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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS oWNI]R BUII,DI'R DILC RA I'ION
<br />I herchy rmnn undcr n.Mlry oi n.rrury rhd I am.xc rpl imm rh€ Contddor'Licensc Law li, rlE folh$i'rs t.avli(sec7oll5'
<br />8unn.s. .kl ProL$n (ode) Any Cir, or coonrt shich '.qurcs r Nmrir tu .on(ruct. .lrcr. mrror., dcml' .r r.,rn my
<br />rrtucrurc. I1notn, r t{am.. al$ rcqur.s rhr,lplicMI lor su.h p.iinn t',ll.. si-sncd srarc Enl lhxrh..r dr rs lr.nei puN.
<br />ro rlr povieions .frh. Onnr.dor s Liccnsed l.a* lcnapr.r o. fi,n.,si.rn! $irh Sccrn. 7l)0(, ofDirkion ] olrh. Br\in.* itul '
<br />rn,ts$n! (ixic)orrhri h.rsh. i.x.nrrrrh.refiomr d rh. h.srs nn lh..Uescd.remnri{,n Anrlt'larionofseri,rnT0.ll shyin,
<br />aml'c,nr rirr,rnn bcctrlhc applc.nl lo ncivilpcn.llyof.ol morcrhln [!. hundr.ddoll.( lssclo)
<br />-1,
<br />$ o,ner otth. I,DIcny, or my .ntlqEs wirh wag.s ai rh.n $h on{Erstion, *ill do llF wo* a,id rlE $odw h ml
<br />ii.od or ofie..d lor sl. (Se.r044, BusinBs .nd Poassions Cod. 'l he Co racloas Licen* tlw &.! nol q,!,ly lo 0n ow.d of
<br />r h. pmD.ny vln buildc or i@n)6 rhd6n &d wL do6 tuh eil lin!.lf or h.mlaor lhmu8h hh or h.r oM .6ploy(r.
<br />tmvidcd rhal *ch idro\tGhB e m( inrai.d o.oirad 6r iL ll tbwffi.
<br />'tF
<br />tuildins or iqmr^ft irsB*ni'inoftF
<br />olompkrt q rh. oo.d Bualld eill h,E lh. hodo otpmrine rhd lE or sh! did mi toild or impmve llr fllrsry for rh. llx{hs or
<br />-,.]/'/!-las"*no"rrrrcploy..n.xchrnrlyodEunswirhli&trk<lsnrdro6rootr{ d rh. rmidr (s(. 7044, D!$rc$
<br />-and Pmfdnn Cod. I h. Conrador ! LEcns. Lar d..s mr arply to a.6snd of or.nyqho buildsor improv.s lh.r.on,
<br />dnd *hd o.hc$ lor iuch pmjets sirl' a Codhclo(s) lic.ns.d ,usunr lo rh. Cor'Eclor's Lic.nr LN)
<br />X,,'.c
<br />!tr!L!-Btll!!!
<br />I hdchy .mrB und.. Fmlly ol psjury orc oflhe lollovinr ddlnl ionsl
<br />IhlveF wil!trrirnrain !Ccnific'reorcohwnr !)sclllnsurc nr sorl.rs coupcn$non. ns Dmvd.dlorbysccr'on1700olrh.
<br />L.hr (id., aor th. ,erlirnn0rf,r oflhe *olt for shich rhe pemir h t\ued
<br />,l hav. and willmairhin *o*.n c.n!.Brrion inflmrc.,.s r.qun d by Setion 1700 ofth. Lator Cod., fdr lh. ldfomm. of
<br />thc wo for which rhB l.mn is is&d. My wort6 conpmr.ri.n inru6m. aEi.r ed policy rumb.r e:
<br />'ll l"rd',\rh. tr,rl*D..i,n'L'n!colrhcw rlloru)"c[rhNp. nir FhsEd.lshrllnoremnbt3nyp.rs,dinrnym0trncr.P** m *c,,r *Ll{i r, rr'. u.nrt en c,,mnc $rn!n he\ orCiLfom'r, nd ryr.c rhd rf I slx'ul(ln€.on* qrhjecr rolh.
<br />qorterC comrenqrionlrovFions orS€cron 1700orrh.l-ahtr CodL,lshlll, ti,nhN[h c.tnD]yq1rh rh.e tn,visonr
<br />WARNINC: l-ailurc lo slre mrk rl oftp.Mlion mvo8. h !nl6q{ul, dd shall $bjd s aryloF to cihi l ,,.Ehi6 &d
<br />cMl in* up lo oG hundr.d ttsud .loll.E ($100,000), i. o&lnior lo lh. cofl of @nlp.Mlioq dataScr ac pdvidcd for ln
<br />S6rion 1076 otlhc Llhor Cod., i .Er .nd lltorEy\ fG.
<br />(
<br />urcl lltlto]
<br />I h.rchyrmrmuad€r pcnaltyolpojxry rhd I on li.cnkd und.r torBonofchintd 9 (commnciry *ilh Sclpn ?m0)
<br />oa th. Busin.ss and Pmfcssions Code, ond my lic.nE is m tull forc. arrl.fftcr
<br />cq-lisrBlcrou8trlclcBcr
<br />I lml,y,lfinn xnder p&'lryoar.rjurytlmt rhde h i codrucrion lcndins rycncy Iitr rh{ pdlomnc. ofdt work for which rhh Fmril is
<br />iss.d{s.c 11097. Ci! C )
<br />AITTICAIUUiCI,Ia^IION
<br />I hst{yrmduodcr po.hy of!.rjury on ofrh. aollowinE del.BtioNl
<br />D.nn,lirion Permirs Asb. dNorifiol'onl:.dcral R.eul0tio.s(1i1.40,Pin6)
<br />-R€q!rcd
<br />L.rr.. of Nd'ncdion
<br />-l
<br />cenfy Lhd rh. &d.ml r.Blldtions rcsardins 0sh.slos r.mval 0r. mt apnlicablc ro lhis pojrtr
<br />7.-"*l*"llr;r'.myg icolioh dd 3l{t. rh.l rh. ator. infomton i. coE d. I s8r to smdy qnh 6I Cilt tnd Conoty
<br />tuclioi, a.d lEahy ruih6rt. r.pmetuotiv.sofdis Cityand Counry ro.nrd up.n'lr
<br />atnvc ftntioEd pop.ny lor iN!,stion
<br />.\!plicrnl or Ascn. Sisnxl0tr:
<br />-P.mlreenrmeOn )
<br />,.,,1#/t4tr
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarifier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Piping
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOUSPA
<br />P{rap/Drain Line .?
<br />Main Drain/Pool Pipino
<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 t )Ll I tlt I nw*er/7r)r carNotes, Remarks, Etc.T
<br />x
<br />F
<br />B. & P C. forlhis r.!s!
<br />2fur4
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