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PLUMBING.INSPECTOR RECOBD
<br />DATE ID/SIG.COMMENTS
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under Iloor
<br />Gas-Underfloor
<br />Building Sewer
<br />lnterceptor/ Clarilier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Pipinq
<br />Rool Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P{raplDrain Line
<br />in Drain/Pool PipingMa
<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 />Rough Plumbinq
<br />Final Gas Test
<br />Meter Release -<\
<br />FINAL t0-t6-tr 9.W.Jil,\a=
<br />Bl' .t)II{ Ir'j.( \R1I t()\
<br />I h.Eby amrm undcr p.mlly of p.rjury lhal I m.nng lrom lhc C.nradm Ucrc Lls for lhc folhwing r@$n (56.7011.5
<br />Busi.c$ aid Profcssion Cod.): Any Cily or Counly which EquiEs a Frnn io conirucl. !116, inrpovc. d.mlish or elit dy
<br />srruclac. prbr lo its irs!,E. rl$ icquncs rlt applksrt for such lrmir ro 61. r si8n.d aLBnt rhar lE or sh. b liccns.n puNdr
<br />to llE pmvisio.s of tlt Co @rols Liaicd t w (Ch!tn* 9. Commcftin8 enh Sccrh 7000 of DiGion I ot rl* Blsircss .nd
<br />Prcfcsions Cod.) or lnar $ or snc k cxcot r th.etiom aod tlE bsih lor $. aucgcd cmlltlio.. Ary viohrio. of Sc.rion 7011.5 by rn,
<br />afl,ljc, ror i ,.rmi slbj(ls thc applicanr ro 3 .ivil pcnalry ol ml mrc rhM fivc hudrcd dolldr (1500).
<br />-1.
<br />a owmr of llE pmFrty, or my.mpk ycs shh ue$ ii tlEir sh onIEnsrion. will do iE {qt ud UE slrucw is Dl
<br />i.rcnd.<l 6, ofreed tor slc (Se.7044. Busituss &d Piof6sioil Cod.: Thc Conrraclois Li*n* tiw &,cs nor arDly to M o,ft. of
<br />rhc pmrEly who hiiks or inpro6 rlE6r. ad *tD doc! su.n m llimkll or hcmlaor llml8! his or tEr own .mployM.
<br />provid.d $.r .u.h inpmw@.k @ mi i e'tdcd doftrd fd sh. lf. hokE rtr building or inpowft issldwirhinorcru
<br />ofconpLtion, dE Owr Buit . wil h6E 0E tud.n ol Faiig tlm hc n lhe di, m brild or injprcw lne pqEiy for rlE FiriDr ot
<br />llaf,EBs:tlXdPilsArtolt
<br />DECI,AMIII]N
<br />I hercby alliro und.r petuhy of pedury om of rhc followins dcchmriof,s:
<br />-l
<br />hlt ard vill minlah, Ccniararc of Cotre lo S.lf-ltrsuE for worlcr' conlEns ion. !s l,ovi.lcd for h, Scclior l70O of tlE
<br />LahorCode. aor c Frformrc oflhc sort for whtn rl* pdmi b nsu.d.
<br />I h.vc rnd will mrinrrin worl.rs con[.n\dn,n inuruncc. as rcquncd ],ySc.rion l?(X) ofrhc l]horGnlc,l'orrhc pcrlbirEN ol
<br />,rn i i\ i$1cd Myworl.rr ornlEnuior iNurlmc
<br />-6 -o 6q-o I-J6I 1
<br />\l crnir! rh. irrhc Nri{tutrr.,'rr[clurl litrnhtrhrhiipcrnrir is iskd.I \hrllior.npb] uy Fry, i. an, nrnnf
<br />v' r\ h hcdnm suhirr ro rhc *ortcrr coq*nqrrion hss oicnlilor.ir, .id !8rcc thd ifl snou[ h*om $rhr.r lo I1*
<br />*oiicD corDcnsort,n p!,snion\ olScdior 37u,ol rh. Utn cric,I shrll. fonhsirhconply wirn rnos pmvnnnF..
<br />W IININC: FriluE ro r.ud sorkcri.onrr.nsarn,n covcm8c i\ unL{Iol. and rhll \uhr.d rn.mlbtrr ro.nninrl ,[nrliic. and
<br />.ivil fincs u! h onc hxndrcd rhousdnd dollds ($|fl),Un), ii sdd n'n ro rh. co\r of.onf.i\ nrn, darogcs ds ptulidcd fin rhc
<br />f th. tih). Oldc. inrcrc( &ld ntronry s fd.\t?O-e
<br />Dflct r.StIQN
<br />I hcrchyar'lnmu cr Fnrlryollrrjury rtnr I !m li.ctr*{ undcr [ovisi.n olChdprcr 9 (onrfrncin8 *irh s('ion ?ou)) olDivirn,r,l
<br />or
<br />'tE
<br />Buw\.nd Pmlil$r codc. r,n nylr.n{ r m txll rtud,nd.fifrr
<br />l)5J^"6 j
<br />,r.li -t?-/t .*,*'(Co )f\
<br />CONSIruCIANI'NIIIM-ACEXT.I
<br />I hctohy rrfirm trndcr pcnrhyol pcljury rhrllhcrc is !.oNrrudn'o ].uai'r8 lscncy for (he Frfonmncc oilhc rork for which rhi\ p.rmir n
<br />i\su.d (Scc .1097. Ci! C ).
<br />APPLICANT DFCI ARATI(IN
<br />I hcd,y dlmr lndcr pctrrlry ofpcrjury onc ollhc lollowinS dcclmlions:
<br />Dcmolirion Pcrnis-AslEslos Notili.dlion F.d$ l R.Bulrtrionl (rirk 40. P0n6l
<br />-Rcquircd
<br />Ldlcr olNoriff, rlion
<br />I.diryfilr rhc fcnc rll .c8u ld i,ns rcsadin8 a\bcnos rctrnr.l orc tror.pt'licoblc ro rht poFcr
<br />_l snify rhd I h,vc rcd inis dlrplicarion od sr dh.r rhc r&'!c inforro(hn isconur.I agrero€nplysirh r[ Cny ond Counr,
<br />ordinu&s and Sltrlc tjws Ehliry ro buitling 6n{ocrioo. an<l her.by auho'@ repr.$.l.lirs of lhi. Ciry
<br />ihovc mnrioftd pmn n, fo incnccti.i p.4nscs
<br />ApDli6nl or ,{Aenl Sitnalu \1-
<br />APPROVALS
<br />Area/Storm Drain
<br />Notes, Remarks, Etc.
<br />l. J\o$nqol
<br />'hc
<br />DDIcnr- 0nexcb\nclyconrmcrirt wrh hccnscd.o.rNor ro c.rslrud rh. lrojc.r (Se... 7($r. ltu\incs
<br />r*l holassi Codc Th. Cont&ttr s Liccns. Lrw do.\ nor lpplt h xi o*trc of pR,Fcn y who bu ild\ or ihpuc\ rhcrcon.
<br />rnJ eho.onhcrsrir ic[ projr.h wirn ! Conr.cto(sJ li.cnscd pursurnt ro rhc c]onrdols Liccn{ Lnwl
<br />I rncrcrl ond.r S(rion_. B &l,C lbrrhisrci(,n
<br />l.ndd \ Addrc{
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