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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG,COMMENTS ()NNUR BllILDI:R Dl:l-CAlt,rl',lON
<br />! h.rct! illirh und.r n.mlry (Jf rcr,ury ll[l ! nar cxcnrnr &nn lhe Conlrictor'l,tcnse Liw lor rhe Iillh*h8 r.aq{r r\(7r1lt.
<br />arsinsi and PNIc$n. Cqlcl Ant ciry or cou.ry sh'ch r.qurcs r n nnir to cotr(rucr. alr6, rnpnrt, d.nFlish or aPrr 8ny
<br />ern'crurc. nriorro irr rsurc.,al$rcquresrlre0nr[c.nr,i,rs(c|Fn,itn,fiLdsilkdrarcaEnrrh.rh.o.shtNh.ns.nntrrnrtnr
<br />ro rh. tmvFion! ol rh. Conrhclois Licen*d Latr' (Ch.trd 'r, ( onrnrrcrn! $ h Sccrnn 7000 ol Divhotr ll oarhr Bus tse dnd
<br />Prcfesrcns ConL) or rh tu.rshercxeD rh.r.hm.ndlhchansr.rrheall.scdcx.nrflion nyvnn tr,nolsehnT0ll5hv.nv
<br />rpllicrnr nr, peim qun](Bihc anplicad l. n.i!ilpcmlryolnor Rtrc(hrn firc hudred dollr I i500)
<br />-1,
<br />0r owftr of rh. tNr.ny, .r my emploFs with ws8.s s th.n $b otjl)meriol! will do dE *ort .ri $. $ruor ! ml
<br />inrard or ofLrcd for sL {Se.?044, Buein* .nd Pmf.seioB Cod.: 1 h. Conmcloi! Lice Lls d.d @i !t ply to s owr ol
<br />ri. pmr.ny wln bujlds or opov6 th.@ll .rn wh. don $ch m* himrlfor h.elf .r t,muAt tk or hf om .nplor!6,
<br />p6vid.d rh.r .uch ihlmw* @ ml hr.xH ororl..d 6r sL. lq io*.g, rlE irildi,rs or inircls8n i! $ld wilnin ok Fr
<br />otoqrLiioa rhc O{n4 Build€ will iaE $. bud.fl ofpmlins rlsl h. or ihc dit mt build or itlporc lhc pdldy t r ttE ,rqns of
<br />-1.
<br />s owm, oithe Dron.ny, am dchliv.ly co r&rin! wnh liccN.d co.rmcloE k' snn cl lh. !m.i.ct (Se ?044, Buines
<br />dl Polist n Cod.: -l h. Contrlcloi s Liccnsc Low dod nor apply {o .n own t ofpmr.ny wln build, or iolove rhmn.
<br />ind who @nrEB for strchpmictswirna Coni6cto(s) lic.trr.J Ducunr rorh. Cont.dor's l-iccnrc L!v)
<br />I am .r.mfl xndfi Set B. & P.C. fo. dris Rosn.
<br />.!oa[[8!30Mlr!larla!
<br />DTCIAAAUq!
<br />I h.Ebyo,Imhdd pcMltyofpBturyom ofrn ao,lowifl8 delomlioBl
<br />lh.vcandsillminlainaC.nifr..rr.fcon*nrroS.llltr{rclor*orldtconPcnsdlion..spmvttdnxtys(oon:1700dfrh.
<br />Liborcodr, itrrhencrnn anseolrhcworkforsnthrhcr6nnr is icsu.{.
<br />-l haE dnd will n.inr.in porl.( cohr,.malion intuB*q &r r.quir.d by S.cri.n l?00 ot lh. L!b.r cod.. for |fi. pdfolm of
<br />rh. worl fo. which thi. r*mil ir iss.d. My eorl6 @dti..slion i8ulM. cEir dd F,li.y nusb.r d.l
<br />llrlicy Nu,nhcr
<br />-tixpnes
<br />-l
<br />cdiry $d in rn p.rlortue olth. work aor whi.h lhis F mil i, isN.d. I ihlll mr .nploy tny p.mn h .ny ft'Mr
<br />s as h t@m stjd ro th. mrtd' ompm*tion la8 of Cdif.mn, trd t8r lhd if I slhlld &oc sbjftt lo th.
<br />wo*di contEosrion pmvisioB of S..lion 1700 oflhc L!t{, Cod., I tlEll, fonhsnh ohply wnh rho- povieiotu
<br />LlctrsflcQNraAqaa
<br />D.}:CIASAIION
<br />I her.by.mrnunder,xhahyoIpcrjuryrhar I am liLrnEd und.. pn ir'.n.fclqrd I ($mmrcinr wnh scrio. ?000) ol DNisDn l
<br />o,' rhc Businss Bnd l,ole*n, C.d., ad mylic.Ne ie in tull torc.rddllecr
<br />CAISIBUqIIOII.IUUBC-ACETCI
<br />I h.r€hy ifir und.r r.Mny o i Dr.jury ltal ltur. is. conno.rkrn kndins asdcy fo. rh( FrliJM.. olrh. trort tu $h(h rhn Fmil ir
<br />hsued(stc 1097,C,v C )
<br />AIILICANI.IIDCIA8AIIOX
<br />I tF:ry ,nim u6 d Fn.hy olr.rjury on. of th. f.Uowing ddl,nriof,s
<br />D.molitionPcrm s Arh.{otNorincarionl'.dcr.l Rerll.tions('l'nk40, P.n6)
<br />-Requirerl
<br />t,err.r o l Nolnorion
<br />, cclifyth.l rhe fcdcml r.r!lar(,B rcgtrdrn8 Nhcclos rcmular. nor applic,bL b lhis Pmj(t
<br />-lcenLtyrharItsvcr.idrhBrpplicrlnn0d(larclhalrh.ilx,1!n,fimmroDncorer.I!src.t'-mplyN
<br />h.ll(-rlv. Counr,
<br />.dimncel and srd.l,{r rcLrns ro huildins con(n'clion. ftl h.r.hy durltrn. rcrrsnhlrv.s oirrir Ciryand Counryro.nlfxFn rhe
<br />160\c mcnrpn.d prep.ny lor iGperion ,uqrscs
<br />ADDllcrnl or Agenr Sl8m.ur
<br />P.rnlr.. ncme (prlnl)
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor
<br />Buildinq Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarifier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Pipinq
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />Ptrap/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 />Rough Plumbing
<br />Final Gas Test
<br />Meter Release I
<br />FINAL al5 1_0 D*ooa t,*ffi
<br />Notes, Remarks, Etc.
<br />Back Flow Device
<br />WARNING: l:nrluE b sur. work.R srnp.N.lion $v.n8c rs unlawtul, .nd sh.ll I'Jcct a. .mrlorr ro nm,.!l pmlts.nd
<br />civil fitres up ro one hundrd rhousrnd dollau (5100.m01. in 0ddilion lo rh. cos otconrp.nsalion, dnme.s .r pmlided lot the
<br />SLrrion :ltJ76 oi rh. l..tnr Cql., inr.r6r lnl atonq's i.6
<br />L.rd6r Add6
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