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
|