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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS oIYNER I]UII,I'T]R DF]I,('ARATI0N
<br />I hcrchy rf,nn tr cr pctrxlr, ('tn rurr" rhnr ,M,.r.'t, lnn rhrCo Lr.t^ l-ic.n{'ln! lorrh.tull,,q'n{ r.rw)n (Sc.7o.rl5
<br />{ru.luu. p tro irl i\n'rN.. rho rcqttcs rhc rffll.rtr tr R'.h t^-nnrh licr $!dcd n icN nd hc.r shc i\ liccrscn pururr
<br />k, rhc pnni\i,nr\ ol rh. Conrrrctr'\ l.iccn\cd Ls ((lsflcr 9- (innmrn.ing {irh Srrrrr'rtXX) ol D'vniitr :t oi rhc ltr\in.s in,l
<br />rt,t'licrtrrlitr r lf,rnir nrbj.(rr !h. !pli.rfr!rrcivil!.rrlryolmrNnth3trlir.hudrcJdol!&\(\5(lr)
<br />-L
<br />as owftr of rhc lhFrry, o! my eoplorrs eith wlgcs .s rh.n sh omlEnsalion. wi[ do d* sort ud tlE smtnE is mt
<br />bt ndcd oJ otrcnn 6r sk (Se.?lX4, BBiBs and Pmacssio Codc: Th. C4rtrsrols LLuE Liw dds nor .pply ro M osns of
<br />r,r. ImFdy *tn hiikls m inpoEs th€tur dd ats &s sh Mrt nin*lf or tErslf o, rkough hat or lEr own.mployc.s,
<br />pbvidcd thnr ru.h inpbvft !smri cndcd orolroEd to.sL.lf.hftE dr bildine d in9,lEmnt is sld qirrin oN Fs
<br />ot@nphrk iL rhc Oercr Blildo will lErc dF b'rko of preving $,I lc or 3h. did ml build or in{,mE t E !'npqiy for rhc prq,s of
<br />-1.
<br />ar owmr 6l rrb IiDIrdy. m .xclusivcly conrr.dhg wnn lic.nsn conlrsroB ro mnsulcr rlr ,tui(r lS*. 7(144, BEiEs
<br />ad Pmfi:rsbn Codc: Tfic Conrtutor'i Licenrc ks des nor attly ro d oqn( 6l lrop.fly who 6uilds or improves lncrcoi,
<br />lnd vho 6!!&k lor 3kn Foj.crr with . Co.rtrtorts) liem.d puBunl ro rhc Conrtrtols Lir.* kD),
<br />-l
<br />m .x.mpl undd Sc.lion-, B. & P.C. for this d$n.
<br />IABtrI8I..SIIMTENSAIION
<br />DECIJAAIII]N
<br />I l*rchy alrrm !trd.r ,.Mliy of Friry one of thc followirg dcclmlioB
<br />-lhrvcrNlqrllautr[rinrCcniicrlcoiCon\cdnrSclflnr{ctu*orkcrr.onrFnsrli(nr,is
<br />|n)vidcdt rbySecri.n:]7(xlolrhc
<br />trlx, Ctxlc,lir rhc r$lnnMkc ol rhc wo tus[i.hrhc r^-irni is nrucl
<br />-l hrlc ondsiu maint.in *o cB conFncarion inx!ran... oi rcrtun d ty Smrbn l7u) of lhc L{hor C.dc. for lhc perfoMc. of
<br />Uh
<br />-l..nify
<br />thd inrhcF.formRcof ltu work for whichlhisFmjl h issucd.l shall Nr cophy.ry p.Mn in 3ny numr
<br />so !sro l*em subicr ro thc worloJ con cnr.rion l.wr olcolituni& ed,gnc rh, if I should bccom subjccl lo lh.
<br />*o*sJ or{Ensark n Imvisions oa Srrion l70O ot rtE titEr Co<h. I rldl. rdhwhh omply *ilh l,$s Imvhiotrs,.
<br />WARNINGT Flilure lo eurc sorkctr coq*.mlion corcmg. is unlsw6il. lnd shrll subi! an cmployo lo ciniul IrMhics md
<br />.ivil li.es q, ro o* hrndrcd lhouend dollos (!10o,0@J, in sddnbn lo ttr cosl of conltdslion. danE3ci .! prcvt.d fo. tlr
<br />Selio. 1076 olihc L,hor Gi., inlcrcsl and.lrormyt fes
<br />Dnle Appli@n(:
<br />r rcunsrn crrxrnrCnrn
<br />DECT A&trr9tt
<br />I lErcby dfrm uodo p.nalry of pcrjury rhd I !n lkrnsd undd pmvision ofch.lrld 9 (onmfting *nh Sdhn 7000) of Divhion l
<br />of th. Busitus and Profcsions Cod.. dn my lkenk i, in fiill fo@ a,t cfiel.
<br />,"r"b
<br />CONli[BI]cIl1}NIlNlINliiGEXla
<br />I h.rby all,ro undci p.nnh, ol p.rjury lhd th.e h a con{dcrion hndh8 agercy for lhc pcrfomftc or I hc Bor* lot shich rhis ll.mil is
<br />hs!c{rse :1097,civ c.)
<br />A}ILIIANI.DECIIIBAUAN
<br />I h@hy arm undcr ncnrhy of pcrjury onc ofth.foll.wing declMrions
<br />Dc@lnion Pomns Asb.tus Noriilcdion Fcdml RcguLrions (Tnk40. Pd6)
<br />Rcqun d ktr.r of Nolitrcalion
<br />-l
<br />ccnifyrhlrrhcfcdcralrcllhrn'n\ ftg,rding asn {o\ rcm)!,|,r. noramlt.hlc ro ihis t}nrj.rr.
<br />l.cdifyrlr r l hrv.tord rhisapfli.rtiondld sl,cr rhc obovc infor@lion t conecl I asra lo @nply wnh aI Cny .nd County
<br />n. rrd hcrebyeulhornr rcprcsc adv$ of lhis Cny ud Cou.ry l. cnls uFn tlEordinn.ccs d6d st,rc trws rcbrinB ro build
<br />arx,re mlrhncd rmpeny rd irspr.r
<br />^ co[zollK
<br />UNDEH GHOUND
<br />Water-Under lloor
<br />Gas-Underfloor
<br />Buildino Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Pipinq
<br />Gas Piping
<br />Rool Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />It/ain Drain/Pool Pipino
<br />Fill Line/Back Flow
<br />Miscellaneous
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbinq b/t/trt 9lr#(.
<br />Final Gas Test
<br />Meter Release
<br />FINAL T/zz/ c +D€\
<br />Notes, Remarks, Etc.
<br />Waste & Vent
<br />Pool Heater/Gas Line
<br />I) rr ( )rr rr
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