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APPROVALS DATE ID/SIG.COMMENTS
<br />UNDER GROUND
<br />Waste & Vent
<br />WaterUnder lloor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Piping l7<-1 *|0 ,Lufi)I Jr.cn? Jo aM aA,
<br />Rool Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOLiSPA
<br />P-trapi 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 />w{aRough Plumbing 1\u \g
<br />Final Gas Test
<br />Meter Release
<br />FINAL t,4is,,ryf .(os e7 \
<br />Notes, Remarks, Etc
<br />OWNOR BT'II.DER DT:I,CARATIoN
<br />I hcrrhyait,u .r p.ulrt (,1p.rjury rhrr I rdrnlpr frnr rhc Co rn.kn l-rctrrc t-rw fd rhc li'll.sin8 r.ison rsc.7()ll5
<br />Inr\irr\s oxl l,roltl\i( Coi.l Any Cir) or Counry trhi.h rLalui'c\ n J).nnir ro ..nNrucr. 0lrcr. iNnil)vc. d.lnolish or r.nrn rny
<br />\rru.xrc. lrior ro irr nsuMcc. aho rcquts rhc lplli.rnr hr nBh Frnrir b filcr si8ncd dnrcrmnr rhn hcor sh. is liccn\cd pu$lrnr
<br />ro ihc p(,!isi,n,\ of rhc Contrrcttr\ Li.r.{d Lis lch prcr 9, Comfu .nr! airh Srction 70d} ol Divrrnr I ol lhc Burincs and
<br />rrnli.!.r tu ! rcnir suhjccrsrh. ln,rlicinrhJci!ilj,.n!llyoln.ln}rcrhJnii!cId ]r.Jdoll r\(S5Ix))
<br />-l-
<br />ri osncr ol rhc nmFnt. o! my cmpkrrce{ eith wrAcs !\ rh& snc conrp.n\dbn. will &' rrr wod ad rlE ndm n nor
<br />idd Ld orolldrcd li,relc(S( 7lx.l, Bu\in.s rnd Prof.\sio6 Cnlc:'I hc Conba.ror'\ Li.cn$ LawdoBio! rrDlyrootro*ncrof
<br />rhc tmttny Eho h{ilds or iirgrorcr lhcE n. aM aho d.cs skh work hims.ll or hcrsll o! rhmu8h his or hcr o*n chploter,
<br />pn,vi,lrd lhnr such irpmlc.E s m nor ir cnd.( or oflt,o, for $lc. l( howcrq. rtr trildins or irymvcntnl h sotl *irhii o.. r!4
<br />ofc.ry1lclion.lhc Owrcr Buik[r will&E rhc ltrRlcnoff.lnr8 rhlrh.or shc d nor hnkl o. r{'ovc rhc ln,Fny fo lE IUtF sor
<br />-1.
<br />s ovn.r 6f rhc rer.ny, n.r.lusiwly conimcring wnh liens.d oniadoN lo 6nslruc1 tlE ImjEl (SN. ?O44. Blsincss
<br />rn hDr6sin Codc: Th. Conlrerols Liccnsc Law docs nor spply ro ,n o*ns or po,Eny who build! o imFovcc rhc..on.
<br />rnd sho srtEcri tor su.h por.ct *iih a Co @rodr) liccnsn nu*@r to llE (bnrelor's Uccn* r,w)
<br />-l
<br />mcxemr lRld SFrion
<br />I h.icbyrnir rndcrl,cnrlryof pcriry.n..frhcft,llotri.gdcchmri,'n\:
<br />-l
<br />halr! *illnrli iitrrCcnifi.lrcotcoo\cnrloSclflnsurcn,$ortch.u,p.n{snon,dnmvidcdlorbys(Ii(}n37([ollhc
<br />l-ahn (tdc. turltE l,crfornmncc o I I hc f,ork nn *hich ttu t).nnn h hsucd.
<br />_l hdc .nd will nainrain wo*.6 ompc.slrion insudrce, nr Equic{ by Sdio. lrm of lh. t4bor Codc, tor lhc lcrtomtuc of
<br />rhc qo* for *hkh rhis !.mi is isned My eorkcB &ep€rsrhn inslrec @hr &d Flhy Nmber m:
<br />-l
<br />ccnily lhal nr rhc r.rformne oflhc wort for which lhis Frmi{ k hsmd. I snol nol cmplny an, pcsoo i. dny nmfti
<br />$ rs ro h.co'ic \!hj.d ro rhc w6&dr .onpcnsarinn hsr of Calitoni{ and lgrc rh,r il I sh.uld beom subjcr lo ttE
<br />workcn comf.nsrrion pmviaionrofSc.rio.l?mofrh. Ilhn Cod..I shllL ionhwirhcomply *th lho* pmvisions..
<br />WARNINC: Failuc ro *u,. w6rkc* conF.erion .ovcmsc i3 lnbwnrl rnd shall subjer rn cnplor€r ro aininll lf,stix and
<br />(i!il ln!c\ op b oDc hu rcd rhou\rid dollnr\ (S i'r lJiron ni rh..on ri .omFnerion, dansg.s.s p.orard for lh.
<br />I ncreby dtum !ndc, Fnany of F+ry lhol ,'mvniotr ol Chrflq 9 (commcncins sirh Sccr ioi
<br />of thr Arsi'rcs 3trd Prcfcs\bn\Cod.. tull nyli.cn\. i\ in follntr(dlclla.r
<br />(:oNS'IRtJ(:TI(IN I.I:NI)IN(i A(iENCY
<br />IhcEbyafftmundcrpcnrlryolFrjurylha'lhcrci!a.on{rucri. lcndinsilency lnrrh.rtrlannri..orrhc *orl lbr shi.hrhhrdnir is
<br />i$ucd (S.. l0)7, Cir C ).
<br />AIIUCdIII-I|EIL ArrUQN
<br />I lrtr$ynlllnnund$ Fnrlry ultrrury onc ol rhc nilkNin! dLrlnrdi(ntrl
<br />Donniliri{r l'.qn \ \h.{o\ Norilllxri{r lidl.r l Rrgrhri(nN frii[ +{), Prn6)
<br />R.qunc{l L.(r. ol Nor'lnrri(n'
<br />fcdcrol rcSulotions ESordinB as&sros rcmval lrc mt rydtlblc ro rhn p,oFcr.
<br />Md thh arplicurion lnd srarc rhar rhc aulvc innmdion iscorc.'. I asrd r..o'nrly wnh r0 Cnyand Counly
<br />ldi.scon(rucrion. d ncEbylurr$rizc rct snr ivcc or rhir ciry md Cotrnry ro cnlcr ulx'n lh(
<br />,,,",\-{"-iLS -a-D
<br />PLUMBING-INSPECTOB RECORD
<br />UffiErt
<br />I
<br />s.rli(nr r,?a or nr l.xhrcrtrl. o1.r.nrnd
<br />Drle:
<br />k dd'rN.m
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<br />ladcr.. Addls:
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