollh. folhwinS .h.rmlions:
<br />-lharci
<br />$ill nuinrdin a Ccnifl.trrc or conscnr h Scla lnsnm for *olkcN compcnrdnrn.,\ ttuvid.dfor6yScction1700olrhc
<br />tihor C.dc. lor rhc pcilhrruncc .a rhc worl ror *hi.h rhc p.nnir i\ isu.d.
<br />-t hdve lnd wiu nui 0in vorkcrs compcns!fion in$mrc.. !s Eqlied by Setion lr00 of thc L3bor Codc. Ior rhe F,lommc of
<br />rhc aork ror whi.h lhhpcmir is hsu.i. My ompcnkrion in\ura c .Micr id polty numbc. lrc
<br />c r.\.F
<br />-l
<br />ccniay thsr in rhe tcrformnce of rh4 *ork lor whi.h thk p.rnir is i$u.n. I llull nol cnplo, any pctron i. any mdM
<br />so 8roh..om bi(l b0E m*6c.omrcns.lion bws ofcalifo ia, andt8@lhd if I should 6.com slbi6r lo E
<br />ertc6 onp.nsarion prctiions of Sdioi l7m of llE L,tbr C.dc. I sh,ll. lodhwnh coq:|, wilh lhoe prcvlrions.
<br />WARNING: foilurc ro *uc sorkcn .omFnelio. colm8c i! unla*lll. lnd $1ll subitl an onPloy€r Io qihind FD[i.s und
<br />rivil fin.s ut ro om hundrcd rholsand dollus (Sloo.filo
<br />Sd io. 1076 ol rhc L€hn Cndc, inrcre$ and allorhy'r rccs
<br />). in lddirion to rhc cosr of
<br />1.r.\q
<br />t hcrb, lf,irm untlc. r.ndlry ot p.rjxry Ih0t t liccn{nundcrpmvi\ioior(hrrrd9lconnrfNins*ilhSedn,n70m)olDivisnnrl
<br />of rhc Businc$rnd Pn)rc$n,ns Cod.,,nd my li.cnsc G iri liilll'ore nnd cllNr
<br />I 'J844 erc
<br />Ylkn^
<br />CO EIf,JJCUTNI.ENUNIiTTiIN.CI
<br />I hcrcby rfitmundcr ncnahyolFrjtry rhxr rltrrc is a consrfl.rion lcndirS a8crc, far lhc IErlbroDm. oirh. *ork lhr sni.h rht Frmir i{
<br />issucd (S.c. lO9?. Civ. C.l.
<br />.
<br />-lccnifyrhar
<br />rhc lcdcrrlBsrl ions BgddinB astrsos rcnsvll!rc mt rprlic$lc t, rhh pmFr.
<br />giinny,u r u,..,a,r'i. rt dic.rion onl nnrc rhar rh. ubrc inrotuurion is.onsr. I trE! to comply w'rh lrr cnyand counry
<br />ordindn c\ md Srarc lrssrlditr! htuildinEcor(rucri'n,, axl hrrchy of rhis Ciry a.d Couniy lo cnlq upon thc
<br />atole mnrioncd Ir.n ny ror insFcclion purposcs.
<br />Applic.nI or Ageni Siaetuer ^,.,4.2.fr
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under Iloor
<br />Gas-Underfloor
<br />Buildino Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Pipino
<br />Roof Drain
<br />Tub/Shower Test
<br />Rouqh Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />Ivlain Drain/Pool Pipinq
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbinq vf?./z 9bq$
<br />Final Gas Test
<br />Meter Helease
<br />FINAL w?/n >\6'Y
<br />Notes, Remarks, Etc.
<br />L.hdcr'\ NonF
<br />-
<br />AIELLCANI..P&I,A3AIIO!
<br />I [a+ry afiinn utrds lcnolt, of p.rju.y onc ofrhc r.llowin! dc.lantri.trs:
<br />Dc'mlirion Pc.nirgAstEsros Norificurion r.dcrul Rc3ulrrioN (Tirlc 40. Pdr6)
<br />Rcquir.d trtrcr of Norifi ca on
<br />An4
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