|
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
|