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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER I]UILI)ER DI:I,('ARA'I'IoN
<br />k, rhc nm!i\t,N ofrhd Conrractr'\ I (n{d Lf,* lChn|1cr 9, CunmrNiDF rvirI S.(riln 7(xr).1 l)ivi\i,in.] ol rl'c llu\i',cs r
<br />rrdicrd tur IDcnnir\ubrursrlr. rrpli(unr x, n civilpcmlr!ot ortrx{rrhrnliv.hutrdrcdd,'lIrs(15(xr)
<br />-1,
<br />s oM.r of rh. ,l,oFny. or m, rndotEs *nn wages * lncn soh onlEnsdlion. will do rlr uort 0!d t rlNtr is rcl
<br />inrcid.d orolt r.n for sh (Se.7lX4, BusiN$ dod Prof.rlioM Cod.: Tt* C.r{rdo Licc.sc t w dm3 ml llirly.o an o*ftr of
<br />rlE pDD.riy who builds M itrp,s6 llen. and who d.N sh M* himsclf or t mlr or rhoulh his or h.r oM cmrlor!$.
<br />pbvA.ri rhd sn implmnls m mr inr.,rd.d notu fm s!.. l[ tn{tc. rh. buitdaie o. in]roEr is $ld wttinoic ]rr
<br />of6i'0brion. tlE Oem BuiE r will har dE liftbi of provinS $or hc or inc drl mr hitd or in{mB dE piDIETy for llr puryot of
<br />-1,
<br />aso*ncrotrhc pmpcny. aneiclusiv.ly.oor..ling wirh lieoscd .onlhcroN lo construcr rlE Imjtcl {Sec. ?Or4, Busitus
<br />ard P0l6sar Cod.: Th. Co.tncrols Li.cn* L{w dBs nor aFly ro un osncr 6a proFny who builds or improEs lhc.con,
<br />and eho conhcr. foi ru.h nojccri wirh r Co.rhcro(1) lic.n$d |)usunl to lhc Contretols Liens. ljw).
<br />-l
<br />!flcxc'nfl undcr Srrio B & Pa f.rrhir r.tr$n
<br />lhNc$d eillnuinr0itr rCcniarcdc of(o$c n) Sclil'Nurc nn {orkc^ .on)pcn{nnr, !\ trovid.d tur hySccli(r'lTulolrhc
<br />Lft.r (i .. ft, rhc pcfrnrtrn.c of rl[ work lir *hi.hrlquntir is issucd.
<br />-l
<br />h&c .nd will minllin *ortcis coqrcnsllio! inslnmc. !r ,.q!n d b, S<tio. lrm .l lhc ljhor Codc. for tnc I'cdormre of
<br />rhc s'k for *hE! rhiiFm rt D.ucd Mvs kc'.tutr'n n.trk in nrur ok. cM 'cr 6nd llnlry numhn rc
<br />,-,", SS*, Ca,vf-
<br />70 d l2 ,a
<br />-!.cniry
<br />rhar inrhc poro@rc. olir wort fd {hi.h rhis poni' is issn.d, r sh0ll not employanyFmtr in lny turicr
<br />s $ ro h.sm ru6jcct to rhc wtri6 snFcnsrion b$ ofcllilomi!. and .3m rhlr il I \hould l6m rubixr '. rh.
<br />wrt6 o,q,cnsrion pmvhions of Sdion 1700 of rnc L{&n Codc. I *hall. ronhwnh sm,lly wnh llsr lbvkions .
<br />WARNING: l.dlurc ro $curc *orlcK cotrrpcnelion covc.asc i\ un lorr t0 ai ml pcn iis lnd
<br />civi! fincs up
<br />'o
<br />orc hund.cd ltoletrd dollm ($100.000). in uddi
<br />iolcrcsr ond oltonry\ rcc!.
<br />a,It
<br />I}ECUf,AIII]N
<br />ua". p*i,i.,o ot Chuflc C t.nmftming wirh serioo ?uDl ol bivision 3I hrbyrmro und.r p.Mlry or pcrjury rhd I !fl lia.a\l
<br />of rlE Bulifts ad Prct $k,.3 Cod.. rld ny lh.ns is i! tull fo@ o,n olYd. )
<br />Ihcrchyrlinnu.rltnrlrrofFrjuryrha h.rcisd.onnndiJnhndi.fi8cn.yf{trlhcl[ni)nrE,rcolrl{workturuhi.hrhhltmnn
<br />issudiScc 1(rg7 (:iv CJ
<br />AIEI.IIAII.DECIdBAIT!]E
<br />I My atrm under r.altt ot F.rjury oN of rlE lollosint d(hmrioos:
<br />D.mliion Pcmik.Asbcstos Norificrrion Fcdc6l R.gulrrioB (TnL 40. Prn6,
<br />-Rcq!ncd
<br />l-excr ol Mnifi calion
<br />drh.{olrcmvalar nor lptlk,bk lo lhk F+cl.
<br />ion i\.orer. I lgrc ro.oDplyNirh trllCiryrnd Cou.ry
<br />Applicanl o. Aaenl Sh.alu
<br />.:,",.{r*/il-
<br />-r-
<br />UNDER GROUND
<br />Waste & Vent
<br />WaterUnder floor
<br />Gas-Underfloor
<br />Buildinq Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Pipinq
<br />Gas Piping
<br />Roof Drain
<br />Tub/Shower Test
<br />Rouqh Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />Main Drain/Pool Pipino
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Hough Plumbing
<br />Final Gas Test
<br />Meter Release /\
<br />FINAL g-tg1b h.w,\L)
<br />Notes, Remarks, Etc
<br />ITBTEXEIOMIENIiAIII}!
<br />DEqLIXAIXTN
<br />I h.rcbyrfftrmundd netulryof Dcrjuryoe of 0E followinEda!{ ionr:
<br />Gas Service
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