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PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE COMMENTS OIVN ER BU I I,DfR D}:LCARA'I'I('N
<br />I h.rehy fliirn !n{lq peMlry ol Fr.Nry rhd I nh ex.mnr annn rte Conrric'ors'Lkctrs.l.aw itr rh. n)lhwh8 tersn (S(70115
<br />Business nn1 Proltss()n aqlef Any C y or Coudt wh'ch rcqon.r i ltm b coNNcr, .lter, Dport, d.dnfh .r *ljnr My
<br />srru(ure, rrnb rs rssumcc, ih, r.qutrrs rh..Ppli..nr f.r strch rEnnn lo fil.r silncd srarche rhd h.orshc is liccnsc<l lum l
<br />kJ rh. povhioN olrhc Conuacrois l,icc *d b{ lc&Ilrcr r), ConoctuinS wirh S.clion 7000 of Dn hion I ol rhc Business .nd
<br />Pniacasi(]ns Cod.) ot thrl h€orshc ircien[l rhtrcr.onind rh.hisiq nrrh. il lcserl cxcmpr r o Any vk ,Lonoasedi(,n70-11 5 hyany
<br />orphc2nr tirrDcmn tubJekih. rrr[canr ro.cNrlp.nrlryoln.r nMc lhon fiv. hun Edd.llam($500)
<br />-1,
<br />as oNm. of th. pmncny, o ny .rylorc! wirh {!s6 !s rh.r $1. confcnerion. * ill {to rfie 'ol( srxi rrE {rudne MI
<br />inlod.d or ofi.r.d aor sl. {s< 7044, au.,n6. and Poa.ssons Co(lc I he Contdcroi3 Ltdk L0w do.c mr 8pl,lv ro o. osnd dr
<br />rh. pmp<ny s,hn hoilds or impmlh rllsrn,.nt who do6 sch rbi( hims.lfor h.*.lfor thmwh iiu or hc, own.nDloy..s.
<br />Dtuvd.d rhd slch inDmrmnts e ml inroddl.r.ll.rtd tu$1. lf, hostvd. lh.ltrlditrs .t r.{mva*d is sld wrhin on. )m
<br />.tconpLrbc rhc o*8. BuitLr will tuE lh. tudcn ohrcvinr lll1l h. or dE dd ftn hoild or iq,mv. rhc ,mFrry fot lh. ou.nor of
<br />-1.
<br />owB6frhcnmp.ny, am excl$rcly co,{rsctins *1th licmretconitmronro snsrocl rh. Ptojsr (s- 7M4. Bus'N
<br />a PNlsion Codc 'l h. cdtrlrr.roa s l-i..Nc Law do.s mr onDly t. 0n owncr o l rrop.d y qh. burldr or imtn'!.r l tursn.
<br />ind sh. md6.h lo. such pmj{c wirn! Coormdo(, li..n*d pnBum b lhe(ontroclor't Lic.n€ L.N)
<br />I .n.x.md und.r Sd6r .B &Fc forrh r6sn
<br />ort : Oln.r:
<br />]!a85E8$gl!tfrNsAll9!
<br />DECIABAITON
<br />I IEEby o,Itrm under pdltyofpdrry6Eoflh. following dmldnlions:
<br />lh.vcnkl\illm.inrnin,( en'firar.orcon...r b selHntur. Ji,r Lvorkc6'.o petrern .3r nnnd.d nnnySeclon llT0rrolrhe
<br />l-1l!tr (inl., i* rhl ,rri)nnarce oI r lE snrl t r trich rM ncmnr F Fn'cd
<br />_l h,k and will mri.hin qortdt .oftn nierio! im@r.. ai ,c!tri(d by Setion 1700 ofthc Llbor C.&, fot th. Dirfomm. of
<br />rlE e.t for *hth this Dmil is is.d. Myw6k4 @npd.rion in EN. oricr 5rn Oolcy numb.. r.:
<br />Polry Numh.r-!ipircr
<br />-l
<br />c.niry d6t itr lh. tl.rftlmtr of rh. work tu which lhi Frmir h i$u.rt. l il6ll m| mphy.ry p.rs. i. a.y @.F
<br />s s 16 b.om subFcr b rtE ed.m'oqEtrqlion L$ oacaliaomi,, r.d r8c lhal if I slsuld h..oG sbirct lo lh.
<br />"brk6l €mp.Nalion pmvisioN ols.dion l7m 6f rhc t!tn. Cod.. I dhll. fonh*ilh 6dnly tnh ih* pDvisioB..
<br />WARNINCT railuE t6 c@ mrtd' omn.Nllion ovcms. it u.l.wtul. dd shatl subj(l 6i onlolt, ro diniml p.Elli* 5nd
<br />cMl lio.. up ro oG nudFd lhousnd dollan (!100.000), i. lddni.n ro lh. cocl ofcoq,.nlalio., damgcs ts frcvid.d fot lh.
<br />S*rion 1076 oflhc ldnr C6d., inl.rcn lnd ,lld*y ! fes.
<br />rlcExs[DtotrrtAqraa
<br />DICIABAIION
<br />I h.Eby dflirh nnd.. pen llyolperjurylhll I am lienEd unds pmltnnofch.prd 9(omn]mins *ilh Setion 7000) of Divhio.l
<br />of rh€ au,iNsr .Dd lmf6ri6nr c..L. fun oy lic.nk k in nlll aorcc tud .llst
<br />Lic.N. Ch$:-Lie@ Numb.r:
<br />D.t: Co n tor
<br />ca!flrBtcr&rJ.]:liuNriA!;rlc.1
<br />I hcEby inth undcr p€oaltyolpcrJorylhal rh6. s d s.ifldsn kndirs i-leflcy fo. rhr ll.rli,mn.! olrh. {ork lor *hich lhN rs.fl ir
<br />*iurdlSr 10s7, Civ. C.)
<br /> ITLTC NI.DICTAAAI&L
<br />I lEElry alUnn undc. pemlly.tr.rJuryoR ollhc li)ll,,qr+ drclimr ons
<br />D. r,l{trnr Pci,nds shc{os Notificrri{n,l'.dcnlltrAuhrnns( I l3,tl,, Prd6)
<br />R.qurcd L{cr oi Nor'licxron
<br />-l
<br />ccflify $dl rh. fdrl.6l cgulations Esardins !,b.stos re'novol lrc ml +plicNhl. to rh6 tmFr
<br />Ic.nrfyrh lh$.rcadthn.rrlrcrlnnml(xr.rlr,ihcnl ci nm xii r.on{r lryftthomnlyw h.llCiry. lC.uni!-
<br />o^t ninc.s and Sr.r. L.\s el.rng lo hurld'n-! con(nrcrion. aftl hcrrhyrtrrlvn2c r.rusenldtres o,'rht Cilyand Counry h tnrcr trlmnrhc
<br />rhrve ftntoncd thndy itr msndrnr luqises
<br />Aml.rnr or At 0r sErturc:_
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarifier
<br />TOP OUT
<br />Waste & Vent
<br />Water Pipinq
<br />Gas Piping
<br />Roof Drain
<br />Tub/Shower Test
<br />Rouqh Water Heater
<br />POOL/SPA
<br />P{rap/Drain Line
<br />Main Drain/Pool Piping
<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 />Rough Plumbinq
<br />Final Gas Test
<br />Meter Release
<br />FINAL /z-t.-/r",.//4>aatr)
<br />Notes, Remarks, Etc
<br />ID/SIG.
<br />UNDER GROUND
<br />Gas Service
<br />LdJd r Ad&Hs
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