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PLUMBING-INSPECTOR RECORD
<br />DATE ID/SIG.COMMENTS IhLrchtrflnmu'il.rl.nrlrtoff'ctrD_rldI.Dcx.mprl]lurh.(onrracro(l.ic.nsclrsllnrhcnnkN'nrrrrv,nlse7(rll5
<br />lluirnc$ rnd Pmi.sion Conel Any Ciry or aounry shEh reqrtes r p.m,ir k, ..nndcr, ,t(, ifrpnivc. (lcmo[sh or rq'rtr ]ny
<br />dtucru'€. pn.r1. (s Fsuime, rho rqu'Er r& rtpliranr Lr suchlrmnrk' filcn iS Gl sl .nrfr rh hcornB 's lr.nvn ,)urturnr
<br />ri rlE nnnh$nc olrh. Conrtrclo.s l,,ccnscd Inw (Ce! s9.( nmtrcnrs sih scrr(n 7l)00 ol Drvrn,n I nlr[.llusinrs ]nd
<br />t^ntsnrns codc) or rh.l lEorshe Fercmrlrhcrc,i.nrnn(l rhr hffr\ ntrrhe rll.gcd cx.trrfrnn Anr. v.l.lionolSecronT0rl5iynny
<br />xpphca lnr a pcmn {,hre( rhr atrl'.rnr nJ . cMl n.M lry o l nor m.r. rlsn fi e hundred doll.6 lSSu)).
<br />I, os oMcr ofrh. pmFrry. or my cnplortii wni {ascr * th.t slc onr.oeriorl wdl do ine wort 8'd llE slru.l@ ii ml
<br />inldd.d or orlccd for el. (sd 7044, Busin.$ .nd PmfdrioB Cod.r T1l conhclois Lic€M Lss &,6 mr qrlly & .n ow.f
<br />ttE nmFny vho trilde or impoB lh.mo dd wtr {kE sch tu* fiitu.lf or h.ellor ihmueh hi6 .r h.r own .ilt'hyes,
<br />prorided th"r tuch ionrowrnrs m mi id.ri.d or.f.rcd fo.sL.ll lb"'M.ltE ttriBiB or iq,@mnt i$ $ld wirhi. on. td
<br />ol mrq,hion, rlE o*Er Buit{d will h.w rlE honLn ofF.vins trd 1.. or s1E dtl ml hild or impmE lh. pqEry br tu Nrrh* of
<br />-1,
<br />f.rer oflh. pDp.nr, u.xclBiv€ly conlmcri.S * h lrc.N.d ontRtou to otrntud lhc p,ojcr (sd 7044, ausrn.s
<br />a.d lmtshn Cod. 1'n. Conmdor'! Lic.N. Law do.4 ml spplyro do{M.frop.ny who huil& or imrmld lh.r@ll|
<br />.nd who co.l6cis for ruch pmjdrs wirn a Conrmcb(o liccns.d pll'@r ro rh. Co.tft.lol3 L,c.M. ks).
<br />-l
<br />@ cxcmpr undr se.ro B &PC for'hisr.asn.
<br />!981i!8!:CAUllNS IlO!
<br />DICIABdIIOB
<br />I h.Eby !,iirn und.! D.mhy of p.rj!.y oft oflh. followins d&hnlioN:
<br />_lhav.rnlwrll'ni'nri'niacdinmr.otConscnthScli.lnsurcftrNUkc^'coi,pensriotr,asrn{idLdlorbySdi,n'lr00.fth.
<br />La}itr Codc. tu rh€ ncrlonrancc ol rh.qhrk id s|ichrh. pmn F arucd
<br />I havc r.d will frlnnain wo*.rr compcnsl ion rn$mnc., !s r.quir.d hy sftro. 1700 .f rh. Lat'.r Codt, for Ihc psft,manc. of
<br />lor wbch *FD.mir ie iscd. Myuo.ldtAl'.l.vkl- lr,itrr
<br />snrD.nstion ifl$r0nc.6ris dnd Flicy numh.r trc:
<br />-1,^<
<br />I
<br />_l enily thd in rh. t. fomr.c. of rh. wort lor which this p*nn is irsu.n.l shallml €nqJloy lny lgsn i. anyn.nBr
<br />$ d ro t 6m $5jar ro rh. wo*m' onricMtion lass of C.lilomi( lnd !8ft lhd if I st uld b.q,m subFl lo 0E
<br />sod(6' onp.N.rion pmvirioN ol Sa:lio. 3700 ofrhc lrsr C6dc. I ilsll, lodhwnh omrly with lhos Fmvisiodi .
<br />wARxlNC raituE lo Gm mrt R onDaerhn 6w6sc is u.law|i)l, and rhau 3uhldr d .!i'rhrt. ro dimiMl IEELts and
<br />civil nn.s u, to o.. hundrcd rtbusond dolln (3100,000), in addilion lo lhc.ot of6n Ensrioi\ rlrmS.s a3 pmvidcd for th.
<br />Serion 1076 of thc rltor cod., i .Mt and.nomey s f.cs.
<br />,",.,1,10\/ I 5 2ot8
<br />ITECIASAUA!
<br />!heebyr,l-rflnunderpcn.llyofp€rjurylhalIanrlicln\qluDdclinlFiurolchs.rI(onnr.ftirywirhS(non?(D0)olD'rFrnl
<br />oi rh.Bus'n.ssrnd Pmf.ssionsCodc, ond mylicenr is in lulllorcend.,L.r
<br />13 /bn?6z
<br />h,r4.r>.
<br />goxslaucruurt};lDlNclclidcr
<br />I h.rcby afin6 u.d.r pe..hyofp.rjurylhat lh..€ ha con(ruclion kndins as€n.y f(tr Ihe ldlo@nce ofrh. "ork for wfiichlh* p.mir h
<br />Ftu.d(sft 1097. civ C )
<br />ATIIICANIDIiCIJBAIIO!
<br />I hdlby.f,im udr la,hy ofpsjury orc of lh. follovins d.clddiont:
<br />D.6oliri6n P.rmils-A.bctus Notification F.d.Bl R.fluhtioN ( l irl. 40, P.n6J
<br />Rquftd L.fl.rolNoridron
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarifier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Piping
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOUSPA
<br />Ptrap/Drain Line
<br />Main Drain/Pool Pipinq
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />-,-raED
<br />Miscellaneous E ,^r"-
<br />Gas Service r1
<br />Water Service Ll - ..n e67
<br />Lawn Sprinkler :', &43' R.lJ' - - '
<br />Sanitary Sewer/Cap -.rofREDP"
<br />..e t 3 ?Ut',
<br />Rough Plumbing * Efi6' G'67
<br />Final Gas Test e$fce,.ro',r7-r11
<br />Meter Release t till ,/.ltl1/
<br />FINAL t I ll\//
<br />Notes, Remarks, Etc.
<br />APPROVALS
<br />'==:
<br />-l..nifyrhat
<br />th. tdenlrSlhtn'n, Es.rdi.s.sb.slos rc.nvalare nol 0Dr'|cauc ro rhis tmj.c(
<br />&iy rr,u t r.*" *,a tnrs .nplic0r ion a s.rcrlNrhrrborrinlorm.rioniscomcr.IagrdrocomrlywirhallCnyflndCounry
<br />ld'..mcq .nJ s, r. tjws EhhnF h hu, d,ns rdrd-tr4jslarnn rfl7fltr.6*!4qllhn ( Yindcoun') r..nr4 uF,nrh.'l,.I.iLiLl*^i*V=L l",ltov r s20rs
<br />-";,,..,*.,"",; @,;ilv,4
<br />Back FIow Device
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