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PLUMBING-INSPECTOR RECORD <br />APPROVALS DATE COMMENTS ( )$N tiR strt t,t,r:R Dt,],cllt{A ( )N <br />rtflrr r lor r lltrnir \uhF.r\ rhc iflrl'.drr tu r.n1lt)cNlryolfrr nxtrr rh{n lnr htrndrcrllollx^(t5(x}) <br />-1. <br />rs o$ncr ol rhc n!,Fn y. .tr <br />'ny <br />crnrh'lcc\ $irn $!scs r\ rhct v,l. conrFn\dri(,n, $ill do rhc wolk ,xl rlE slnf,lu k nol <br />i[.kl.d oronrrd (r ek (SLr 7O]{,Ilu\imrs and Pof.\non\ Codc:]'hc Conru(ktr s Ltcnr l.w der n.r q,Ily n' nndwncr oa <br />rhc pmFnr who hitts or impro\$ rhcmn, dd who dfts such sorl hnn\clfor hc6clfor rhrough ht.r hcr osn cn,floyc.s, <br />F)rnbd rhlr sn.n imnn)Enrnls arc rxn i'rrc .l{l or onircd ntr $h lt tx$cttr. rhc hui[i'r8 or inDmk ttrr h $U wirhr onc ]trt <br />ol con$lcli)n. rh. o$nc. suilds s'ill hrvc llE budcn of pmvirg rhd h. or shc li1 mr huiu or irryn,E rh. pn,rd, lir rr* puqrM or <br />-1. <br />!sowncroirhc popcny. r rcrclusivclycoorrucring lnh liccned conrncror x, con(rucr rhc poj.cr (S* 7o,r4. Bu\inc\\ <br />ifii P$hs*im Cndc: Th. Co.lmcroCs Li.cnsc tlq do.. nor oprrly ro tr.o*ncr ol p..rcny *h. $uilds or inDmhr rhcmn, <br />drd wlr, .odrucrs for slch nNjc r warh ! G,l E.ro(r liei*d Nr\urtr( ro rh. Coitodols Lien$ tir) <br />-l <br />am crcnlpl undcr S*lio U & l'C lnrrhi\ rc {)n <br />ljlaf,EBs:coMfENtauq! <br />DECIAIAIIIIN <br />I lErcby ilrfo undf pculry ot pcriury oE ol rlE followhE d6&&rioos: <br />lrfir(i ..li'.r[.plrfornJ(cof rh.$ork i(n$hi.irhcllnnir i\ i$trrJ <br />Mh r n,lq ll rtr r a,rl.^' (innr.tr\rr'.tr n {trirtc, r\ rcquic h}Sc.rnr:l7lx)olrhclihorCrdr.nnrh.pcrrormmcot <br />rlrc q.lk tu shi.[ rhisFnnii i\ nnrcJ My*.rk.r\'.o rt,ctrr.innr iNurrf.c.rnicr r ro]icynun$c!nrc: <br />'. frr: Co.af LLo- rwcst <br />l,l"-lu*,*, r. bYLVf oqfu(l@ t7 <br />I.cdify rhnt ir rhc pcrrormnft rfrhc work f.r whkh rhi{ p.rmit h ii{u.d. I rhollnor cmnloy ary J"'"",*' <br />$ r\r)hcomsuhjc.ltolls$o crr cnmncns io lnas oi (.nlilorni( nnd l8ruc ihri irl shoul,l hcco r\uhjccrhrl'c <br />*orkcrl conlNn\ irIn,visionsofSccrnrl7 )olrhchl G)dc. I tull. lonh\rith conDly wir h rho* nnrvtions.. <br />WAnNINO: Fail,rc ro $dr. {o*crs @npcnclri,m ov.tusc is liln*fxl, rnd snrll subF.r ar cmrlo}r. io 6imin.l F.rxts md <br />civil fitrcs trp b onc hx*]rcd rMxsind doudB (Slm.mo). io nddnion iotr. dduss is lnridc, i)r rhc <br />DECbAAIIQ! <br />I hcEby alfirnr und.r p.nrllyofFrjuryrhar I !m liccnan undn,,rcvnion olChorrs 9 (ommmin8 virh Sslion TUjO) 6tDitisi.n:l <br />of rh. Bu{err lnd PNr.$ionr Cod., ur! m, li..n\e n in i,ll t*.! olll cllrr <br />c t <br />I h.at y !finn u c. IEn,lly of perjury lhd thcrc is ! consldclion lcdiry o$ncy r'o! rh. D.yfornancc of rtc sdrl rnr whi.h rhil Fymi! ir <br />issu.d 1S... l{t97. Civ. C ). <br />d-tfu( NfDEcLralrIQN <br />ItErht dlinnu .r |En.lr!!ll{ijwto.colrhclirll'tr\$pd..liniions: <br />D. nnIrr] PonnNA$.{or N.ri,l.iri, Ftdcnrl RqrtrllrnnsrTflc.l),Prn6] <br />-Rcqunc <br />L.rrcrolNolili.!!ir <br />- l.rrirJ r',. r1,.1,11..,l'.!ulri,ar n.!r,lirg LJ\ ,^ <br /><Jl.{r'rj rt,I h,rc '.Jd r\'Jnrl.Jrr{r.trii Jrt'rh. rrr' <br />rcnnxil s. nor Epdi.dl,h ro rhi\ pmlrl. <br />inaomrion is .(rer. I 3gr ro 6nply sirh lll Ci <br />.din0tres ond Sial. L!*s clllinS !o buildinE ourh.rir EprNnlalircs of lhn CI, and <br />trh.vc mnrion d F)pcny r$ ir <br />L.t/ <br />Waste & Vent <br />WaterUnder floor <br />Gas-Underfloor <br />Buildino Sewer <br />Area,/Storm Drain <br />I nterceptor/ Clarif ier <br />TOP OUT <br />Waste & Vent <br />Water Pipino <br />Gas Piping <br />Roof Drain <br />Tub/Shower Test <br />Rough Water Heater <br />POOL/SPA <br />P{rap/Drain Line <br />Main 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 />FINAL lo 7 t///DWwv 7 <br />Notes, Remarks , Etc. <br />ID/SIG. <br />UNDER GROUND <br />Meter Release <br />L a,lr"\ Nrmr <br />I. ,t.,\ <br />^JJ,r..