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PLUMBING-INSPECTOR RECORD <br />COMMENTSDATE <br />UNDER GROUND <br />Waste & Vent lLDe, -Water-Under floor ,l <br />Gas-Underfloor <br />Building Sewer <br />Area./Storm Drain <br />lnterceptor/ Clarilier <br />Waste & Vent <br />Water Pipino <br />Gas Piping <br />Roof Drain <br />Tub/Shower Test <br />Rouoh Water Heater <br />POOL/SPA <br />P-trap/Drain Line <br />Main Drain/Pool Pipinq <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 />'7r44,b(Rough PlumbinS //0 /20. I <br />Final Gas Test <br />Meter Release IF|NAL 'j/z/zQ ,.y.#YL7-/ <br />Notes, Remar(s, {tc 7- t <br />OlYNF]R AU!I-DER I)IiI,CARA'I'IoN <br />t'l]Dli.rtrr liirr|tnnir \ubjr.r\ rlf, q'nli.rdt,rci!ilttnilryolmrtrtncrhr rivc hu rcdiolhAlS5(X)) <br />-1. <br />s *ncrolrhcp'oFnt.(, ry cnrdoyccs wirh \ rs$ r\ rh( qnc co'nt$.nri(rr, sill dd rtr sork Dixl rh niNurc i\ nol <br />inrdxtcd orof,ar.dtu$lc(Ss?lrl,l.Busim\sJndlrofc$ion\Codc:lhc(idr$tn\l.i..i\clrwdkrnor!!Plyro!nowncrof <br />rhc poprny $ho tuil,hor i'nfr.v.\ dti.\!i. idqhodoc.n(iwo'khi'n\tlforlt*clforthrou8hItho!hcro{nc'npk,yc.\. <br />nn,vidcd rhrrskh in!!D!..Enr\ fla rrr inr. cdrollt(dlnrv'k ll,lx*c!tr. rlE$uildinSorin,pm\ctrtirisq,[l $irhironc )!tr' <br />ol corlPtr ior. rhc Ownd lhikhr*illhivc rlrhurdcnot |rrinB rhi )rDrshc di, r[ bnilior i lfirc rhc ntu|f,n!_ fnr rhc IU'F)* ol <br />L r\ oN cr rl r h. pnrpcnr-,. 3r, .xch\ir.ly .o tr.r i,rE tr h liccrql qtlntx.rr\ I' dr{nr.r rtr [tr.iccr ( S( ?l!J. Bu.i"c\r <br />rn{l lh s\i'nCodc:Th.C iri.r.r's l-iccnrc l,aN,lo.\ nori|nlyh riostrn oflr)}'c'ty*ho htildsor imp.()vcs rhcrcor. <br />rrcirk wnh { Conrmlo(s) lic.nsn p!R!..r ro Uc conhdols Liccn* L!w). <br />I h.rc$y nllirm undc. pcnilry of Fjury <br />DTI;IAIAIION <br />L'}xtr Cotfu, turrlr |rr,o,nrNr.l rh. $.'k,nr$hi.hrhc Nnn n i{oc,l <br />r tu \ ork nlr \ hih rhis t^-nnir i\ Nncd l\{y tr o.kch .orn.Nrr i,nr l Ntrric. .ins Fnlcy nu ftur rr. <br />-l <br />enifyrhlr in rhc p.raoiruncc olrhc *ork lor whi.h rhir l.rmt ir issucd. I stall nol cn9loy lny Pcson in.n, mnn( <br />s N lo lEcom slbJccr ro rhc wotcB comt ns,lion lsws of Colifomi{. snd agftc lhul il I slsuld t$om slhi(l lo ll* <br />worksl con{Enerio, IeririoN of Selion l?m ol tk Llbr Codc. I dDll. fonn$nh 6trq,1y *irh llhs 0n,vhfttns. <br />rc work 6 .onrr.nsuliotr onmBc i unlisful. lnd \hrll srhj.ct h cDpk,y.t kr mrniral Fnahics md <br />r. rh. cosl of coqrnsttun, d.@C.l &s povidcd for rhc <br />I h.Eby .,Iirn un&r Fnrhy of F.+ry ud.r p|ovisionofch0ptcr9 (ohftfti.g snnSelnn 70m) of <br />of rhc Bu\inc$ lnd Pn,fcsion, Codc. a.d nry liccns t in tull lo,e Md cff(l <br />CAITTAIC[IANTENDIN(i.AGENCI <br />I hcrchy.ftm undc. rEoahrorPcrjurythat rhnc isr nnrudionkndi'rsaBc..yl.rrhcFcrlo uncc ol'hc work trahich rhirimi n <br />issuL{rs(.1097, civ. c ) <br />afEltgall.D[cl,axarll]! <br />I lrrby lnnm hdcr lcnalry ot p.rjury onc oi ltE rolhwinS &.nu!lions: <br />Dcmoliriotr Pcrnits- A s beslos Nor ifi.ar i.n Fcdcdl RcEtrl.rions (Tirlc 40. P!n6) <br />R.quiEd t cr of ttolifEar <br />,!dldE nor opt'liclhh h rht F+cl. <br />rc rh0r tnc !h,vc innnturi.r i!.onNr.l agre rocomplywirh rllCiry lnd Counly <br />in8 conslruclion. ofll lErcb, lurhori& icFc*flldlivcs ollhis Cily and Couniyro cnrd ulDn llE <br />$-12-1a- <br />APPROVALS ID/SIG. <br />TOP OUT <br />Back Flow Device <br />I <br />Liccnsc Ch$:-Li.ctrsc Numbct