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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />UNDER GROUND
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptori Clarifler
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Pipeing
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOUSPA
<br />Ptrap/Drain Line
<br />Main Drain/Pool Piping
<br />Fill Line/Back Flow
<br />Pool HeateriGas Line
<br />Misc
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />EXP IRED
<br />Rough Plumbing
<br />Final Gas Test ti-.t I I n iJ
<br />sAi,tc R-4i
<br />FINAL
<br />Notes, Remarks, Etc.
<br />Ovd-Blildr D.chr,tid
<br />I hatUy .6m u& F nry 6f pdjury d|.! I h d@O fch fi! CdE ao.r' Li6. Ls fd lh. follryina lqd (s.7o3l 5 Asind
<br />ud lrcfdi@ Codc): Any C,t, a Centy wti.h EquiB 3 p6mir lo drtu.1 rlra, iaprcvc darclkh d rcp6t ay rtEtr., Fic ro its .
<br />isuec!,.Ie Equi6 $c.rpli@l fG.ud p6nit to 6lG . ri8ldn.ra@t Od ic 6 rh. tu lic4ql ,altur to thc FDvi.i6r of ri!
<br />Cdr&ia'! Li@.d ln (Olala 9, Corm.irg *irh s..rj6 7oo0 of Divirid I of $. BBin !. &d Prcfdim Cod.) q lnd hG a
<br />3h. ir creftF lh.rlion &xl fi. b.rt ta tlt. dl.gd cranptjotr .Any rcl.dol' of s..tiar 7031 5 by in, lpplicr fsr Frn lobjer. $.
<br />eplican !o . civil Fdry of n.. tl@ tE fiE h6&.d dolld (l5oo).
<br />_1, e omo of liq FoFty, d my @ploy6 virh wag6 a $.ir el. cmF !.!d, sill& th. wdt 6d $.3ticur. h id in.ad.dq ofsd fd r.t. ( Se.?044, Buir od PrDfBi@ C.d.: It. Cot.!.r6 3 Lic.e Llw d6 .o. Tply !o o om6 of th. Fq.ny
<br />wno buil& d imFovd tnffi, dd *ho dE ruh w6t nic.lf c h@lf o th@gl hit o hE (m @rloy€, prcvidcd rlur iuqh
<br />imFotllMB e nol i.6.bd or offEld fd 3d.. Il h@.c, th. buildi.B or imFovfiat ir rold wittin o.. yd of .mpldid\ 1n.
<br />Own6-Build.r eill h.v. $c b!r&r of P.oviis tlEl h. 6 !h. not build d imprcvc t6 drc p.?.6. of 3dc)
<br />_1, a Md of lh. Flpary, d q.luiv.l, eE .!ing *irh ,im.d ontBldB lo mlEud lh. Fojd ( Se ?044, Buins &d
<br />P6f63id Cod.: Thc Cs$&1d'3 Lica. L.* dc not ,,ply ro u M6 of FoFry wto brilds a inpEv6 th@ , Dd who
<br />@nr.cE fs lEi proj*t wilh c Cot&lo(, li6.d plll]Wr ro lhc CmE&ro.s Liq!. bw.).
<br />_l m qmP1 uidn sdri6
<br />WORIOn!| COMDENSATION DECLAR TION
<br />I nety .f6m sd6 FElty of Fjury m. of lh. folldinS rrE,rdi@r:
<br />_I h.v. ed 9ill iDir.i! . C6!6c.l. of Cotstt to S.lf-b!c fd rsi6' @mFrti6' a Fovi&d fd lry Seri6 !70o ofdr.
<br />trhd Cod., fa rhc Ff(lr'M. of rll wdi f6?hid lh. Fhit i. i..u!d
<br />_l h.v! ed eillnanra. sdt6 .@paErio iNllltG, a 'quiEd by Sctio aToO of th. trbd C.d., ad rh. Ffdr@e of rh!
<br />*dk fq which this pdhn i! iisu.d My wort n' cmF*.rio iNumc! c$ia ud poli.y numbr s.:
<br />(Th lccdon nc.d nor b. ffipla.d if Ih. Fhil is fq Orc hu(M dollu ll I00) n ls)
<br />_l c.nify lha! ii th. Ffolme of thc *dl fd which thtu Fhn k isuc4 I shdl no( anplo, e, r6m in ey run6 $ s lo
<br />b.c@ lubjerro lhc arkd ' @np. lrion h* ofcllifomi4 ed a8r.c dat ifI should b.@m. &bj.cr to th. wate'
<br />@mpardion p6vki@ of S6tis 3700 of |n. Ldv Cod., I rh.ll, fditwi0r c@ply willt tt@ Fovisio8.
<br />wAXltlNG: F.il@ ro icc *dt6' cmpaedd @vdag. i, ul.wful, sd insll rubjc.l e .ln loy6 lo siniI.l pa.ld6 &d civil
<br />firB sp ro 6c h6dr.d lhMd &lla (l l00,o0o),in rddnid to th. c6l of cdp. !rie, d.h.ge a Fovidld fd lhc Scti6 3076 of
<br />ln. Lbor Cod., i.lqar ad drm.y'r f6.
<br />LTCENSED CONTNACTONS DECI,AiATION
<br />I h@by .fam uda F .lty of FjEy lnr I D lica6.d oda p.ovisin of C1'!pt6 9 (comdd.8 *ith sdtion 7000) of Divni@ I of
<br />ttc BwinB ed Prcf6i@ Cod., ed my lic.e k in tull fo@ ed.fidt
<br />qOISUCUAN,EIDIIGAGEdCI
<br />I tdl0y.f6 !r& Datdty ofFj!.y O.l6@ n r @ta!.rid ladiir.galry fd $G Fforrc ofd. *dt 16 rti.t ltit Frir ir
<br />irs!.d (Scc. 3097, Civ. C.).
<br />AIIUCANI]IDICIdBAIION
<br />D@ohio P.miE-,&b6td Notifielio F.d.El R.8 ditu (Tid!,r0, Pd 6)
<br />_ R.quirEd t ndoaNdifi@tio
<br />I edry $.r !h. f.dE l l!sdc,@r qudim 6bals ,!mQl e no. @Dlictbl. to tti! projca
<br />_ I c.njfy thal I h.v. Ed tht qplic.riq 4d ilr. thd th. .lDv! inf@nj@ i! .@.i I aSte io @oply vidr .ll City dd County
<br />ddidd &d Shr. L!* alarint io building @$riucdd, &d heby 6!rhsi, rcp6allriv6 of rhk Cily dd C@ry !o al.r lpoi ln.
<br />aboE Bmrjo.cd F.pcrty ad inrp.ctio purpcB r
<br />I
<br />nnse€ctoo Forms 03.31 06
<br />Waste & Vent
<br />Water-Underfloor
<br />Meter Release
<br />on", -1- , I c.*.,*. Y/ <' ,
<br />Pmir* nm (Eiro @
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