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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDBR DELCAR TION
<br />t lEEb, tum und.r FMlry ot pcrjury rh&r I m cknpr fiDn rh. Contr&rou LE.* lrw t6r ilE follo*in8 @en 1S.c.7031.5
<br />Busimss lid Prctcsskn Cod.)r Ary Ciry 6r Couir, which EquiB, Fmh lo onstMl, .t6. tqrcv.. &mliih or tcP6n .iy
<br />srru.re. prhr lo irs i.!rudc. aLo equird lhc ip,lk..t fo, sGh Fmil ro fih r sigftd stltcm lhar ti or she ii lic.nscd I,Mr
<br />ro rhc pmvisions of tlr Conrdctols Liccnsd kw IChq,E 9. Cohmncing wnh Selio. 7000 of Division I of lhc Blsitus rnd
<br />Pot*si.ns C!d.) oi rh lE or sld is cxcopl lher.tDo &d tnc hosi! for thc slLg.d cr.iption. Any liolllioo of S€. on 7011.5 by tny
<br />rppli.&lroroFnisubi(lsth..pplkanllo!cirilpcnlllyofnotmrclnanfithundEddolLrr(S5ml.
<br />-1.
<br />a o9d of rlt Fbp.nr. or ny engloles wnh wage. ar tLt $b conp.Nrion. wil do dE wct 3,n dE flnErE b Dl
<br />inrcid.n or ofrcrcd for eb (5-.7044. Buims. ed Proldsioo. Codq TIE Colllsdoas Li.us ti{ .loes mr rfiply lo e ovmr of
<br />lhcpmFny wlb b'rilds or inproBll.oq !d wlF dG sn w* hiN.ll or lEelf or llftugrt his o. hd ou cnlployes,
<br />pevi.tcd rhll i&h ioprc\tm.rs e ml i.lcndcd oroficnd ro.sb,li h.EE, UE t{i8ir€ m inpovcEnl is sld *irhi. oG F{
<br />of onpktk I! rrr Ownd Builra eitl har rhc hrdo of provi.g thm hc o. sh. dA Nr buiU or inpmw lh. F.lEly for lhc puPos ol
<br />-1.
<br />as owmr of rnc pmpcny, am cxclusiwly cofltrsring *irh lkctr%n snFlcrou ro otrdru.r 0r ,,Ditl {S*. ?o14. Susils
<br />sid Ed.srbn Cod.: Thc Conrturor'! Lic.n* Llw de. rcr .rply lo e owmr of prcFny who huilds or i,Drotr lhoer
<br />a.d *ho oMds lu $ch prejdrs wilh a Conrn lo(s) limEd pulT@r ro the Conmclor'3 Licns tls).
<br />I bf,.rcnpr ud.r Serion- A. & P.C. ,or lhis rcasn
<br />Dar. Ow.er
<br />JIA8AEBs:STUIIN$AIION
<br />DEII.AXAIION
<br />I hcrchy af6m undcr p.mliy of Fjury om of lhc followinS dsh8lions:
<br />I haE .nd will minroin s C.nifMrc ofcoHnr ro Sclf-lnNE lor work6 @mD.nBrioi. &r Devidad for by Salion .]?00 of tlE
<br />L,hor Cod.. fd rlr tEfotr1@e of ttE vmk for which rlE Fmil k issu.d.
<br />-l hrvc lnd will.ui rin sortcs conf.nsdn ios!r!.cc, !\ rcqrtcd b, sNr ion r?00 of rllc bt'or (bdc. to, rhc pcrtuntutu. or
<br />h iso.d. My wntc6 @r{Eos.rio, io.um.aicr arn Inlty nunbcr e
<br />h
<br />7?
<br />_l c.nilyrh inrhc pcrlorroR. ollhr wol* fo, qhiuhthh pcrhn is iss$d.l shlll nol cmtloytny pcron inanymnncr
<br />s sro b.om subiEt ro rhc wortcB mry,.nlltion l&ws ofcrlirb,nia, and lsrce rhir if! should tFcom sutic<l lo lhc
<br />workc*' ooFtrr.lion lmvisions oascclion 1700 of lhc khor Cdlc,I slEll. fonhwnhcomply wnh tlFs pbvhi,ns..
<br />WARNING: l,ilurc lo KE *orkcF mnqtnsarion olc6se is onbwtuL and *h.I subjNr o cmplo)cr ro oi' nsl IsEllics and
<br />{d"slu
<br />dollm (Slm,Ooo). in addirion lo rhe c6r olmrpoqlion.
<br />A\
<br />I h.Eby alirn od.r lsialry of F jury lh.l I u [erEd unds FDvision of cldplc 9 (hmftEing wirt S.sbn ?000) of Dirisiotr 3
<br />of r,Ic Baifts ud P,ofc$k'ns Cod4. dd my lbcns is i. tull fo@ rri .fl41.
<br />TI{l[Y
<br />e a 1f\1[
<br />tr f rur "
<br />qTNI:IBIJCIX}N.LTNIINGAGEXII
<br />I hcehy affi,n lndo ltn y of F jury !ho' rh.E k n snsrdcrh. lcndin8 as.my for rhc llcrfomtc ol rh. *o.k for wnth tht Iln is
<br />nslcd (Scc.3047. Cir C.).
<br />AIErcANLDtrCI,AXTIION
<br />I rrr$y ,fln n und$ N rlry .l ,i.rjury orc ol lhc rbllos,ins dcch6( io,!
<br />Dcnn,lirion Prrmir\ A\h.no\ N.rifi.arn r l;cdctul Rctuldtnrs rTirlc.lll. t'fi6)
<br />Rcquncd Iancr or Norill.rrur
<br />l..nify rh,t rhc,cdcnl rcsulalions rcslrnins osbc$srcn,vrl rc Nr rtfli,:ahlc ro lhis pmjet.
<br />-11 (di ty 'hJ'
<br />I h1rc rcJd rhF rpl'rJrk{ dd n dr Ihr' rhc $ovc in,nnM i0 is .oFccr I astur h cooply u irh all Ci y lnd Counry
<br />dnlinlnct\ and Srarc llws dlarin8 ro blildine consrucrio..ofrh Cny&d Counlylocn'cr upon llE
<br />abovc mnrioncd pmll.ny for i.srccrion
<br />ADlrli.anl or Aeml Signnlurc:
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under lloor
<br />Gas-Underlloor
<br />Building Sewer
<br />Area./Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Pipinq
<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 />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Roush Plumbins ff'fr fflc-
<br />Final Gas Test
<br />Meter Release
<br />FINAL *t )os 7/zehd D9 to/
<br />Notes, Remarks, Etc.
<br />Water Service
<br />Pemlree mne {pdnl):
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