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PLUMBING.INSPECTOH BECORD <br />COMMENTSAPPROVALSID/SIG. <br />UNDER GROUND <br />Waste & Vent <br />Water-Under f loor <br />Gas-Underfloor <br />Buildinq Sewer <br />Area/Storm Drain <br />lnterceptor/ Clarif ier <br />TOP OUT <br />Waste & Vent <br />Water Pipinq <br />Gas Pipinq <br />Rool Drain <br />Tub/Shower Test <br />Rouqh Water Heater <br />POOL/SPA <br />P{rap/Drain Line <br />Main Drain/Pool Pipinq <br />Fill Line/Back Flow <br />Pool Heater/Gas Line <br />Miscellaneous <br />Water Service <br />Lawn Sprinkler <br />Sanitary Sewer/Cap <br />Back Flow Device <br />Rouqh Plumbinq <br />Final Gas Test <br />Meter Release )t <br />'nz-/*O HttoFINAL2t <br />Notes Remarks Etc. <br />oWNER BUII-DI]R DN,CARATION <br />I hcr.hy iflnnr tr cr |Enrlly {)i pcrjlrt rhli Irn.rc rt, rionr rhc C.nlt.nm l-iccn\. hN nr lhc tull.cnrc rcr{,n (s.t7r}:ll5 <br />Bur d\ r ltolcs\ion Codc) Any ciry.r c.tr rr_ shich rciltrtcr r p.nnii t' .oi{ru.t. illct. irnln,k. . n'lnh ot EP(tr anv <br />nnr.n{c. prirn, rrs n{mrc. nl$ rcqut$lhc lp,'li.rtrl tur \uch Fnnn r,Iik d (i8f.d srrtcntnr rh, h.or shc n liccnscn 0!r\8nr <br />fi) tlr $)vi!nr\ oi rhc Contr.ktr-s Liccn\dl ljq lchnlcr q. (oNncn.i,,! tr h S(rion llx){r oI l)i!i\t'n .1 ol rhc B$irrsr $d <br />Pn,lcsi,,n\ (ivlc)orrhrrlf.r lhc ircxcnrnr rhcrcri.Na rn.h \i\ litrh.rlL3ulcrcmpiio. Aryf,trtionofscdotToll5hyDn, <br />rptrli(n i ntr rltnnirrubisrsrhc anplicrnln' r.i!'ll[ llry ltrot nnnc rhr nvc h!n&cddollrt\ (55n0r, <br />-1. <br />x|isNrof itu F)tr n y. or nry cnDloy.cs Nirh *rgcs r\ ,tn n,h .r r$n\ irr- *illJo rh. \rk ird rh.dBhr. i\ Rn <br />i' c'kllal orolhrcdfttrslclse..71).1.1,Bu\inc\sn d Pn,f.\!o sCGlc lh.({rlB.i{t 5l i.ci{ lnwdoc\ nor lPplyr)iiosncruf <br />rlt pn,nldy $ho htild\ or inrt (r.\ rltd\ . $rlNh) d,$ $ch *.rk hi'n\.lf,r hcrsclfor rhtouEh hi\ or hf.$tr cn!noy.c\. <br />l- rso*r.rol'rhc pr,!My, r'nrx.lu!ivcly.otrk{.ti S $ilI li$tr\.dcoiIr.ntr\10.on(n,cr rhc In'jc.rlScc 7(]!1. BLFirlt\{ <br />trtrd lh)f.(i Cdc: Thc Conrrrcror'\ Ltcnsc l.rsdocs iortrl, yr) ino*ncr olln,Pcnysh. huikl! Iimpmrcsrncrco <br />nJ wh. .otrrr rstlr\uch pric.h w ha conh.lor(n liccn{d f' r*krr h lhc co.lrrcktr r Lkcn\. u8) <br />I rmcrcnrfl undcr SL{rio <br />u1Btrli&uglur[lsairor <br />U[CrzIBAII0X <br />y or p.riury orc ol rlE follo*in8 d(Lutiols: <br />llnuirkin!C.niftJr..fGNctrrr,scll.lNurclorsorlci.onfctrsJtio..n\nmvnl.dtuthysc.rn:17(x,.lrhc <br />hc F-rli'irun.c.flh. {ork f(trshi.h rhcNndt n is\rc.I <br />!cnnJ wil!rrn 0h sorkcr' .oflrpcn\llnrn in\trru c.. rs rcquncd it S.cri,nr.l7(nolrhe ljhor C dc.Ihr rhc Pcnnrnrn.cof <br />nr irsuntrcc {ricr lnl Fli.y iu rh$ dclrhc $ork fo, *hi.h thiq !.mnl is issucd. My suk * <br />o O <br />-l <br />(cnilrrhol inrhe pcrtortuftc or lhc sort rar rvhicn lhis ncnnir is iqrcd,I sh0ll nor cmPloyatryll.6.n in nnv nDnmt <br />s, Fr{,h<lonr*ubjd!olh.m 6'ompcnsulion lawr oactlifomi., ond r8rec rhlr ifI ihould bc.onE subial l{, rhe <br />lo,kcs compcns,tio. prcvisions ofSNli.n lTO0olrhe hhn C-ndc, t shrll. fonhwnh.nmlly wilh th'€ Fd)liions <br />WARNINo hilu.c lo {.ur. work.n'onlFcndion covc tols ro niminrl tlcellls lrd <br />civil 6ncs !p ro om hundr.d rhousnd doll.c (Sl( <br />I h.rcby rlltD u cr !,enalryorp.rjory thd I dn I <br />y ol Frjrry thut rtqc h ! cu @r i.n lcndir8 .8crcy {or lh€ Frfor@n.c ol rhc work foi {hth rhk Fmir h <br />hsucd {ss. 109?. cir, c.), <br />knd.l' N!m:- <br />APpr tcaNT nr(|t,,\R Tl(rN <br />I hortyanimuodr p.n yofpc!.iury om ofthc lollowins dNldsri.nil <br />l)(noliri(in l'.nnir\ \If,{o\iotr Fcdcrrl Rc3ulori,'n\(Tirb.r0. Prn6) <br />I rhc fcdctulrcsllations Egsding aibcsros rcmvrlnc ml arplicohlc ro rhis Pmi.l. <br />ilylh l hrvc rcad rhh ,ppli.i.i Md nil.rh{t rhc ilxrvc i'rtunmri,'n i\I rsN ro conply sirh nll citynnd cotrtrry <br />con{rucli,,o.!'kl hcrct'yn h,rhi\ Cn, hnd Coutrtyto cnlc! upotrrhc <br />/-Z)--Zo <br />r.4& <br />I <br />ds1 <br />DATE <br />Gas Service <br />sNnn rE6 or ih. Ijtn crc. inlcRn <br />,"",LJ22/zc' <br />I