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PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE COMMENTS OWNER BU!LDER DELCAN"ATION
<br />I h.rchy atfiu tnncr pcnahy of pcrjor, ih l!mcicmll ti.m lhc Conrracx,F l,iccnsc l,w Lr rhc rbllo$iitrcnv,n (sd.70.115
<br />Bxsincs rd ftofc\\t Codc) Any Cii, or Court which rrquircs ! Fnrir |o conn d, alrcr. inllolc. dcmli\h or nlJn xny
<br />nru.turc. Drn L' ns isruu.c,0ho rcqunc!ttu alpli.dt Lr \u.hp.rnnrro lllu r signcd dcntrtrr rhd l.d or shc n liccn\cf pursunnr J
<br />ro rlE,ii)visi.n\.l rhc C.nr..ror\ l-rctrscd lrw ((hntr.r 9, (inn,knci'rg wirh Scdn 7Un of Druis.n I oi rhc llusir.$ .nd ,
<br />ttoicsi(,nsCodc).r rhnl hcorshc is cxcm!r thcr.froh u,l rlE hl\ir ror th. LBcJcrcmplion. AnyvidrlionofScclioi70.]1.5hyany
<br />nppli.atrr ror ! p.lmir sutrsr\rhc ryplicnnr k,:cililpcullror.ol nn,Erhln nvc hund.cd dolhrls5fi)l
<br />-1.
<br />as owNr of lhc pD,Eny. o, ny .mphyrcs wnh wlgcs $ rhct elc .on{En$rion, wiI .kl ttE wtrt 3rd tlE irarw h ml
<br />intcnd.d or offcEd aor salc (Se.?044. Busimss &d ftol:sions C.d.: lh. Contmlol s Liccnsc trv &$ nol lpply lo an owkr of
<br />lhl prcloly sh6 hiklr or i,pmtusrhc6n. rt whd &rs ch tult hinsctfo, hcrelforrtuo4h hk or hs own cmtloy..s.
<br />Fovid.d th'r sn h inporGnk d mr inrerd€d orofidd for eL, lf. houer. rlr hining or ir\Ermh| h $ld *iihin oic Fr
<br />of.o,qilcrion. rlE Oemr Aui&, *ill hrw rL bnrd.. .f polins tnd h or slr dil mr tD d or in!ftr irrc tftFiy ror rhc Fnpos or
<br />_1. aqoeftt.frhc php.ny. dncxclusikly.o.rrdinB sirh liensd conlncroF ro onsrtod rlE rftiit (Se,7044, B$iass
<br />ond Rotxsim Codc: Th. Conh.rorrr Lk.nsc tiu docs nor q,Ily r. an owno nfpropcnysh.6uild3 or impmv.s th.rcon.
<br />and who o mck for su.h Imjcdr rith o Conlmro($) lisnsd puBunr r. rhc Conrr.crols Lic.ns. k*).
<br />I m.rcmD' undcr Sd'ion , B. & P.C.lorlhr @son.
<br />D.l.: O*Ml
<br />WORXFTLS' COMPE-NSATION
<br />DECI .ATAT-ION
<br />I hcrcby lffirn undcr p.mlty of p.rjuy orc ollhc fouowing dslnfrraoBl
<br />-l
<br />naw {d will minlah!Ccrrifsrcof Conenr ro Scl m!rc fm worlca ohpcnsrion. !s prevt.d aor by S6rio. l?00 of lr
<br />Ith.r C.de. fq th. Dc.fo@ of lh. wo,l fq qhich Oc p.mn ii i$Ed.
<br />_l h8w aDd will mainlaifl workcs conu.nelion insurrmc. a Equircn by Sel bn l7tr0 of lhc L3bor C.de, for r |rrfolrj18e oa
<br />thc sork for *fii.h lhis lcmn i3 is!€d. My turkss Nmpetrslhn in$Bn.c ericr ond Policy nudbcr ec:
<br />-l
<br />enifrrh in rhc ,x.fortutuc ol r hc work ii, whi(h rhis pcrmir is hs*d.l shcllno! 6plo, any pc^on in an, mMmr
<br />s srotxonr bjcd ro rhc workd ompensrtion l,{s o, Crlif.mid. .ftj rgmthd irl sbuld tx.oft suhjccl lorlE
<br />workcs mmp.nsarion pmvti.ns oiS.crion lT00oflhc trhor C-odc l shall. ionhwnh comrly wnh
<br />'hos
<br />pmvhions.
<br />WARNINGT hilui. k, s.urc workc( coDpcnsdr shnll subj.lt M cnq,nr)e. lo 6i,niml lEmhts od
<br />.ivil fin.s ut ro om hundred rhausnd doll$cou of conp.netion. .Lm8cs !s pfrvacd tu llE
<br />Sdri. 1016 nrrh.ll}rtr and. i .r.{.
<br />2a(
<br />I ncrubynlfinunds Fmlryolrrjur,lh l an liccnki undcr tmvni{,n of Cnolncr 9 (o,nnrcrcins wirh Scdbn 7000) ol Divisin l
<br />ol lhc Busincss Md Prerc$ions Codc. on my [ccn$ is h full ldN ord cfi('.
<br />c)Afrtqt-
<br />o,,", oiftq{nae
<br />llllilB!cuallu^UlMlif,fEl
<br />I hrrhyrlllrn,u cr rcnxlry.lpcrurvrhxr rhcr. i\ r connrucri{)n hBiing +ricy f{tr rhr l.nnnu,h.rrhc $ork lor shi([ !hi{ Irnnir is
<br />ir\urd lS( :1(D7. Cir C )
<br />A.ttutANLl2[cL trauoN
<br />I lrNtiy rllinn xnJf ttrnrlry ollujury.D. orrhc n,lk,anrS dL{lnrrtn,nr
<br />Dcntrilirn,n lcmirs A\trnor Noriri.rrio Fcdcrrl Rcrulurtxr\ r'lirlc,10- I'>an6)
<br />(cquncd hrr.,oI Norill.rrttrl
<br />-l
<br />aniiy rhor th. (cdcEl rcelhrions rc8urdin8 asbcslos Emval m mr .Dlicohlc ro rhis pmj.rr.
<br />I J @drhhapdhiion$d c rh,r lhc oh)w inrormrion is.oret. I r8r to mtrll'ry wnh !I Ciry and Counry
<br />consrucrio( dln hcrcby aurhrizc rqtrc{nlalnls of thir Cily and County k' cnls upon th.
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under lloor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif rer
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Pipinq
<br />Rool Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />l\4ain 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
<br />Final Gas Test
<br />Meler Release
<br />FINAL I 7 0/z{/ls E\\g b
<br />Notes, Remarks , Etc.
<br />to/stG.
<br />axa.- Loq,^,., as-/tr.tqe,
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