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PLUMBING.INSPECTOR RECORD APPROVALS DATE rD/srG.COMMENTS O*a.Buildr D..Lr.tio! I h.r.by lffim un.l.r plMlly ofp6ju., $.r t.na.mpt fod rh. Conlndo6 Lire Lrw for lh. followins r€e. (@ 70JI.5 BEi!63 rnd Prcf6eio. Co&)r Aly Cny or Coury phi.h r.qun6 ! Ohn lo .oturrlct. .hd. iipov.. &elisn or rcpli. ey &ctu.. prior to ns i$um.. lls r.quiE rhc lpplidr lor ruch p.mit to fiI. . .iglrd rl.r@6t thrt h. o. dE i li..Md pu6@t ro th. pDliiiotu of rt Conmciolr Li@n*d Llv (Clqpr 9, Con,twins wnh Sation 7000 ol Division , of ih. BEin6j .nd Prof6rioE Cod.) or rh{ t. or rh. i!.r@pl th4ioE.!d lr!. bai! fo.lh. lllcgcd d.6pdon .Any viot ion ofs*lion ?031.5 by &y lpplio for ! p.nit tubjeB lhc .pplio ro . civil pdhy of mt tue rhe 6vc hmdrcd doliB (1500), - _1. E own.r of th. pop.ny. or my .mplor.B whh qag6 !s llrct soL comp.tu.rion. will do rh. *ort ind thc (ru.ru. n mi inrod.d o. olt ..d for $1. ( se 7044. au,i6! and Profca"om Cod. Tn. Conhdoar Lic.dc Lrw doB mt rpply b .. o*ri of . pbpsty who builds o, inprovd $.fun, ed who doe $ch wor* hitullf or h@lf or throush his o. lF osn mrloy€. provid.d rtd such iDpro!.m. s .rc nor int.nd.d or o,Idd for *lc. lf. lDs.v.r. rh. buitdirs or inpmvm.nl i! sld eilhi. os yo of onpl.tion, rhc o\"tuFBuildd will h!v. th. budcn oaprovi4 th.t h. or rh. nol build or isprov. for th. pniroF of srlc). l. a own6 ofln popcny. d .r.lBivcly conmdins wnh liccE.d co E.loB l. octD( thc pmjd ( Sc 7044. BuinB! Dd Prolcsion cod.: Th. Conr&1of! Lian!. kw do6 ml rpply ro .n oMd of prcp.rry who bul& or inpro!6 !hd6n , rni ,ho @nircis for su.h pojeG wnh a Conr.do(r lrc.nsd lu6um ro rhc conn&:ror'r L'Nn.. tre ) I m d.npr udq S.dion B & PC f.r rhii r.r$n WORKERS COMPENSATION DECLARA ION I h.cby amm u.d( pc.llry of p.duryoeoartc followiq ddlfariou: I h,!..bd uill mai.hi,!. C.nilicorcofco dr lo S.lf-lBur. for mrk.s 6mp.nstiol! !r p6vi(l.d aor b, s..iion !70o olfi. Llbor C.d.. ror rh. p.rfoM oflh wort for which rh. ,.mn t irsu.d. _l hvclnd willtuin[in torl4 6dr.Ml6n 'n!ucn@. d ,.qut.d by 36l io. ]700 of th. L.bor Cod., aor rh. prform@. of lh. worl fo, vnich lhs p.mi! i3 i$u.d My worl.B .omp.nnlEn insumcc cMi.r ed poli.y nunb6 e.l Policy Numb.r Erptca: { rhi scclion n..d.or b..oDrl.t.d iarh. p.mit is aor otE hundEd doll6 lil00l or l.s) _l cdily rhl in ih. pdao,flft. olrh. worh for *hi.h rhi. p.dir i5 ilsucd. I .n!ll @l onploy rny p.6on in .ny o.nn.r so as to b..rm. subjd 'o rh. m .R @mpcneton hw! of Crliao,n'!. lnd iB.d rhll if l should b..oh. lubJ&r lo rh. vorkst comp.nlation 9tuvisioos of Sc.rion l?00 of lh. L.bor Cod., I sl8ll, l)1rr WARNING r.ilur. lo r6uE wo eB omp.Bllion covcmg. rs unL*.lol. lnd 3nrll eubi<l m .nplor.r to oiminrl p.!ahi6 and civil fin6 up lo orc hudrcd thousmd dolhB ( l I 00.000).in .ddn ioi ro rn con otcomp.Nrhn. &mg* a providcd for th. Srrion 30?6 of rhc L!bo, Cod., hrerd ind.norNy s lc Ltct!!!Dl0!raAqras!-0Ec!.6BArlqN I bd.by .trm unda pca.I, ofp.rjlry rhlr I e li@.d uida pDvnion ofchlrrd 9 (comttr.ins wilt Scrion 7000) oa Divilion 3 of rlE B6i'B .nd Prcf.*rioB Co.L. 6d iy lic.s. i, in tull aorc. ud .lrBr. CONSTRUCTION LENDINC AGENCY I hdcby .mm undd p.ulry olp..jury rial thft is i co6rruclioD krdbs !s.my aor ln. Ffom.nc. of fi. aorl fo, whkh tht pmil is ilro.d (Se. 3097. Civ. C.) AffIICANrtDEclAAAIIotr D.mlnior lmiB-Atbc.lo! Norificlrion F.<Ldl Reulrtion! (T-nL 40. P'rt 6) _ Rcqui!.d t rd ofNorifiorio! _l ccnify th.r ttc Ld@l r.3uhrioro r.Brdilg ab6rot r.mlal r. lor rppli.lbL ro rti! prei*r. _ _ I c.niry thll I h3v. r..d rhis erplicrtioo md srar. th3r lnc .bovc i!tumlrion i! cor.cl I leE ro comply wirh .U Ciry and Co6ry ordinaEB rnd Sl'r. kws r.lrlins lo buildins .unoria BpGot'rivd oatli! Cir, ud Cou.ry lo . 6 oFn rh. UNDER GROUND Waste & Venl Water-U nderfloor Gas-Underfloor Building Sewer Area/Storm Drain lnterceptor/ Clarifier TOP OUT Water Piping Gas Piping Roof Drain Rough Water Heater POOL/SPA P{raplDrain Line Main Drain/Pool Piping Fill Line/Back Flow Pool Heater/Gas Line Misc Gas Service Water Service Lawn Sprinkler Sanitary Sewer/Cap Back Flow Device Rough Plumbing Final Gas Test Meter Release FINAL oytbltt =6t -an^hlt Notes, Remarks, Etc.\J\Y lnspeclion Forms\Plumbin9-lnspeclo. Rscord.doc 03.31.06 Waste & Vent Tub/Shower Test x tt f------T------ -=