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PLUMBING-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS orvNER DUll,DUR Dt:t,CAllA',rl()N <br />I hc.eh, ifrrm under penalry ()fErlury rh0r I am erc,npr fmnr rhe (onrra.ro6 l-ice se La* litr rh€ ft,|l.$in8 r.,$n (sd 70ll,5 <br />Brrn.$ fll Ptr'fcssrnr Cod.): Any Ciry dr Counry *hich r.!un s r n{rnir !, .$nerucr. nt.r, innmr., dcnlnhh or rclan my <br />srnrcrurc, nnor ro ns ssuMcc, ilso rcqulrcs rhc 0pnlr.d for such Jrcrnir ro ,llc o si3..n rral.menl lhar ltorsh. is liccns.rl puNanr <br />tu rhc p(x1si,N ofrhe Cont.ctois Licetrscd I ar'(Chafler 9. Conrm.miry qirh S.croh 70I)0 olDiv6ioo I oIr[c ansinc$ ond <br />tmlisen'nsCod.) rllBthrorslrhexcmptrl\..etunrndrhcbrskiorrlEnllc8.dcrenDtion.Anyvnilio.ofs€lion70ll thyiny <br />appl'cinri,aI'cnnilsubjcclsth.applicanltoacililpenahyoimrnnrerhannvchundreddolraB(Sto{) <br />bh,lr--yl.NnBn{^frl,ernlely..rr\ernnl^)eeqtr(hr,'se!aqr'Etrq,l.rnn'Fcnsdrinn.$ill.tl rh.$orlMdrh.ntudrnn{ <br />'nrcrrl.J nr,LEdI $c(Sa 7N4, Bu!m$Jn'l I'mfessons Cod.'l h. ContrrcrD. s Li.cnse L.w d.es nor 0ml-\,rannonnerol' <br />rhcpmr(ny trh burlds or irrr^,vs rtf,r$c md slr drs cEh *'* hinr.llor l[Rlf or rlrtuu8h hB or hs oru employccs, <br />rmv rl t,mr ru.h iDnn,vdknk n. mr mr.Eldl or onk{d f.r sl. l[ lnv.L... rhc huildinE or inr,,m'cmnr is $ld *ithD om )Hr <br />olcotr{'lerion, lh€ Os'ner tiuildcr qnl h.rc lhe nurdm of nmMry Ittrl he o! sh. did tror huild or nlll'n\e thc pmFly [r rh. purr$E of <br />H,ai ownd ofrh. Dmldy. ad cx.h.iv.ly coddd ins wnh lic.n .n odlEcton ro oisrucl th. pmj.rl (S4. ?044. Busidi <br />PDision Cod.: Th. Cotrrdctor's Lic.m. Lar' &'cs mr .pply lo an .s.cr olpmltny pho 6uilds or in[6!.. rn rmn. <br />who @,'r6cr3 for och pmicrr wirh a Coir@ro(i) liccdrcd puMor ro rh. Conlroclois Lice.k Liw). <br />t4,*n-. B & P.c f.rrhk m$n 30ty'I """,,, P.!t{ WL-/ <br />lQ8liE8S:.cAMtlltAltA!pEqd8au9! <br />I hmby amm u.dd p@lry ofp.dury o.. oilh. folhwi.S d6LEtioNl <br />ffi, ** ".a <br />*,, .,"," , cd, n(a,. o I coNmr ro scli-l nru'. ror Nort.c con,pc.eion, as notd.d ro, h, s..toh l?oo orfir <br />li'l$' c..t..1.' (h. F I'dm..ofrh. uo'l fd wh'chrh. Fm ! F Ftu.rl <br />Pdn*. *o *,,."... *ork.is conp.nsoriotr insu6nc., ns r.<!utcd by srrion:l?00 orrh. hrlor cod.. aor rh. p.troman.. or <br />My worta comp..srio. insrnnc. qfticr dn ,olicy tunbcr e: <br />@.-,ry,*, t,* *r"rm!E orrh. uort tor shich rhi Dcmn ir i,s.d.l snall mr mploy ony p.Fn io..y mRr <br />\rt &r rn b.6nc ohj..r ro rh. m*6' onti.trd <br />'on <br />Lws olcalafomi., and .!f. lh.l if I .tbuld h.sE sbjlcl lo th. <br />wort6' @mt Mrion pDviihN olsfttion 3T0o of th. t ti.r Cnd., l dsll, fonhwil,r 6mrly Pith lios pdlisiont. <br />wARNlNc: l:ailu(c i6 suft w.rt n' mnp.nstion s!dg. is u.lawtuL lnd sldl sut jet sn mrloytr to qimiEl l.tulti* rnd <br />civ,l finB u0 io oft hundEd thouend dollar (S100,m0), rn .ddnion ro th. cosl ofconr.nulion. drmsci ,i ntuvadcd hr rlE <br />at r€ v/LJ.,-(,",",fi <br />ucl:lsliDllNr&tctQ8jlrill,aaaug! <br />I lEct'y allm u.dd l,.olty of ,.dury rlul I m licr!.d u.<l.r Fovi.ion oach4t6 9 (onrecing wi$ selion 7000) .f Dividon l <br />of l,. BwiE$ rnd PDIcssioN Codq e'd my lic.M n in tull for !d .lIdl. <br />cl)xsrai,q[loxlirDltc-dcl:&c.l <br />I h.rby,mrmuhdd !.'uhy or p.rjxry rh.r rh.r. isa odrucriJn Lndin!.rcmy tor th.,idlolmrc€ oflh. trork for{hrch lh* Ilm ig <br />Bsued (sec 1097, Civ. C l <br />AtrucaNr.Irl:0aaalp! <br />I lE t y llIm hdcr n nalty of pcrjury oB of r& folloqns d.clanl ions <br />D.molillon lcrmns'Aih.sro, Notifi€aln'n lcdeml Rc3ulalions ( I irl.40. [ad6) <br />-ltequt.d <br />L.tt€r olNoli6cdion <br />I ccnifyrhd rh. r.d.tol rc8ll.rions r!.rdrry dsher.s r.nDkl arc not,lnlrahlc ro rhis ntujd. <br />{?-n 'O <br />,n, , *,. ."0 ,nh 0pplic ion and nirc rhar rhe rhrvc iD lnnMron 6 coF.c, I aexee ro co rry N ih au rny rnd coutrry <br />ordimmcs and Sr.lc ljws Ehtins to buildins coo,rNcrior\ .d h€r€by lurnori:. rcprsibriver .lrhii c <br />atnvc m.dioncd Dmlrny for iNoelion purlnks 6--rLr4,v/Appllonl or Agml Slgnilur.P.t t <br />PD6M/rR''/ Dl"rlt <br />,:,;hTfr- <br />UNDER GROUND <br />Waste & Vent <br />Water-Under floor <br />Gas-Underfloor <br />Buildinq Sewer <br />Area/Storm Drain <br />lnterceptor/ Clarifier <br />TOP OUT <br />Waste & Vent <br />Water Piping <br />Gas Piping <br />Roof Drain <br />Tub/Shower Test <br />Rough Water Heater <br />POOUSPA <br />P trap/Drain Line <br />Main Drain/Pool Pipino I <br />Fill Line/Back Flow <br />Pool Heater/Gas Line <br />( <br />Gas Service <br />Water Service <br />Lawn Sprinkler <br />Sanitary Sewer/Cap <br />Back FIow Device <br />Rough Plumbing <br />Final Gas Test <br />Meter Release I <br />FINAL t\ rq\r9 ,U-A{r") <br />Notes, Remarks, Etc. <br />L.nd.ar Ad&E. <br />- <br />Miscellaneous