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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE rD/stG.COMMENTS owNlR al'lLDUR DEl,caItA I loil
<br />I h.rcht n0tD undcr pr lry.llcluryrld I mr crcn fnnn rlE Conlrrdois' L'.cn* li{ ror rtu li)lloqiD8 rerYnr (Sc( l(}.ll t
<br />tsustr.ss .i Pn'le*ion Codef Any Ciry or (ounry $lrch rcqnn.s d p.nntr b ( end. alrci nnFrrt, denn,lfh .r r.Tntr my
<br />{rucrure, nriorro irs issrmc.,.!r. rcqurcs rhr rplcd tu tu.h pcnn{ to,iler \lstr€d {ircmchr rrt hcorshc s lNna{ puNml
<br />h rh. pmvsrns olrltr conrracld s Licdns.d I aw (chaprrr t). (imme ms tr[h Sccr]on 7lro0 .ll)i\1sion I ofrtf, l]$ints.nd
<br />rrorissi,nN (,r1.) or rharh.orrk iscr.tr$ r lErcli(nn.xl r lE bisn 6rrh. xllcscd e\cmrrn,n Any vt'l.lk,roiSccli,'n70rl 5 hyrnt
<br />rnnhcaraor.,Emriruhjdsrhc.prilrcanrr.acivilp..nhyofnornxftrh&hchundrcddollas(S5l)trl
<br />-1.4oM.roflh.lonny,ormycmlloF!withmg6ultt$Lon..krio.twill&0E,brktitlrinudEbDli.lord.d o. orlcrcd for sL ($e.?044, BuriB .nd PmfsioB cod.: -th. codt.cld t Lic.trG ttw.b* ml .Poly lo .i oum of
<br />th. pmr.ny wts t{il& o. irptuc rhd6$ and eln dod etlj m* hinr.lfor t.Rlfor thoush hh or h.t ow. .mployes,
<br />lmvid.d rhar $ch inpbtw ! ft Dr inlsd.d orotu for ol!. It ho*tu,ltE hlildiry or iigotqE r i! sU wilhjn.m ye
<br />ofboplrt r! rh. Om.r Bui6.. wil h.E dE ttrd.n .fpmviig t,El tE or slE dn 6l rriB or iniroE !h. pDrdy ,or tlE l,{qm of
<br />-1,
<br />sowmrof rnc popcnn mdclwiv.lyco.t&ri.8 *irh licmcdco 6doB lo snrtocl llE,,ojdr (sc.7044, Autircs
<br />&rl Potshn Codd Tnc Conlrrctol3 tic.ns Lrw rlod mi .pr)ly l. on own.r oflmp.ny wl'. l,uil& .r ihpmts lhosn.
<br />md who onlocis for such l'$irts wnh a Coirdcto(,) liccmd pBud lo thr ConlEdois LiccNc l,!,1.
<br />I rm.r.m undcr Sccl a.&PC turlhisrc.mn.
<br />llaaliEEs:caullllalrgN
<br />PECLAEAITO!
<br />I h.rcby amm undcr ,l€Nlly ofrsjlry.E.nh. follo*i.8 ddl..arionc:
<br />-lhav..
<br />will mrintlh . C.ninclk oaco srtos.lf lose Ii, wk.G onrpenelion, s pmvid€d tor$ysetion1700 ofth.
<br />Lahr Ai., lor rh. D.rlomoB. o llhe e* for which rhc nmir ir n{.d
<br />fl hav. on<l will m inraia wo*.r3 conFns,rion an$rimr, is cqut d by Sd ion 1700 .t rh. L.bo. Cod.. for th. I,dfirmmc ot
<br />rhe wolt for wfiich rhk n mir ii rs{cd My workdi oriD.nerion insmm. orid anl polic, nudner m:
<br />/
<br />/172 ,'//-//- zd/'f
<br />fal c.dify thar i. rhe p.rro'mmc of rh. qo'k for phich rhis ,.mir i. h$.d, I sn ll mr snDloy dty p.e. io lny ron*r
<br />e asrob.omNbj$rt rh. s*c6'@mpcrdio! hmofcslifooi', aid asd $$ ill should bdoc bjl.rrorlE
<br />mrtm' 6n msr ion pmtsioN of Scrion l7m of rhc t bo. Co&, I JEll, fodhwilh @nDly vith rlEs pmvieions..
<br />WARNINC l;0rlurc to sur. workc.s' comtcnsalion co!.Erc x unl.*tu|, alld ,hrll shjd an @pbrtr r. diniMl n Mhi6 0d
<br />cMl fin.r ur ro orc hundr.<l ttnusa.d do
<br />sarnn 1076 nfrh.l rtnr a.d. inr.r.d lnd
<br />in,ttdtion ro rh. corl of€oqt €ho& da@8.. .s lmvid.d for th.
<br />/-o//
<br />DECIAAAI]qN
<br />I lErcby amrn hd( p@lryof Frjury lhil | !D li.c.sd und.r pmvisn,n ol Ch.,'td 9{comn$cing wiln S.clioa 7000) ofDirkbn J
<br />of lh€ Busrmss 0nd PrcIcssion. (udc. ,nd ey lcenk n in tul| foR nnd .Ifsr.
<br />a 72787LEcmClaii
<br />CAIIIaIICIONIr]XDIdGIC}:ICI
<br />I hchy amm ond.r !..rhy ol prjury lh.l ths. is 0 coNlructk n knding os.my lor lh. p.rfolmrcc . f th. work ior whicfi rhis ,Emn i,
<br />issucd (S(.1097, Civ. C.)
<br />AXILICANLDIiCIAXAIIA!
<br />I hctdryallid!.d.r p.n,lry olp€tjuryon of
<br />'lE
<br />folloginB d(llmrioDS:
<br />Dcmolnion Pcrmirs Ash.rros Norncd nr6 I'.d.61 R.gll.tons ( I itl. 40. t 1a,
<br />_l(equtcd Lert.! of Notifi.,rion
<br />t c.nraylhd th. fed.El EprltrthN Essdiu. ssh.nos rem'lal arc &r rpolictbl. b thh rmjat.
<br />4t ".nirr,U, t tu'.,.oa,m,lpplic{lio.nndsr.r.rharth.at v. i.lomralion iscor<r I .8te ro smrly {nh rll c yand Coomy
<br />ordiMnc$ ond Statc Lo$s Elori.s 6g co6rddio,r. old h.rcby Nllhri2. EpccnlditG oa(hir Cny .nd Cout y ro .ol.r upon lh.
<br />.hovc mnrioEd ,mp.ny for Z- \ o.,. lk?-24//Appllcrtrt {r A*ent slgh,
<br />X c fc, r
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor
<br />Building Sewer
<br />lnterceptor/ Clarifier
<br />TOP OUT
<br />Waste & Vent - l.zr r.%.^t
<br />2Water Piping ttl.l.-ttD\u '\"r
<br />Gas Piping
<br />Roof Drain
<br />Tub/Shower Test
<br />Rouoh Water Heater
<br />POOUSPA
<br />P{rap/Drain Line
<br />Main Drain/Pool Piping
<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 Plumbing
<br />Final Gas Test
<br />Meter Release
<br />FINAL llzl(414 trptaVtt /,'72)
<br />Notes, Remarks, Etc.U
<br />lind.as AddlE'-
<br />Area/Storm Drain
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