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PLUMBING.INSPECTOR RECORD <br />APPROVALS ID/SIG.COMMENTS <br />UNDER GBOUND /^ <br />Waste & Vent '.zq.B 'llrn ?lrbv <br />Water-Under floor <br />Area/Slorm Drain <br />lnte orl Clarifier <br />TOP OUT <br />Waste & Vent <br />Roof Drain <br />Tub/Shower Test <br />Rou h Water Heater <br />POOL/SPA <br />P-trap/Drain Line <br />Main Drain/Pool Pi n <br />Fill Line/Back Flow <br />Pool Heater/Gas Line <br />Miscellaneous <br />Gas Service <br />Water Service <br />Lawn rinkler <br />Back Flow Device <br />U4: E -f.Rough Plumbing al toltgG v2) <br />Final Gas Test U' <br />Meter Release <br />FINAL ffirua <br />Notes, Remarks Etc. <br />OE?IER BUILDER DELCIRATION <br />I hcrcb, atfun uds Fnalty ol Friury O l 6.rcmpt lrcn th. Co 6.lou Liene La* for ttE folLshB ,.ren (Se.7OLj <br />Businc$ 3!n Prolo3id. Codc): Any City or Cotrhly {hkh Equircr r tsnn io o.srd.( !tr6. irpb*. d.mthn or EFir lny(Murc,lriorrotu isuaN, llr rcquiB the.pplicMl lor such Fmi ro f c!sigmdidcmd lh rEorsh.btkcn*d po;o&r <br />ro llrc povisio,s of th. Comn loas Lien*d trw (Cluptcr 9, CommminB sith Serion ?OOO of Oivision 3 of ltE Busincss a.d <br />Pmtcssions Codc) or rhrt lI or .hc ii crcmpl rl*rcfrom ..d thc tEsis tor rn. rk8cn cr.nptiotr A.y {olsrion of Selion tol t ., br rny <br />amlic. for . ,Emir subiels rlt lpplica to a civil pc@lry of tur mr. thln filc nu rcd doues (t500). <br />-1. <br />a ow*r of rhc |lml'eny, or my cmploFes wirh w.eca eq thcar stc onpc.sat ion. eitt do dE m* .In rtE nnt1@ i. mt <br />inrei&d or o,Lrcd td eL (S( 7044. Busincs ,nd Pma.sionr Codg Thc C.nlrodols Liccn* tlw dcs nor ortty to cn owmr ot <br />lh. tmpcny *ho hoilds 6r inll'mws ttEMn. .nd who de. *h e* himFclf or hcMlr or rhftrgh his d hcr own cnrlolB. <br />providcd lhrr such imprcktunh arc mr hrcndedoroffcEd for eb.lt h.Eer, ficbuitdinBor nrrmwm is sld wirtin one rwof@nll'ktir lhc Owftr auitlo will hor lhc budo ol pr.ving thar hc or shc did ml h.ild or ift+&r 6e nmlcny aor th. pu4Ds of <br />asownfoarlE pmp.rly. m€rclusiv.lyconnEtins *nh lensd.o 6.106ro conslruct th. proi.d (Se. ?O{4, Burinc* <br />ald PtDftssim Codc: Thc Conreloas Liccnsc L{w de3 ror arlly to !no*mr oaproFny who bnitd..r inprews d.rcon,ond who @ $crs for slch Fmlf,rs viri a C.nielo(, lic.sd pr6u{r ro rhc C.flractois Liaosc L3v). <br />-l <br />rm crcnDr ldcr Ssrion . B. & P.C. tor rhis Esson <br />It o.*. ? <br />\\oRXFR$ CONIPENSATIoN <br />Dr.cI ,\niT(tN <br />I hcrcbydfiirmundcr p. lryolp.,juryomof rhcfollowinEdnladraons <br />l.rhtr (,trlc. li{ rfu D nr r rc ol rho {o,k nn rhich rhc ,trrrir n niut <br />_l hlvc and willdai.rain qortcB comp.ns.rion ins!.inc.. trs rcqutun bySccrion17fi)ofthc Lahor Codc. for rhc F formec of <br />rhc work for which rhi pemi is isn d. My wor*B .on cDsarion insumncc .fi.r 0d Fli.y .unber m: <br />-l <br />enif, fiat in rh. pdformm. of !h. wort fo whirh lhk Frnit is hsEd. I shltl.or cm0toy any p.mn inrny lmde &s to bccom suhier ro llE slt6 6mpcn$ti.n lN3 olcdiromi!. .nd +G tnd if I struLl bcne subirr h Be*c6' ohFMrion lDri.iooa of Scction ll00 ol lhc t t r Cod.. I slEll. lonnwitn onply uidt rtos poviiioni.. <br />Sccrnr .11)76 olrhc ltrlitr L]trlr. cfun nnd ronry ( t.cs <br />eL,fl!J2a)g- eepr*t ?4E*' LICFNSFII CONTTUCT(JR <br />DECI.ABAIIqI <br />P++Ar.r <br />I h.re6y lrtrm undd Fndry of pcqury thlt I am lisn*i undc, ,ovision of Chaptc 9 (.omEing wilh Selbn ?OOO) of Division 3 <br />of lhc ausires dd Prcf.ssions Codc. nd oy licen* is in tult foE. .rn .l[er <br />(xlNsrRuclI(lN I ENDTN(: ]r(:FNCy <br />I heEby rfirn undcr acnulryolFiuryrhd rhn. is a onsrtudion h irS u8cn.y for lhc poror@oce of rhc vo* to. which lhi\ Frmil k <br />issu.d (sc. 109?. Civ C.) <br />APPI I(IAN-I'DIC! A|LA I(TN <br />I ltRt,arllnnutucr Fndxt orl).rlur, otu ofrh. followinB dn.'hr ionr <br />Dcrml ionPcnnirr \hcnor Noriicdio. Fidcr.l Rceutrrnn\tlnt.(). Pan6) <br />Rcqdtci Lctrcr ol Norff, Jrhi <br />-l <br />dily tur rhe fcdc.ll rcslhrk ns E8lrding .shcsros rcmvd arc nol {pplicrbL b rhis pmF.r <br />-l <br />enify rhul I navc rdd rhi*.rplicarbi d stutclhll ln. abovc inforturion is cotrcct. I asre to ondy wnh altCirysid C.lnry <br />ordin0n.{r rnd Srarc Llss rchrins ro bxilding co.stucrion- and hcrebt Drhorir rcpescnrlrivcs ofrhis City&d Counryro chr.rft[n,tud por.ny lirr msFcri pur|oscs. <br />^, ot/tr/tpt4 <br />DATE <br />Gas-Underfloor <br />Buildino Sewer <br />Water Pipinq <br />Gas Pipinq <br />Sanitary Sewer/Cao <br />/-8-/8 5:VZ <br />'+4 P,?flar4 <br />L.1dn's Addrcs: <br />ar1,1 <br />I DATE <br />=