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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />-t.
<br />ai oe6 of 0E ,'mp.ny. or ny .,n ,bFe with . r!.s .r lh.ir sL odl<.tario!. will {t tE s..t ad rlE sod@ b mr
<br />ddrH o, otr r.d for sl. (SE.?044, BBiffi lnd Pmf.$h Cod.'lhcConin.lolsUcrELlt&.tmt4!plytoanowndof
<br />th. rol.ny wts toil6 or inpoB $c6i. sd wto &E Mh m,k nin!.lfor lEMllor lhmulh har or h.r.m.mph)tcs,
<br />pmvidcd rhnr Mh inpD\Eftd36di cnd.d orolld.d nir$k.ll h.gtr,lh. buildu's or ispmsMr tu $ld wilhin orc r@
<br />of@spkiioq $. Ow*r Build.r will tEt llt l{dd ofpmvins di.r h. or.h. di! ml t ld or rprcE 6c F.ldry ftlr ltF ptqErof
<br />DECtdSAr@N
<br />I h.rcny .mrm ufl&r p.M,ry of pdj!ry o* of rh. hllowin8 dcL6roB:
<br />lhrLcrxlsllnrN nr(.drll(ir.ol(\nscri)S.l,rlns,r.lnr\$'lc(c.f,Pcn$rnn\ispnrtrl.dlnrhJS..ri l7ol)oIrlr
<br />I rktr Codr, li)r rlk ,)tr,onMrf,c.lrh. \..k lnr \h'.h rh. ncrnnr r asu
<br />-l
<br />haE .nd wiu tuinrrin m.I.n coq).n.alion inflEftq a! r.quiEd t y S6rioo l70o oflh. Lal'.r Cod., Ior lh. I'crfo'r1rlff of
<br />rL $o.l for *hth rhir D.mn ii i!$.d. My wo*63 omn Nlion iNuENc dkr 3ri policy Nmh.r ec:
<br />PolicyNunbd: ExPiGs:
<br />-l
<br />ccniry$ar intn. p.rfomE ollhc Bort tor Bhich lht Fmit i3 is.u.d, I sh.U mt chploymyFMn in.ny mnM
<br />m er ro h.sR shj6r ro th. e&6'oopctrerion lafl.f Crlifomir. and dsr lh.l if I ilould heom. sbFtl lo tl!
<br />wolkd'6mn.n$liortDvisio*ofs..lio.lT0oot0ELlhorC.d..ldEll.aonhwithodplywnhth.s!6virions..
<br />waRNlNC: lj.ilurc lo scclr. sork6' ompd36lion cov.6s. is unhvt!|, and .hall subjer .nploytr lo siniMl ndDlricr ari
<br />civil finer !p ro on. hundrcd ltou..nd dolld (1100,000), in sddnion lo rh. con oac.mr,.Mlnrn, daes.r N povid.d lor lh.
<br />Cod.. hld.st and.nomeyt fc...
<br />lrcldnAro!
<br />I h.rchydflnfl trndcr !. ilrlofperjury rhll I Mr liccn{n undcr rr,lisonoa( lmpt.r o (qnnnrcncins * rh s.crion ?000).fDivhi.n l
<br />ol rh. Bonn*s,nd Pmies{onscodc, ml nrylioen,e ie in tullntrc. el.rrecr
<br />co!f,rrucr&!--Ll;llllcicrxcr
<br />I l*Ehyafiirmnlldcr p.Mllyolrcrjuryrhar rkrc n d cohntud(rn lcndms nseocy nr lhc psrom,ncc oirfusork for tr,rrchrtis l€mir ir
<br />'ssud
<br />(S.c :1097, Cir C I.
<br />Latdd r Adts
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<br />ATTIICAII.DECI.ABAI]AN
<br />I hftbyrfmunder tBnalyol!.rju.yom oflh. follo*'"s dftLt onl:
<br />Dcmlilion l,crmits-Ab..klr Norificaton Ld.ml Rquldions ( I ill. 40. Pan6)
<br />-Rcqutld
<br />Ldt.rof lLrilica'ion
<br />I c.difyrhd lh. a.neml r.sulllions rcsardi.s lib.nor remo!.|are mr arplicabl. ro lnis preJt r
<br />I c.nifo rhd I lEvc rc.d rht lnDlicdrbn. l sr,t.rhllrhe6tnv. infomlion hcoF.cl.I slG ro mmply wnh allCity.nd C.n.ly
<br />ordimN.s ..d St.r. riwi Ehlins lo blildins 6ndcr iol! rnd hd.t y du'tbiz rq'Emlllild of rhis Cny tnd County to ol( uIlon ltE
<br />!b6v. n6lioGd pE!.ny fd nrpdlion pulnsi r
<br />Appll.!nr o. Ascnr SlBnni,,r.3,'ste.)-r rna a',ll a
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-under floor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarifier
<br />TOP OUT
<br />Waste & Vent .^lJ n .6-z)
<br />Water Piping )t4,tl' D n/l\*\*<--
<br />Gas Piping
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOUSPA
<br />P{rap/Drain Line
<br />Main Drain/Pool Pipino
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Rough Plumbing
<br />Final Gas Test
<br />Meter Release lt
<br />FINAL iltl 11 4t/tfitv{v il9-/
<br />Notes, Remarks, Etc
<br />()\vNt:R Ill -Dl:R Dt),CARAr'lON
<br />I hcreb, nmnn rndrr lc rlry ol n.rrrry rlw I Nn .rcnrr lnnn the (irntacldr l-i.c sc I rn i)r 11[ Lllotr ns reNrn (s- 7011 5
<br />Buenrss rl Ptufu*(on Coacl Ary(iry.rCou yNhrc[ reqtrrc! ] prn,ir h co {flcr. rlrcr. iDnNr. deh.lsh or nn.ir any
<br />Fcuanc., rko rcqrtrcs rhcnntlrair hr ru.h'l.nnii h filcr {i-!.ed slrrenr.m ihai h.or dt N lEens€d nunurii
<br />ro rhe nornions olrhc Conrador s Licetrs.d I iq iCh+rcr I, CoNn.No-! w[h sccri,r ?(X)0 of l),!(ron ] olrhe llunnes and
<br />I'r,frscion! G'dr) or rhd h.orshc iq exeqil iltrelir,nr rnd rhc hies i{y rhcr!l.!cd.kiDrtrnr AnyviolilnnofSrctbnT0:ll5iyrDy
<br />irnLmDr itr!p.nnl suhj.cr\lhc appl'crnri) rqv'lrcnrlryoi'rn nr)R rhrn nvc hutr(lled dollrr{{s500)
<br />-1,
<br />s owmr ofth. ,mr.ny, om .rclusivcly co.'lrndins wnh Ic.4*d cod6clou to onrtuci ltE lmjdt (sft. 7044, BuriK
<br />ad Ptntsi,n C6d.: 1 h. Contr.clols Lic.nk Lau doB ml.prly ro m o*nd .f trorsly wh. nuiueor idpmv.! lhfton
<br />lnd who olnars for tuh pnj..l3 eirh ! Coirhcr.(r) licn*d luFd lo rtu Conldcl6l3l,i.an riw).
<br />///24/ry
<br />Fill Line/Back Flow
<br />Back Flow Device
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