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PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under floor
<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 />POOUSPA
<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 />Rouqh Plumbinq
<br />Final Gas Test
<br />Meter Release
<br />FINAL ul'30 9tItrnu u.fr-b"/
<br />Notes, Remarks, Etc ,l rl
<br />th,z/z.o {b,.*ovo4 a^r?ul -.4X.11/
<br />I /-.r
<br />OWNER AUILDER DELCAI ]'ION
<br />I hctchy.mn trnde. I).nalr,.f Frjr,r_ rh,t I .n ex.nr fmnr rhc Conrado6 Lice.* L.N lor rht ldloq'in8 niq,n (s.. 7i) l l 5
<br />Bu{'n.$ ind Pmf0sM Codc} Any Cily or counry *hich r.qund t pcnnir k' c-nsrruci, rlicr, mrF re. denr[sh or rcnnn my
<br />sfl.ntre, prm,lo ils 6swcc. alv, rcqxfts rh. .prlicanr ri,r su.h lFmil b 6lc t sLln d {ri.Nd rhd ht or she is l,c.nrsl rummr
<br />lo Ihe I'nrrir'.ni ofrh. Cotrtriclo.3l-icensd Lr* lChrPts 9, ( dnnrnciry wrh Sccxon 7m0 ot Div,rion I olth. Lusine$ rnd
<br />Ptuf.$idns cod.) or tl[r h.orshc 6 excnrpl lhercfirm and lhc hr$s for rhc 0Llcged ercmtnon Anylid onorscclnn7l)lI 5hyin,
<br />i k hr.a.nn uhrccr.rFc rnrl'Jrd,1i,tr.lp.nilry.lmr,m'.rhrfi\.hd '.dd,1,.tr<r\ro rI' l)ry'9,1*"**,"',*n-n.ny,. m, emnloyr\ q th Ni8er is rlPn {nc snl]e,srion. s ill J.' rhe work tukl rh. nMruc F nor
<br />inr.dd or o,Lrcd for $1. (s( 7M4. Burimsc rnd Pmf6si,)ns Cd( 'l hc ConlDcnn i L&hs. hN dos n.l apll, ro M osn.r of
<br />rhc tmpdv qtr) l,o'lds.r in!,(tr'.s lh€6'n. aRi wln dxs {I.t trT* hmr.ll.r h.6ello! though ht or h.r osnenployees.
<br />lr)rnhdrhrr {'ch i'nnmkr. Giro({ 'nrdrd.(loroftnl lhr sil. I[ hos-!r, rhc hu'ldins or mnm\otnl h vrld nlh'. onc ,ar
<br />ol'comnldion.rh€Otrn.,BurLlcrwdlh.v.rh.burdrnolrhvrnsrhlrlk.rsheddftnbn'ldormlmErhePmpen,l&r&norrs*di'
<br />-1,
<br />ar owr of th. popdy, .m.rcluriEly contMlins vilh licd{d .o rodoRto onr rh. r,Fj&r (sc 7M4. Busm$
<br />anl Pmf6sir Coder 1n. Conr.cto. s l-'c.ns. L.u dos R .nrly ro atr osn.r of builds or imphlB rh.r6n,
<br />.nd who 6.rEct3 forruch t"oiels wirh a s)liceNed NRUn brhe('
<br />llgclASalro!
<br />I h.r.by alUrnund( pe,Dhyof D.rjuryone.llh. lbll,rwins delanri.ns:
<br />I lBr sd qlll mnrDin . c.nr ficare oaaon€nt ro Sclf.lnsre fin *$kos conrPensrion, as pmvnkd for ny sdnotr 1700 of th.
<br />L0tin aodc, lorlhcDerformanccolrh.woll forwhlchihcFdmir h hsucd
<br />-lhw.rndwillDii ain wolt.B omn .sadn itlsmr., 6 Fqtrcd by S{l ion 3700 of li. Lr5o, Cod., for lh.,6fol1rwc ot
<br />rh. vork forwnich thi D.rmir i! ie.d Mywor[6! ohpa$tion indEx. @di( &d policy numbq e:
<br />mrtd' smpnerion Dovhionr ollcrion 1700 ofrh. trlsr C.dc, I Call, fonhwith @nply wilh lh* pm
<br />IVARNINC ljr'lurc b *uE {ork 6'compcnsalon orcmlt 'icril li..s up to oE hundr.d ttFusnd doll.s (Sloo.mo). n lh. cofl of.oqrderio.,
<br />inrcrcst and anorney s fas
<br />ll[cLAEarloN
<br />ItcEbyamrnund.r p.mlryof,Frlutythd I anr liencd u cr pmlrdh of( h^nra 9 (commmios wnh se(itn Tolxr) of Drh'on l
<br />of rh. Busin ssond ltofesn.( Cod., arn 6y liccnse h h tulllnrccondeflecr
<br />l-ic.ns. Cla$:-I-i..nsc Nlmbcr
<br />Drt. corln.tor:
<br />coNsTRtrcl-lolt I INDIN(: A(;f,Ncv
<br />I h.r.by,mnn und.r r.nrlryofpcr.,!ry rtd lh6. ir t snnrudbn kndins ns.rc, for rh.lsLnmxe ofrhc *ork lin whrh rhtr IEm, is
<br />issucd (s.c.:109?. civ c )
<br />A.IIIICANLIIICTASAITO!
<br />I h.Ety atrm u.d.r p.nrlly of pdjury oN offic followiiS dftl@rions:
<br />D.mftion tcmil.-tul,Gnos Nolifialion r.d@l R.sllrlio.s ( Iirl.40, P3n6)
<br />_ll.quir.d l!(dolNoriic.tion
<br />rcgulat6ns r.8ard ing .shstos nor {'plicablc lo this tejccl
<br />ion iFcorcr Ia8rloom, ywnh!UCirya.dCou y
<br />outthrnc rq'dc .riv.t olrhis Cny and
<br />ahok mnndmd poteny nr
<br />,\pplhunt or At.nl Slqnrhrn:A?.L
<br />COMMENTS
<br />Gas-Underfloor
<br />kndd i Nrne
<br />-
<br />I.n,l.rr A,lJr.<(
<br />-D4-
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