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PLUMBING-INSPECTOR RECORD <br />DATE ID/SIG.COMMENTS <br />UNDER GROUND <br />Waste & Vent <br />Water-Under floor <br />Gas-Underfloor <br />Building Sewer <br />Area/Storm Drain <br />lnterceptor/ Clarifier <br />TOP OUT <br />Water Piping <br />Gas Pi ping <br />Roof Drain <br />Tub/Shower Test <br />Rough Water Heater <br />POOUSPA <br />P{rap/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 />Back Flow Device <br />Rough Plumbing <br />Final Gas Test t <br />Meter Release l <br />I <br />Notes Remarks, Etc <br />FINAL <br />orvN[R Bt lID[{ t,tt,cAR I()N <br />Ih.r.hy,nnnrnd.rrMkt_oln.r.Juryrt lmd.mnr fi,m rh. (o.tr6croi. l-ic.nsc l-ns Lrrhc follown8 reNrn (S.c7lrll5 <br />Aushcs ary.l Pmfesiion Code) A.yCrry{r (nu y qhrch r.qnrcs. rsmi n, coo(ruc|, rlr(. 'mpid.. &mriqh or r.,3r,ny <br />(rucruE. nnorh [s nsm., ol$ r.qurcs rh. nllnlrcMr for nrh Fm k, il.rnrEdrl.reru rlrr h.or rht i lrc.tr{d nur i <br />fu rh. rovrrnB.frh. cdntarlois Lrcc s.d I i{ lcMprd 9. Gmm.n.,ng w h s.crmn 7(x)0 of Drvnon I oarh( Ausm.riand <br />tmrasi,)nr Co,le) o. rh.' lrorsh. N.xcnlnrrh€r.fhnD d rh.b.$ ntr rh. lkt<lcr.oflinn Anlyrnii.nors.crnaT(,:ll5hyrny <br />ipnlicanr Iorap.nn ruhl€krh. innlrcanr ro a(!'lprmhy.fnor nn)(rlDn fir( hunnr.dd.llnr (55rn) <br />ff,.*.*,*,,r,n.n",,.n)..rrny.mnl,'ytdtr1rh$8$iirh.tr$l.conD.nelon.{llldorh.q,'].lelrh.qMUeFnn' <br />'dcnlGl i ,inil.n litr (rl. (S( Tiga Bu$ndr m.l Pn,teseon! (.d. lh.(irntadoas I 'c.ni.l atr &r.s nr qlllt n, dn oq tur ol <br />rh. pmrdny s,ln hurld< or mpmrB ilEra fln *'tFdae{chw'* hrnF.li( h.r.lr.r rhmush hE or h{ o{'n.mpk,}c.s, <br />rrevd.i 'h,r <br />euch m,IltrsRnrq dE n mr. .noronidl tnel. l( h,$6tr, rh. t{rldru.r n{nemd r{nn h'rorc}t.r <br />ol$nDl.lnq rlE o*mr tluid.r sill haE lhe hqnLn .I nmuns tltrl h( .r sh. dd mr hnH .r rrq'nrr rh. pmpdy r& rlE NrF,* ol <br />-1, <br />N.r,rcr of rlE rrnp.ny, am crclucikly contmriry sith licdrd conlmcloF nr otrqrucr rlE rejer lsd 7fi.1, BBNsi <br />!d Pof*m Cod.: l h. Conlr..lois tic.ns Lrw dod n 0tply ro m or.d of nmp.ny wlh buildi or impmE! rh.r@n.dnd *b @nntulr tu ach ptuj*k *[h r cirnrEdo( 9 licm{d prdsnt ro rh. conkicr, r l-i.rn* L6w) <br />-l <br />d.x.mpl urd.r se <br />)o." q l" (rq o"*.)!aa!i!iEstgJu&!! .Il!2!rrc! .BA!r0l <br />lrt!tr(i ., Lrrlf, ,lcr,nnnrfrcolrlx $.rk l(tr{hrr[rtu n.nn['s'ssu(! <br />_l hrv. ind s'll mrnr.i. Mrlsa co,{xBarion ir@tu.. ac i.qutr.d by sdi6n J7m of rh. Ijh.r Cod.. aor rh. nsf.ll:llm of <br />$. work lor wh'ch thn Fmir ir i$u.d My wo*6i omr.ddbn r.ru,m. ffi.r ald ,Dlay numbs e: <br />Del c.ni&lhd in th. p6formm. oflh. vork for whrch lhE p.rm is rss.d.l dsllml mployony rEmn u.nymlitr <br />ar Ilo l'.@m.ublicr ln rhc m (6'@qEe o. bBoacalilonir. lnd aeN thr! rll rtsuld lEom sl'Fl to llE <br />m.l6 onillaimn povrbnr ofs..r6n 1700 ofdE t:fbr c.dc. I dtrll hnhwnh onloly wnh rtb$ nmvilionr <br />WARNINC: I:ailurc to .src wort.n comp.Mtion svms. k unlntrtul. !n<l rhltl subJsl atr oplo,tr ro frnrMl FEIiE ond <br />ctil fin.r un to o* huhdr.rl thouefll dollan {lllxl,mo), in lddnion ro th. con ofcompttrqlion, d!ms*.r trovd.d lir rn. <br />Sdron 1076of rh. Ilt$rcd., i .Enand!flor*y.! re.ql ll I /1 <br />jr.I(IAAITO! <br />ol lltr l]us'ncsslxl lhrisrns(inle. inl ,vl'ccn!. <br />'s 'n l'ull lLEe {rl.ll..r <br />cQ!uatc!o.!it!!!l!cicr!tr <br />I hcEhv ^rrrn unrls p.n,hyofp.luryrld Ihd. Ba sn{rucrr,n kndh8.!.rry itr lhc perlhn'trrc..1rh€ wo* fir sh'ch Ihm n mn n <br />6tu.d (sr :1097. c'v (') <br />AIIIJCAdI.DECIJSAII@ <br />I hdrby.fim undr p.n.hy of Frlury oR of lh. followirS ddLdioN: <br />D.mlition PmitlA.h..l Nohfidiin F.dml R.gulrr^! (Tn[ 40, P.rr6) <br />-R.quircd <br />t n.r of l*,lifsIih <br />-l <br />c.niry rhlr Lhc tu rll (srhrioni ErEdins !di..ror rcnnwl d. r'r qDl6hl. ro thn lmjrq <br />fZl s(rfy rhd I hlk Eld rh6 lr{,ldrFn &d nol. rt r lh. .h.r intotura.n B c6ri!d. I rlB ro 6rrly wirh lll cily lid colnl,-dli"*',,'a sr,,. t-,*. *ra,ru io rru'rane ooMrnr &d h.Eby .[h.riz rcpltddi; of rhi! ciry lid counriro dr6 uFn dE <br />'.,,, 1/u lt <br />lf,-MYG1I <br />APPROVALS <br />//--:- <br />I h.r.hy lmrm und.r F.Mkyornsjuryorcolrh. tollowiry &.hmhN <br />Lia6c Cl.rs:-Lic.B. Numhcr: <br />- <br />D.l.: Conlr..ror <br />L.ndr r A&G <br />- <br />nh'v. mnrhncd FmFny Lr iNrKtnr nurFE! <br />- <br />^ppdc.rtor^rdrsirn.turc: L) /liz---- <br />p.ml,Fn.m.(rrrr,r ./)"n)i,. 2rr"/n, <br />Waste & Vent <br />I Ut