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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area./Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<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 Pipinq
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Gas Service
<br />Lawn Sprinkler
<br />Sanitary SeweriCap
<br />Back Flow Device
<br />Rouqh Plumbinq
<br />Final Gas Test
<br />Meter Release
<br />FINAL DAoac
<br />Notes, Remarks, Etc ll
<br />OIyNER tlUlLlrliR Dl.:!.( ,tRA1l( )N
<br />I hcrrhl ilfinn u cr p.nrlrf {)fl.ritrry rhd I a'n c(cnu rnnn rlr Q)nt&t,^ ldtrsc t-rLv li,r rhc {oll.$irE rcJY,r lscc7o.115
<br />{nr.ntrc. lni,{r, irs h\rimc. nllo rcqutes rhc,rp]i.n l,tr srh Nnirl,r rll. r lignr nrrcnr r rhd hcor nr is lle.n{d NNrinr
<br />r, ilr tn)vi\iof\ ofrh! (nnrr.ktr \ Li.rn\cd t-na r(hJtrrr q, (itrn trrr8 tr[h S.criM ?(XXr.f lhi\ion I .l rh. Bu\nr\. rB]
<br />Profc\$or\Clt).rthItror\hct.\ctrrplrhcrcnonriodrhch!n\L.rhcnllrg.dr\cnlPri,r Any!i{nni{,nofSc.ri 70:llthfrny
<br />ipplicrtrr inr aJxnnir \uhJ..r\ rhr rptlicanr b a.irilncmlryolnornnm rhm n\c htrnddl dDllnn ( 3500 )
<br />_l- a\ o*tur oa ltc thpcny. or ny coplryci. wnh wrgc. * !h. slc.on{Ens0'ion. will do lfu (dk ard tlE slrDclE i\ hl
<br />inr.ndcd or oficrdt fo. sk (58.7044. Busircss md PmLrsions Cdr: Th. Conrtlclols LtcnF Lr* dei mr qldy ro s owmr of
<br />lhc rmlrrly wtn lDilds q inpmB rb.a6n. dld wts d6 sh M* him..lf6r hcrsrf or lhrcrsh his or hcr ovn cmttlotles.
<br />,nvidcd rhll such iqmvcmnls m tul i'rlc.'d.d qo,tu for slc. ta hoehi rlE hriui!8 r in{,Ercmn' is mld, nin o* tle
<br />of coopldion, rh. Owncr Build.r will htrw tlE txrdcn of lmving rhtrr lr or shc dil nor bliu or inlrow rhc prrory for ltf, port[s of
<br />rfd (lr.'tri .trri'r{drtn.jr'.r!\ilhrC.trrx.kir!iL'(r,,n\lN,{rtrriorlr(tnnxror\li.. 1tlr\)
<br />lmcxenD' undcrsNlion ,B &PC forrhilrcL$n
<br />II}BtrESSIAMSATAII(A
<br />D[ClAlArlo!
<br />I h.rcby rllrm utrdcr lenalry oa psjury om or r,!c folh*inr d(lararion\:
<br />-l
<br />hrw a,i will minrain . C.niaksr. ot Corsnr ro S.lf'ln$rc for sortd onld{ridn. .s provile<t lo, by Smlhn ]7m of dE
<br />tibor Codc, for rh. p.rfom of llE mrt fm *hth llf, Froi i! ns6d.
<br />_l hrvc atu *ill minroin $o*.n comJEn$lion insumac. .r rcquiB{ by Scliotr 37m oa ltu Lrhor Cod., ,6r $. p.rfoMc or
<br />conpLn$rion if,suamc cMir ond llolty nlml,s @
<br />rC-
<br />-l.cfify
<br />rhor in rhe pcrfotrmme otrh. *ork nn which rhn ll.rmir h kqucd.l ih.ll nor.mployany pctro. in any mnNr
<br />$ NrolE o@ subj.r' !. $c $orkc* coqr.nsalion lavs ol c,liforni.. and tr8e lhal ifl slnlld tc.om slbFr lo 'tb*ork n $mpcn.trlionpovisions ofsclirnlr0o oflhc tihor Co.I{rll.lnnh$irh( rpl, sirh rltuy tmvni( i
<br />WAiNING. Fqlu( ro qum sorken
<br />.'v'l fmcr uD rdo!! hundrcd rhouqnd
<br />serhn 1076 orrbJLhr cod.- hrcrc{
<br />"^". v{b-ro
<br />trnluwrrl. rtrd \hnll {'h]ccr an cryl,,}[r ro dimi.rl Ftukid nnd
<br />ion to rne .on of comFnsarion. datuscs d! pii,vidc; lor rh.
<br />l)r,(t.tlt\ll()\
<br />Incrchy ainnu cr rcnrlry.incrjury rhlr I am liccnql lndcr provi\ion orCh.tror 9 (.nmrmn.,tr! *nh Sdir 7(xnr oil)iri\iotr l
<br />.f rh. ausircs dnd Profcsio$ Conc, lnd nryliccn{c ir ir lnll lnrcc 0!d.rlNr
<br />L ,,r t0s?l OU
<br />li=zpza
<br />g.}NiIAIJCITONIENIIIN!.{GENII
<br />Ih.rchylllirruddrrnrltyDflcrjurylhdrhncis!.otr{n'dirnrhndingrB.Nyhrrhcpr.lomlmcofrhtw.Atrshichrhispcrn h
<br />is\lcd iscc 109?, Civ C )
<br />a.ttuc NfDEtt"tSauaN
<br />I lurby rlin undcr Fnrlry.ipcriury onc of rhc lblloBin8 dcclamrtr\l
<br />Dr!to,lirnJn P.rni\ rh{{o\ Norin.rrbn Fddcirl Rcgulnr i(,n\ l_Iirld .l1]. l'f6 r
<br />Rr{tuircd lr($ or Norili.iidr
<br />-l
<br />ccnifyrh rhc,cdcralrcglbrions ,sbcsros rcrBrvdl,rc nor lpplicrbL ro rhir Frojccr
<br />?.c,r,r-vrr, rhrvc..rrrhl!slrtcrhrr thc sh,vc nrfor.nnnnr i\corc.r.I !S'rc t,co Dly wirh all Cir!.ni Counry
<br />o(lirrtuc{rtr Sfurc l-n\er r.ld rcby.urhoriz. rqrrcullrirs o, rhis CnyMd C.unlyro cnrd ul)onr,r
<br />rtx,v. rirn,ncdpn,pcn,f.r
<br />I itia.^4 5 ' -,", l<-?Azo
<br />I
<br />Water Service
<br />b r, JJ'cs
<br />-IWu
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