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PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS ()WNI,lR BtrILDllR DEI-CARA IION
<br />3u\irci\ rtrd holc$i(r Oxlc) A y Ciry or C,uny *hich rcqtnc{ r ltr rr r, .on{ntr. rll.r. i'nPrvc, dcmnNlr .r r$rn tny -
<br />trffl(urr nr r t nrir {rtl.chlhc al,t,li.rtrr h s.irilpr liyo, rnn nnd rlrtr tlvc htrtrdrc,ldolli^rs51x,
<br />l, rs .snrror rh. DmNdy. o ny cnrdoyLr\ wil| {rscs $ rhct v)lc compcn\dn , sill do rhc tr'nrt.Drl ltE srtu1uu n 'ri c d oroflir.J for srlc (Sr...7O14. B!\itu$and hotcsion\c{rlc: Thcc trr!(roirl-icc \cljudocs orrmryhrno\nqoI
<br />ric pmpcny $h, bu ild\ or int)n)vci rlrior. od sh. d€\ sr.I s.i( hinrll or lf, .ltnrthouBhhisorho.uncmployccs.
<br />p()vidcd thd su(h nnir*qEnrsnE n i,n.rN noll.rrlfor eh lll lb$c!.r. rh. bniktirS or inDnv.rrcnl Gsoki$irhi'r"r tt.tr
<br />of.oi$krn ilx Osn.r tluiUd wrll i0!c rhc hunlcn of pr)ihB d hc or drc dil lor buikl or i'.l)I(M rh. pmrd, tu th. |nrlxit nl
<br />-1.
<br />$ oNrcr of thc ,,!!Ety. an.xclu*ircly conh.rang wirh li..Md .onrraclo6 lo on{ocl rh. ,rcjRl (S..- 7044, ButiNs
<br />,.d Poissbn Code. Th. Conlmlols Liccn$ L3w des nol srplylo an o*n( ofnmp.ny wh. builds or inpoEs rh.rmn.
<br />md vho onrdcrs for och lJoixrs wirh a C.nmdodi) lk.@d ptrrsunl lo lhc Co.lreloir Lic.osc L!w).
<br />-l
<br />dcx.dtr lodcr serio B. & P.C. for lhis roron
<br />]lI}Bf,EELCOMfTtrSAIlqN
<br />DECIJIAIIO!
<br />I hcrny {mrmudcr p.mllyolpsiuryon of rhc followir8 d(hrolions:
<br />l.rhtr (ixl., tu rtu nc,tm kr of rlt \o,t nr \hi(h rlt Nrnlr N i\ntral
<br />-lharcandwillmln
<br />rin *orlcB comF.rllion anllancc. o. rcqniEd b, Sstion 1700.rlh Lihor Codc. ror rh. p.rfumEc of
<br />workd!NtrDrn{rt,ninsurdNccuricr 0rltynomb.td.
<br />(-(j
<br />a
<br />-l.cnify
<br />rhat io rhr performRc ofrhcwor* forwnth rhispcrmil is ir{.d. 1 \hal l no' .nq,loy an y r,cson in any tunncr
<br />s as b hc..m subj.{r b r,E workcG'conllcosl ion lawi of Caliromir, ind agmc lh.l if I should tc.oft $hF lo llr
<br />*ortc6' empcnsrtion pmlisio.s of S*rion ]7m of rlE Lltnr Cric. I stull tunhwilh .omrly wirh llx'c prclilhns
<br />mmnctrsarion slcrusc n u.h*tnl, rtrd lhall suhict an coq,loycr lo djnin{l
<br />in oddiiion ro thc.osl of comrcnsalion. .hmsci .s ,ro
<br />I heeby lllrn loder Fnalry or p.rjury thut Lm lienxn utr&t olChlprci 9(.ommncinS wirn SNtion ?(xx)) oaDi!i\io.:l
<br />rT rl'. llr\ir.\\ in(lrt *ions Cod.. md mylic.trsc is in tull forcc ond cfccr
<br />6 a] q\
<br />I h.rcty rlft utrdcrlEuhy.lpcrjurrrharrhcrciaconndcri(,nkirlin3r!.ncytrrlkp.rtun,ri.c.rrhcwortlor*hichrhirtcrn,i!k
<br />is\ucd (src :1097,crv c ).
<br />AfILISANLIECLAS{ITQX
<br />I lml,y !finm undcr pcnalry of p.rjury oft of rlF r.udrine dccl-d ionsl
<br />Dcrmlirion Pcirnik.Ashenos Norifi carhn ft denl Rq!hli.is (Tirl. 40, Pari6)
<br />-R&tuncn
<br />Lc cr of Nolifidirn
<br />I snityrhd r}l rcdcrll mgularions mB0rdinE.sbcnos rcmvll!rc mr lmlt k ro lhis ttuj.tl
<br />-l
<br />ccnify Ihar I hltc tuld thh lpplicarbn drd {dlc rh,r rh. athvc inr.irElion h comcl I as:@ lo ontt, wnh aI Cny aod Counly
<br />o inonccs lnd Stlrc ljw\ Eldin! b bxildine.onin.(n,n. afrl h.r.h] rurhnizc rcprccnhrnts ofrnh Ciry
<br />!tx)!c nEtrriori tn,p.ny ior i!\prrr
<br />Appll.snl or Aeml SisNlurcl 't4lrr
<br />UNDER GROUND
<br />Waste & Vent Y,W,lt)
<br />WaterUnder floor
<br />Gas-Underfloor
<br />Buildinq Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT /A
<br />Waste & Vent 5 -J "tl Ur$#4 tlht( v{vpb.
<br />Water Piping 5-e-t(*.vffi(
<br />Gas Pipino v.ufta)
<br />Bool Drain IA
<br />Tub/Shower Test Y.Wrq
<br />Rough Water Heater " (\-/
<br />P{rapi Drain Line
<br />Main Drain/Pool Pipino
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Gas Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device,A
<br />FrWi-btl Wl gznE y"v4r01
<br />Rough Plumbing
<br />Meter Release
<br />FINAL t2.-11-tC v\1..\a
<br />Notes, Remarks, Etc w
<br />C2.1
<br />>-7-l
<br />POOL/SPA
<br />Water Service
<br />Final Gas Test
<br />I crt..'\ N,,u
<br />t .d..s Addrc\(
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