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PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNET BUILDI]R DII-CA&I'I'ION
<br />I ncrcby nlhar undcr t[nrlry {'l ncrjury rhar I onr crcnru riom rhc ()nrmcr{n\ l.iccn\c lf,r' lor rhe r.rbwi'rs rcnqm (se.n).rll5
<br />l,usirc\\ ! PmL$io Codc) Atry Ciry or Counry shi.h ,cquircs {crnir ro $ nrucr. rlrrr. impr.\t, d.frn(h.r El.n my
<br />nflctuc, pritrlo ir\ i\\u3trc.. rho rcqlnc\ rh. rnplicrnr tu' \uch Frnrir h lild r si8nc nd.m rh l.. or shc h licctr{J tlnruinr
<br />ro lhc [ori\nn$ of lnc Conrlcl,tri l-iccnsd Lr$ (Chrpr.r 9. Connncncin8 *ih scrrnn' 7Ux) .r Dirki{ .r or rhc Busin.ss ,n
<br />Pn,t \\ion\ Codc) or rhlr hcor\hc i\ c{cmp' rhcrclronrnd rhc hrsi\ ttr rh.rlhlLlt cxcnrllion AtryvidarionofSsthnT0.ll5hylny
<br />rmli.xtrrtu,rnnnnrDijcrhthcrptli.Mrk,r.ivilr.nnkyoftroitrxncrhnlilchundrcddollrrls5m).,a/
<br />'1ff..","* "rt..r'.,y.y i1 n'J ctr.rli4cr\ tr rl-rrpc\J\,h.tr -.h.1{T.n\ir, i $'ll'trrh'tr,r1JJrh.{dNhr,i
<br />rhcpn),rny $lm tuilds or n\rn)r\ rh.'srn. r'xl wlx' dr\ {'ch sorl hnn\cll or hcr\.ll or ihn,ufh hk or hcr ow cmlloy.cs.
<br />p(,v ci rhri s!.h lnJnnvcnrrr\ .r! rxf i.tcdlc\l or .fla&l n, {b lf. hotr Ns. th. I[rllDg or ir{rovcEnr i\ v'k] wirhir otrc re
<br />f.ollrbrirn,rlrOwkrBuiklcreillhrvcrhchtrd$orfiovr*rhrrhcorshcdidtr.rhuik]orinprovcrhcpmncnyli)rrn purF,*of
<br />-l-
<br />us o*rcr of rhc ronlny- !m crclusivcly conrrur ins *irh li.c"*d conrEcroF r. on(er lli Eoif,r isd. 7044. aB'mdi
<br />atu Pmf6sin Codc: Tnc Contrlor's Lic.nsc Law do.s mr ,tply ro of, owncr of rmI.ny who builds .r iftpiots In.rco..
<br />und who conthclr for such rmirrs wnh n Conhcrodl licciicd pu^ua ro thc ConrBcroar Liccn.c ttw).
<br />r unld Sdi.. . I &
<br />D"te 4z- a) -?Dzd o,M,
<br />l)l( I \R \ r l()\
<br />l.rlry ( {xr.. riir lhc l)crhnruEc ol rh. {oni ntr *hi.h
<br />'hc |Emir i\ i\lucd
<br />ifu {o'I r,n trhi.hr]rs t)cirniri\ n{dl NIy\o*rrs.odtf,nxriL(i'xn'.frmidIkll].lr.tntrn$errc
<br />ri,lir) Ntrtr.hc' F\
<br />./1-/'fb.ui l) rhdr rhc t{rri{tr\'tr!c i'l rhr *1 1 li1 trhrh hh t{nn F rL'cd. I .l-rl'\.J.1'hq, r.i'hi..rrir5.s l.'\,.'rIl.tru., ' la(. ',i(-'''r nir riJx!'.crhJr
<br />nor cn{,loy lny pcMn in any f,uftr
<br />ir I should tf,.orE suhrccl lo rhc
<br />wo*tr{ .. Drnsd i.n pm!i\io.{ of s.cri.n ]7m of rh. tibr (\dc, I stull. kdh*irh comnlt (irh lhos ,r.vnions
<br />I'VARNIN(;j F,ilu,e ro suE tr.k ^ conwnrarion $vcElc k unhuful. .nd stull subFr 3, dnl,lorrt
<br />.ivil nn.\ up ro .N hxndrd rhoutud d.lhh (Slfir.fiDr. in iddfin,n h rhc co{ ol conD..\ation. daro8cs
<br />S.crn 1076 ofrhr litl, c(dc. inr&c{ and r(ortuv s f..\
<br />. - l -'- Z \r,r,r*-,r,
<br />or rltr h,\ircs\ rtr(lPrnc\\iorr\ (i c. d ry li.ensc n if r lnncc rxl.r'lccr
<br />Ld.r,l rc8ul k'ns ESarJing asbcsnx r.n,vul trc .or amlk0bk ro lhis pmj.t
<br />rcad rhis q,plicrrion ord srarc rhll rlE ovc itrforrornrn n .orcct. I lgN ro oq,ly lnh !I Cnr .nd Cou!'y
<br />or rhl\ Ciry !nd (i,nn! n).trrrr nrn, rh.
<br />1],*,,",".,,^.,",
<br />*s Ehtim to buildim ronsrrucrion.,nd lErcbyourlmrizc
<br />l)rrr
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under lloor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarifier
<br />TOP OUT
<br />Waste & Vent
<br />Water Pipino
<br />Gas Piping
<br />Rool Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />P-trap/Drain Line
<br />[.4ain Drain/Pool Pipino
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Gas Service
<br />Waler Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbing
<br />Final Gas Test
<br />Meter Release
<br />FINAL 7- lo' zott'{L< tst t e t@t Z?
<br />Notes, Remarks, Etc.
<br />POOL/SPA
<br />I hccty sfirh und6 lcnrlry of ldjory orr or rnc follosing &.kEtiDns
<br />Lienrchrr Lietrs Numhci
<br />-
<br />D.r. _ C@|mrr_
<br />CANSIBI]CIIOI{!EIDINCAGENCI
<br />I hcrh, nmrm und* Fnah, o, Friury rh.dhcE ir !.lnarruclion h.dire.!.fty for rlE l.rformkc olrh. $uk for which rhn Frmn is
<br />i\\ocd (S< 3097.Civ. C )
<br />L.r.lcr. \omc
<br />-
<br />t.,n.,'\ AJJ,r.\
<br />AIILICIIILDECLLBAI:IA!
<br />I tf,rcht !finr udcr ltrtralry oi pcrjury orc ol r[c rbllowinB ccl rriors:
<br />I)cftrIion P$n ] stri.sN.rlr.nrk Fcdcril RcexldtrF(Tirl..{). Prn6)
<br />-Rcqutcn
<br />Lctlcr of Norilicarion
<br />!h.v. mtrrhncd top.ny fttr irsp.clion
<br />It,t'licx l r,\xml SiRnnltrF:
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