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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Underfloor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarifier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Pipeing
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />P{rap/Drain Line
<br />Main Drain/Pool Piping
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Gas Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbing
<br />Final Gas Test
<br />Meter Release
<br />FINAL /o/, "/t t,,At ,n
<br />Notes, Remarks, Etc.
<br />oMd-Blildo DeLnriotr
<br />t !s.by rtrm und6 p. hy of pdjlry 6n I u en ford th. ConlIldotr' Li@E Lrw 60r Uc followiig t6on (d.?Ol l 5 Buind
<br />.td Ptofeion Cod.): Ary City or Couty whEh rcqutg ! FDn 10 @@rruc! d. inprov., d.elilh or r.p!n ey rrrudu., ,rior to i!'i!tu!.., rho ,cqut6 d!. rppliGl for iucj pqmn ro filc . iiSn d 3[!o.tn $r! h. o, tb. i lic.N.d tust to th. provilioE of E
<br />Coilrldor'r Li@N.d L.a (Chrplo 9, Com.eiry wirh SErion 7000 of Diviiion I ofrl8 BBin63 ud P@f6rioN Cod.) or $!r h. or
<br />sll. n q.mF lhd.fiom rnd $e b.!i! for d. tlLe.d dmpiioi .A.y viollion of S.dion ?03 ! .5 by sy .ppliot for . !.mn subJ..lt r&
<br />.pplidnl ro r civil p@Iy ol not doc n5& fiv. hundrcn dol]lR (Stoo)
<br />_I, a om6 of dE popary, or my .nploy6 with Mg6 !r rhci, roL 6np.Mlio4 will do 0!. wo.k r.d rh. 3r!uc.u. i. not inrad.d
<br />or ofd.d lor d.( 56 70,14, BuiGt.trd ProldioB Cod.. rh. Conricloa! L&8. L:w dG rc1rpply ro x omc olrn p.opdy
<br />wlD buikb or improv6 dE@,! od who do6 ruch wort hi@lf or h@lf or rtuouSh his or ns oh dployd, providcd lt![uch
<br />impro@.rE u. mr int..d.d or ofis.d lor slc ll hosve, 116 buildinS or inprov.m.n! i! rold withi! on. y{ ol @mpl.rio4 rt
<br />Ow(BuiLld will hrv. ttrc budc! of p.ovioS thll t! or in nor build or ioproE for lh. purok ofoL}
<br />I, a ohs olth. prop.n , u elosiv.ly @nh.ring w lieEt d @nu.cros ro @Nrrucr ih. Fojei ( 54 ?044, BEis* &d
<br />Profsrion Cod.r 11I. Conr.crofr Li..B. L* do6 mr +ply ro e orM of propcr, *ho buildr or imlrovd 6.r@n , .d qto
<br />6fu.6 aor iuch prcjel! witn . coturcr,o(o 1i...!.d ps6r lo rh. conr'.doi! Li@. rrw. )
<br />I !n.x.hpr unds S.dion
<br />-B
<br />& P C for rhi! r6on
<br />WORXERS COMPONSATION DiCLANATION
<br />I hqc6y.ttirh unda peMLyofFrjuryon of ihr followirg d@leriod
<br />_l h!e. ad viu 6.inr!i, r C.nilldEof CoE.lr !o Sclf-t86. for m cR @hp.MrioD, u provido.l for by Sccron ITOO ofth.
<br />Lrbd Co&, hr lr!. pqforltl|@ of th. vdl for *iicb th. pqEn ir iriu..l
<br />Ih.v.&d*illMi rin mrkar' oDpcutio, iBunme s r.qun.d by S.crlr 3?0o otd.Lbo. Cod., for th.Dafot neof6.
<br />wo,k for which tti! p6ai i5 i$ucd. My mrle comp.Ntion @uD6 uric, dd poli.y nuhb.r rc:
<br />fltu s*lion n .dtut b.6npLt.d iath. pcroit t fo. Ooc hundr.d dolbB {Sl0O} orlq)
<br />I ccn'fy tl inrh. paform.e ol th. *ork aor which rhi! p.rmn i3 i$u.d,I !h!ll no.dployr.y pd3on ininynrnn.rsosro
<br />bd.hc subjdt to thc workas onp.Brion .!dl8rert if I rhould t@@ rubj.c ro 6. worlct
<br />CA \
<br />WARNINC Flilurc to sccurc *orkc6'ir unbwnrl, Md lhrll Bubjd .n .mploy.r to 6mi6l pcMh'6lnd civilfu6 up !o on. hundr.d thou{rd d6lLr! (ll
<br />the trbor Code, i d6r md i!@m.r'3 16
<br />00,00o).i, .ddhion b th. @n of@DFMtioq d.og6 s lrovitd fo. rh. S{rion 3076 of
<br />LICENSED CONTRACTORS Df, CLARATION
<br />I ha.by lrtrm uda prDlty of pajuy tblt I s li@.d lds provnion of Cbpla 9 {@mm.ncin8 w S-do. Tooo) ofDiv6Dn 3 of
<br />in Bui&lr .nd Prof6lion! Codc, and my lice6. ir i. lull fo,@ od dldt.
<br />L E \ t3:<.
<br />b Ir.trt,e
<br />I hd.by.trm !ftld p.D[y of Fjury tl
<br />irsu.d (S@ 1097, Civ C.).
<br />kn ling lgcocy fo. ttu D..fodne ol !h. wo,t aor ehich rhi. p.rnit is
<br />ATPLICANT'S OACT Af,ATION
<br />Dmoliri.n PcrEitr'Albdror Noifiorio. r.dd.l R.suLdotu (Tnl. 40, Prn 6)
<br />_ R.quu.d tatt6 of Norifiotion
<br />I €nify th.r th. f.d.6l r.gularios r.8i.din8 db6tos renovil .rc nol rppliqblc lo lni5 projd.t,
<br />Ls rehdng lo buildii8 @crrdio4 !.d h.r.by .lthoria rcptddlrrils of tlir
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<br />mbing-lnspodor R6.ord.doc 0331 06
<br />POOUSPA
<br />M isc
<br />Water Service
<br />WL
<br />D{. __OM.r
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<br />iad tha ippliotlion !d rEt th O. lbovc infom.tioi t @r*t I lsrc ro 6sply wnh rll Ciry lod County
<br />tc{I 1
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