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PLUMBING-INSPECTOR RECORD <br />ID/SIG.APPROVALS DATE <br />UNDER GROUND <br />Waste & Vent <br />Water-Under lloor <br />Gas-Underfloor <br />Buildinq Sewer <br />Area/Storm Drain <br />lnterceptor/ Clarif ier <br />TOP OUT <br />Waste & Vent <br />r/rt /t.t d 'norh-/oz--Water Pipinq 'f 'Lr 'Gas Pipinq <br />Roof Drain <br />Tub/Shower Test <br />Rouqh Water Heater <br />POOL/SPA <br />P-trap/Drain Line <br />IVlain Drain/Pool Pipinq <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 />Rouqh Plumbinq <br />Final Gas Test <br />Meter Helease <br />4ltoh/htltl,tnA-/K7..FINAL <br />Notes, Remarks, Etc t-- 1 <br />O\!NI]R BT It,DER DIJI,CARATIolt <br />I hcrchy rr[ru on&r prtrally r)i p(rjry rh"r I nnr cxcmfl ft'nr rhc Conh.nn Li.ctr* lj* rd rh. lollowitrs rcrv,n lscc 70.11 5 <br />Businc\\ rkl l'rn,t$tr Cix[) Atry airy or Counry shirh rcqrircs I lcanir n, c.iiru.r. rllcr. n.nri'vc r,_n,lir[ or rePt uy <br />sltuctrtrc.primlon\ issurr.r. uls rcqunc\ rhd amliunr tur $ch l--nir ri lil( rsiSned{ c'R.r rhrr lEor shc i\ lion\L'il,nu6u r <br />k, rh. lr,vi\iotrs.Ilh. Conrru.ktr\ l-rctrscd liw lchllrcr 9. Cotrrnrcncin8 *nh scdnin ,000 ol Dilniotr :l olrhc llusinc$ 'id <br />Pftnts\io.s(' crorih r h.ut(hc i\.\cn]Prrhc'dlroN.trd rhc hrsir Ii)rrh.rltgcdcx.nlPlir)n Anyri{rhrionolSccrinrT0ll5hr_ttrv <br />applicunrr{trrpcnnr$bjc.lsrh.an,,licanrt,r.ivirItn.lryolnoinnr.rh li\c huntllcd doll \(550o) <br />-1. <br />f,s owmr of llE I'rcFny. or my e .rplo)tcs wirh waE!. tc fici. sk onw.€ion. wil do tlE vqt &d 0E 3lrEl6 ii 6r <br />inEin d or oficEd t6, qt (Se.7044. auiircss dd ProfBsios Codc: Thc Co.ki.ror's LitM lrw &.t ml dpllv io e owmr of <br />ih. pEpcrty wtn buil& q iryrcss thc@n. !d sho d@s skh mrt him*lf nr ltrslf o. thmugh nis or hc. ovn .nPloy.cs. <br />provilcd rhar fth inpro@ilt@ @r idcd.d mofcftd lor slc l( howE. rE hildDg d in{mhmnt it std wnhin om FU <br />;forplcriotr rh. O,Er AuiE r qiu hlr {E bud.. of Fovins tltl lE 6r .h. dil ml loild d itpiDw nE Flpdlv n[ dE prqr$ of <br />-1. <br />rs owNr or th. Dror.ny. !m cr.lrlivcly .oflmcrins wilh licenscd conrrclor lo onsld.r rrE lmj.rt (S( 7l)ll4. Burrc$ <br />ond t,rtrlsshn Codc: Thc c.nlractn s Licenrc l.ds dms nor.fplt to anosn.r orlm!.rlv wk, hlildt or nn[oves rhctco.. <br />and $ho.onrmclsforslchtNJ.{irvirhaaonlEcro(nficcn\edru6untlolhcConrdr'sLiccnsebw). <br />-l <br />mrcxcflrpr undcrScdion-. B &PC lorlhnE,r,n. <br />loBtrlllrlolllENlArlaN <br />IIECIJIAIIIIN <br />I hcrc$y rfirmlndcr pcn,hrolDcrjuryone ofrhc folbwing dcclJalionr: <br />t harc.dwill nrinrainaCdilicnrcofConsenrlo Sclf In\!r. ro! works! conF.\dion.0s FDvidcd forbrscdion3T0ootih' <br />Llrrr Cod., rff lhc prrio!ronce of rhe wori for which lhc oc,nir ir i$xcd. <br />I hrv. nnd *ill m.inkin workcrl com0.nsrr ion iGudftc. as requn.n by Sd ion ll0o of rhc Libor Codc. fot thc ldnmEre of <br />t0 <br />s as lo hcom subjd ro rhe sortcu omPcn{lion ldws or Ctrlifomi4 dnd t!x!c lnll if I slDlld b.em subiBt lo rh. <br />sorkdr comDcns ion trvhions oa Scclion l70O of lhc khor Code t slbll fonh*irh cotrt ly wnh rho{ pmvisions' <br />WARNING Failud ro *u( worken compcn$iiu.m8c h lnhstuL ,nd snall subjccr d .nll)lortr lo oininol Fmllis and <br />, in ldd ion to rh. cosl ofconwnrdiion. drrogB $ p.ovidcd fot lhc.ivil fincs uI, lo orc hnndr.d lhousond dollG (Sl <br />Sd ion 10?6 ot rhc hhor Codc. intcrcn ed !r <br />I hcrchy ranm und.r lcnohyotperjury rhnr I olChoirtq9(coMncing wilh Scdion 7000) of Dilhion l <br />of lhc Blsifts and Prcf.rsioN C.dc. axl my <br />c- 3a 7e ff ?2 <br />1- (t . (g:*", <br />I hrr.hy nfilm und.r trnrlr, otp.rjory rhar rh(rc is r <br />i\\u.d rScc :1097. Civ. C.) <br />agc.cy fo, d. nslordre of$c eort for whkh rhir Fmit rs <br />lr!td6'r N.fu: <br />- <br />Irnd.''s Ad.lE{. <br />AIILICANLDECIAEAIION <br />I ho$y afiim und.r Dcoaxy of pcrjury orc ol rhc following d(Ltations: <br />Dcmliri6o Pcr$ir$AstEstos Nolili.arion Fcd.rll Rcauhtions ('rnh & Pan6) <br />-Requncd <br />knc. oaNolifratun <br />I snifyrh lhc fcdeml rcSulaliotrs Egsdin! ssh.stE t nsvulrrc nor aPpli.nhblo lhhl)nr.ct <br />_lccditirhd I h.rc rcod rhisapPl <br />ordiuncc\ and sralc tiws rclalinE r. <br />iotion rnd {ale rhd rhe llow intodiElion n conc.r' I "gm loomply*ilh !,lCirynnd Corntv <br />aurl$riz rcFc*darivcs ol this Cn, d<t Cou.ly to .Ils lDon tlE <br />abok nEnri.ncd p6!,cdy for 1 t( ,^t oo <br />I COMMENTS <br />Oro.. <br />rhc wo.k lor which rhis ncnnir ir <br />L1 d-L <br />rh(l itr lhcPc fornunc.orrhc sorl lor *hich