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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under lloor
<br />Gas-Underlloor
<br />Buildinq Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Pipinq
<br />Gas Piping
<br />Tub/Shower Test
<br />Rouqh 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 />,4,
<br />Rough Plumbing 5-K"ty Ywy")
<br />Final Gas Test
<br />Meter Release
<br />',ttUlelJ ))FINAL rblle iCtrUlNotes, Remarks, Etc.
<br />()l!NllR Ii(lII-DI.lR DtlLC,\R.t ll()N
<br />I hcrchv xnnm uD .r p.illtt rn lfrjsy lhir I un c\em lro r rhc Gdrr.r{r Lren\c lrw in rhc 6lk)$in! r.rvr (Scc 70ll 5
<br />&^itu\s lxl ltol'cs\it)n C{ilcr A0r Ciry or o)unry *hi(h rcqtri'c\ r n(nir n, coi(turr. rlrcr, nnftvc. nlctk}li\h r rur,.'i, rny
<br />h rhc pn)i\n,n\ of rh. Conrrrrttr'\ Litdscd llw 1( hJnrrr 9. Connrr rmB $irh Sc.ri(n 7(XX) ol Oivisn,n 3 oi rhc Bu\i',rs l
<br />i|rplritrrktrnNnnir!rbJccl!thcrpIli.!nrk,r.ivil|[rlrtoinr!nnncrlrrli(hundnddollrr\lS5(x)l
<br />l. as owM ofrh. FDFny. or hy cnploF.s wirh Mg.s I rh.t slc cohr.mltion. sill do thr wt and $c slmr@ it nn
<br />inrcid.d or offEcd for sh (Sd.7Ot4. Busiftss and Pmfcsslons Cod.: Thc Coir@toas Uen* Ll* do.s mr rpt ly lo an owmr of
<br />rhe ptuFn, {ho tdilds or inlmrs $o@tr ad who &cs $ch e* himrclf or heftclf or llFlgh his or hr oM .trS,oyc6.
<br />pmvidcd rhat sh iopo\tre s@ rcl interdcd orotrftrt for eh.lf. howe6. ttE buiairg or irposBnl G $ld ihhin o* F{
<br />or.ooplctioll. rlr Osmr Buildd sil h.rc lllc budcn of lmvin8 fiar hc or snc-did mr h]iu or in+{DE ln. polEiy 6r dE 0upo. or
<br />-1,
<br />as owtur oflhc pop€ny. m cxclusitel, conr.ding eirh li.cn*d .o.rrdoB lo onslruci llE F.,.cl (56. 7044. BusinBc
<br />ond PDL\1ion C.dc: Thc ConrEctol s Lic.nrc Llv dms ml lpply ro m owflcr of,,mtcny pho buildr or inpr6w3 lhcmn,
<br />a6d who.o nds for ikh Fri* wnn aco.rracionr) licMd pur@r lorh.Co.hl t Lic.n* L!w).
<br />lo.tem urd$ S€rion . A. & P.C.forthn @$n.
<br />D.t. o*..r
<br />]II}AKE&ICOMIENTA.IIAN
<br />DICI.Af,AIIO!
<br />I h.6hy dfilrn undf lrMlry or ldjury on. of
<br />'hc
<br />following dcclarurions:
<br />Ih,vc4rdwilltuiirdinrCcnificur.orcon\cnrrosclalnsur.trworkdccompcnsln'n.asEovidcdlorhySc.rionlT@orrhc
<br />Lih.r Codc. t{, rhc tcrfomncc ot rhc sork fd which rh. Fcrnir i\ Lssrd
<br />I hrvc d will nrinr0i6 workcm compcns.liotr inslrancc. as r.tuiEd hy Sd ion l70O of rhe ljhor Cod.. fo, lhc p.rfommc of
<br />Mr insumrce canicr ud policy tunbf ac
<br />9
<br />-l
<br />ccdiay lhd in c r.rrornre olrhc wort for qhichlhis p.irnit is issurd,I \hallnor cnploy,nrlc*on i.anynsnlr
<br />v, N to t(om slb,cd ro rhc Mttdr oDpcnrlrk,n ld*i of Clliaomia, and a8m rhd il I sh.uld tx.om subFcl b $c
<br />work$ co mpcn\lr ion te! i4i. .f Serion 1700 ol rhc btnr Glde, I *h!ll. fonhwnh.omply *nt lhos Fmyisions..
<br />WARNINGT Failurc ro src {ork s' conqxnsrion .owragc b unlovtuL lnd shaU subjctr un cnt,.rr. lo oiminal p.mftis and
<br />.ivil nncs up ro oN hundr.d rhousnd dolllm ($lOo.0O0), in addirion ro rhc cosr of comr.nsdnrn, daM!.i {s providcd aor lhc
<br />Sdion 30T6oarhctibor
<br />III:(:IABIIIQIi
<br />ol rhc Ru\i'r\\ rtrJ l\on\\i,,n\ CoJc, rrkl nrl licrisr i\ in liilllnr.c xidcfli.r.
<br />3
<br />3
<br />coNlirxlgur.tNJiNDlNclgn$;i
<br />t hcrhr rlrt und.. |snulrr or p.rjury rhd rh.rc is a co.s'flcriJn lcndinBrScmy tor'nc pcriornurcc otrhe{o,k ror}hi.hrhis P.nir is
<br />hsucd (Sc...1097, Cir. C )
<br />AXILICANI,.DEIIiBAIXT!
<br />I tE$t atrm undtr pcillry of Frjory orc or ftc following d6l@ri6ns:
<br />Dcmfiion P.mil* Ast stos Norifi.srio. Fcdcdl Rciulations (Tirle 40, PM6)
<br />-R.q!n
<br />d kncroaNorifr hn
<br />_l ccn ily rnd rhc fcdcral cgrlarions Eg,.ding .shccros ..mral d. nor amli.lbk lo this toj.rl
<br />_l rcniatrhor lhuvc rcdd rhil tpli.lrbndd {!rc n h corLrt l usc lo conlply wirh ill ( iry .nd Counry
<br />o,ninrdcs md sllic ll*5 rclaranS ro building rtsrizc rcprcenrari*s ofthis CilyaBl Counry ro cnl* upon ln.
<br />anovc,Enlion.n rroDcny s.
<br />I
<br />Roof Drain
<br />rh. work for which rhh lI mil is
<br />Ort, /
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