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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE COMMENTS
<br />UNDER GROUND
<br />Waste & Vent
<br />Gas-Underf loor
<br />Buildino Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarilier
<br />l2-!1r VW'AWaste & Vent 1n^,f
<br />Water Pipino t7'-11-lN V"Vna'il
<br />Gas Pipino U
<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 />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />--.;A
<br />Rouqh Plumbing I l llq Tu ,4/49,
<br />tFinal Gas Test
<br />Meter Release
<br />,reul@ )i ur aANotes, Remarks, Etc
<br />Ptl,W I;-F+ *lrl-t6-tg NJ{l|t)\-Z
<br />o\tNuR BUILI)F.R l)lll,(',AR/\l',lON
<br />I hcehy.lirm undcr lctulry of pcrJury thd t sq.mpl fsm llE Co.radon LiccnE l,* tor ftc foUowi.S lNn l5s70ll5
<br />Blsincss ajn ProL$ion Concrr Any Cily or Coonly shich rcqniEs tr Fmn lo .onsrod. .!rF. iq,mw. d.mlirh o, EPqir v
<br />suucrw. lrir ro ih i$uare, aLso equtes lhe tpplk&i for rucn Fmil lo fik . sigrcd sttl.mnl thd lr o, she is lk.n!.d purM
<br />ro rlE pmvisions of rlr Co.rr&l.is Lien$d L!* (Ch!fl.r 9. Cottmein! vith S& on 7000 of Divhion 3 of llr ABinc$ !.d
<br />Prcfcssions Cod.) o, thll lE or sh. h crctrPl lturcftom and rh. bsis lor l& alt8cd creiirlio.. A.y viol.lion of Sdaon 7031 ., bv any
<br />smli.a.t lor n Fmil subjels llE ar,pli@nt ro s civil pcuhy of nol mrc $m firc hundBd dollac (t500)
<br />Lrs r$n.roilltrpupcdy,or ry.ndoyccs wirh wisc\ x\ rllt (nr .on]Nnqr ior. sill do ih. *ork dlltitulun n n
<br />rh. Dn|rny *ho huiUs.r i'r!v,*c(rluL\nru vho dor\suchsork hi'n:cll o. h.r{lforrhn,uEl,lri\or hcr .wtr cnrPl{ryccs.
<br />I)r.vid.,lrhrrsu.hiUrrovcnrnr\ttrrtroricnt\lor.lfca,ll.trelcll.ho$6tr.rh.huihi.gorinrl(nt'rdnq)kl\!irhinrErttr
<br />ol c.mpLrion. rh. Os f Atri0cr *ill l!\r rhr hurd.n ol [ovi'r! r]( hL or \N diJ nor buiU or nnpnivc lh. Inn iy tur rlf, !xqn{ oi
<br />-1,
<br />ac owmr of rlE l,oFny. ad cxclBivcl, conlraclinE wilh li(nsd .ontdclos ro onscr llE ptuical (5e. 7044 Bu'rc$
<br />!d EoGssion Codc: Tlc CoflElol s Liccns Llq dei ml atply ro !n o*nd of l,mp.ny wlb hilds or inrot.! rhctcon.
<br />ard sho .onlr.crs for such ImirB wnh ! Comndo(s) liusd plrsuln ro thc Conlruiols Ltcn* Llw)
<br />-l
<br />d crcmp unde' Smtior- B. & P.C. for rhi! Ms.i.
<br />ITOBtrDIE:CAMIENSAIIQN
<br />DICLABAIIO!
<br />I hcrby alfirr und.i pcnllry of pcriurt onc ofihc rollo*in8 dmlr0riont:
<br />/r nrvc uA *ltt nuinrain u Ccd iaa0r. of Consnr lo Scli- lns!rc for $orlcr' corq,tn$rion. as pmvirLd ror bv Serion :1700 of rh.
<br />trb.r Cod.. lor rnc psao.mre oa rlE work ftr which lhc nmnil is issncd.
<br />I(*"ud *ill minl,in vorkeB cotrpcnsation inFuBftc. I Equicd by S4liot 3700 of rhc tlbor Codc. for lhc Jlcffollrm. of
<br />@ntmlllion iEunrc Mbl .!d polt
<br />tn C
<br />-l
<br />enirylhar in rh. rcrforrok oflhewortrorshichlhklc rnn k isslcd,I *h.Unolcq oy lny !.run ii liy meNr
<br />so ns b lEcom slbiecr ro rhc w6rtm mqf,nsctiotr hws of Crli{ohia, ond o8rcc lhal if I sholld becoE subjd lo rlf
<br />worknl omFnsarion pmvlrions of S.dion 3700 of thc Lntff Cod.. I .h,U. fonhwith omply wnh rtE* povhiofls..
<br />WARNINCT Frillrc ro $curc wo*.r ompenqlion oveB8. is lnhwtul. lnd shdu iuhJ.cr .n cnl,)hlq b dimntl ltsllas.nd
<br />ctril lin.. ut ru.nc hundEd rhnu\od dnllG rtloo,{XJOl.nddnkitr r, rlr.on ol.o
<br />I hercbyrlltmlDdcr FndlryofFrjuly thlr I !m liEnql ud.r 9(co.@ncing wirh Sarion TOOo) of Divhion l
<br />ol rhc Busincss0nd Pron$ionsCodc, md myliccnse is foll lorec,J .flitr.
<br />< lo .L3 i +
<br />I hmby {1116 undcr Fnahy of p.qur, lnd lh@ t ! @.slru.iion hnding !g.ey lot lhe FrfomtN of lh. s,k fm wfiich this Pfmn a
<br />issu.d (sd. 309?. civ. c.).
<br />trndn s N.m.'-
<br />AITLL{.:AN:LDEILAEAIION
<br />I hcrclry ainm ud.r ,.nnx, ol Erjury orc of rhc rollowing dNlnrd' n,ns
<br />t)tmlilion Pemils.Ashe(os Norilic0rion r{dcral Rcsuhrion\ (Tirl. 4), PM6)
<br />-Requted
<br />t lrcrolNorirMrion
<br />I ccnni lhar lhc fcdcnlelrlnrions rc!,rdi.8 lsb.slos rcmulrc nor npfli.nhlc lo fiis rmFr
<br />-l
<br />ccnify thol I hale md rhh lpplt{lion md slslc lhrl lhc ,t vc inforEnnion h coftcl. I nsra r. smply wirh trllCiryand Cou.ly
<br />ordinan.cs and Slolc Lsws rbli.s r.ilcs oflhh Ciry Md Couolylo
<br />olDvc mn'ioocd tn,p.ny lor inspEtir
<br />Appli.lnl or Aacnl Signal
<br />ldi.E conslruction, md hcrcby
<br />I
<br />Water-Under floor
<br />TOP OUT
<br />FINAL
<br />S.rr0n 1076 of r& tihor (bdc-*, 11C/t
<br />c
<br />I rolsrc.
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