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PLUMBING-INSPECTOR REGORD
<br />APPROVALS DATE ID/SIG,COMMENTS
<br />UNDER GROUND
<br />Waste & Vent
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarifier
<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 Heater/Gas Line
<br />Misc
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Rough Plumbing Exr ,IDtrTT
<br />Final Gas Test
<br />Meter Release FFq n I ?n!9
<br />FINAL , .ru, ooo, t 6t
<br />Notes, Remarks, Etc.
<br />OE d-Build.r Dcl..ti6
<br />I h6r!y.fam ur& Fulty of Frjury tbr! ! u amF fm $. CdEald' Li@c Lr* 16 $. followinS @6 G6.7031 J Buind
<br />ed PrefBid Co&) Any CrV q Cout, wtich Equic . psnir 6 csEucl, d|(, imFovq d.E lish s itp6n Dy rn@t!!, Fi6 to itt
<br />isudc.,.le 'tquiE rh. s@li@t f6 tuci Fhit 10 61.. li8rcd nlr.l6r lhar h. r shc ir licn*d pc@r ro rh. FoviliN of Uc
<br />Coffir.la ! Li@!.d Ln (C14tq 9, Comocitr! wi$ Sani@ 7000 of Divitim 3 of ln. Bui,@ Ed PDfdi@ Codc) n thrl h. r
<br />3tc i! ddpr thfrtw ed thc bait to dE dl.sd qdFi6 .Any viohd@ of S.!1io 7011 5 by &y .rDli@t fa . p6nn ntbjc.B dE
<br />epli@l ro . .ivil poElry of no. h@ ltd fiv. hudld &ll$ (S50o).
<br />_L a oma of lhc !..?dt , dn, dployd eiti *ia6 a thcir el. ffip@i.ie,,illdo thc qdt &d lhc llru.lrd ir &r i a<ld
<br />6 ofqld fd rltc ( Sc ?oaa, Aqild Dd Prcfdid C!d.: Tlr. Conr&ra't Lic.e kp d6 nd arply io e om6 of ln. FqE.ty
<br />*no b!il& d imFovd rt.!@, ad wlD &6 sh sdl hiB.lf d h@lf d U@th hb d ha os dploy.ca, FDvid.d thr iu.l
<br />ihFov.lmE c.ol i.0ad.d 6 oflot l fd t l.. If, haa-,6G bsildioS 6 inFovlIMt i. rold;thia @ yd of cepldid! lh.
<br />OMd-Buil.ld *ill h!. th. bo.d.o of Fovirt lh.l hc d.h. .ot build d imp.ov. f6 lh. p!r?o.c of 3rl.).
<br />_I, ! M6 of d. prcFty, n dclaiv.,y @nE&ti,8 wnn I.a,.d @tuG ro 6Nhcl thc Fljar ( Sa. 7oaa, BaiiB dd
<br />P6f6i6 Cod.: Tn. CdE&rd'! Li6rc La .b6 nol 6pply ro e oMd of poFry who buil& q inpbv6 rhqd , ed tho
<br />@belt fq iuch Fojc.e wi$ ! Cot!.io(r) li@.d p6@t to !n. Cdrrelck Licas. L5w.)
<br />_I m dmpt u.ld S..1io _,B. & P C l@ rhk lGm
<br />WORTD.RS COMDENSANON DECLAR TION
<br />I hdby !86 urrn F rlt, of Frju.y ac of lh. followii8 <L.ld.ri@:
<br />_I h!v. ud will tuinr.h. C.rti6cr. of Cotudt Io SclfJNe for vort6' cmFidtid, a povidcd fa by Selio 3?00 of rhc
<br />tltor Coda fd tic pdfd'M@ of th. wdt fdrbicn r!. pmt i! i!.u.d
<br />_l hrvc ad will minEin vnid' mpau.rim ir!@c, a ilqut d by Satid !7OO of th. ti!.r Cod., fn $. Fftue of th.
<br />wdl f6 ehich lhi Fmi t i$u.d My vdt6' cmFB!.id iB,6e 6i6 d Flicy nmba G
<br />(Tlti !djo. .c.d troI b. 6mpl.kn if lh. Fmn ie fd O.. hu&.d dollm {l I0o) tr 16)
<br />_l .rdry llld in ti. Ff@6@ oa lh. vdt fa whi.h thi! pqnir ir Eu4( | lnJI nol mploy &, F!@ in my lllDr s a ro
<br />be&. rubj.o ro dE wdi@ .@Fi!.!o l.B of Cdif@ia 6il.88 otd if I th@ld b@lN $bjccr to dl. *ot6'
<br />@mFs.ri6 poi.i@ of scqi@ 1700 of dr kld codc, I !h.ll, fdlhwith mpl, wilh ddc FwiliG.
<br />IDAiNING: fdlw .o
<br />'c.@
<br />wdr6 @oFani@ @v6!gc i! ul.wftl, e.l rh.ll rubjd e @doy6 !o eimiD.l pqlrlti6 i,!d civil
<br />lir6 u, ro 6. hu.tql tho@d d.,lla (1100,000),i. .ddni@ b llc ct or @Dp!4r.d6, d&r.86 a ,rcvidld f* 6. Scde 3076 of
<br />rh. t !d cod., inr.rd ed ,rdncy'i f8.
<br />UCINIE.GONIf,ACIqS&DECIdEAIIoN
<br />I h6by .mm odd p6dt, of Filry ttll I d li6.d u.ld Fdidd of C1ryl6 9 (mcin8 {i$ s..li6 ?000) or Divilim ! ot
<br />lhe BBird ed Prct*ionr Co&, Ed By liccne i! in tull foE ud .tr61
<br />COIEBUCtrOITIEDAC.AGINCIIbcdy.f6m'Ddapadly.'fpaiuyddli@it.d!t!rci6l,rxh8{acyfalt€Ff6!l@oflt,6tfalltidllni.F!triti.
<br />Irr&d (scc. 30rrr, civ. c.).
<br />arflc^tEt-DEc!6aal1ax
<br />D.mlid@ P@i'&arb6tc Notifiqlio F..,od R.gul.ii@ (Tidc ,O, Pm 6)
<br />_ R.quird Ldd of Notificrtio
<br />_l @dry tnd th. f.da.l Egul.Iid rcgsdjnS 6bctG Ehov.l 4 nd .rplicall€ ro thi! Fojer
<br />_ I 6dt th.r I hlE Md d:i! .pplic{i6 ed iar. thlr thc abo!. iifffirdd h @d!(r I rgc to .drply with .ll Ciry &d C@t,
<br />odiM6 ud Sl.l. bB Gln1r8 to buildirto8nuctid, ed lt ..!y &dsi& E Gor.liv6 of $i! City Dd C@ry !o ai.r upoi dhc
<br />rbovc mariocd popdry fd iBreti@ Fnp..6
<br />/-tz:ll -//->,1,
<br /><.-
<br />r
<br />1\Foms\Permit.-lnso€ction Fom 03-31.06
<br />Water-Underfloor
<br />Back Flow Device
<br />Uca* qar_ Uc..rG NMha--4
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