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PLUMBING.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS <br />UNDER GROUND <br />Waste & Vent <br />Water-Underfloor <br />Gas-Underfloor <br />Building Sewer <br />Area/Storm Drain <br />lnterceptor/ Clarifier <br />TOP OUT <br />Waste & Vent <br />ingWater Pi <br />Gas Pipeing <br />Roof Drain <br />Tub/Shower Test <br />Rough Water Heater <br />POOUSPA <br />P-trap/Drain Line <br />Marn Drai n/Pool Piping <br />Fill Line/Back Flow <br />Pool Heater/Gas Line <br />Misc <br />Gas Service <br />Water Service <br />Lawn Sprinkler <br />Sanitary Sewer/Cap <br />Back Flow Device <br />&ough Plumbing EXPIREI ) <br />Final Gas Test <br />Meter Release FEB-ta ltJ <br />r. a)? ,QO a 56 667 <br />FINAL <br />Notes, Remarks, Etc. <br />Om6-Buil.lcr D@lardon <br />I hEby .ma ud.r p@dry of Fjlry $r! I m lxopt fm $. Cotr&!o6' Li@e b, fd thc follow'rg @q (16 70r l 5 Bsinqs <br />Dd Prcf.nio Codc): A.y City d C@r/ vhich rcquiB t Fnnir lo cd!l'*! !116. inprcv!. dnolish d rcp.ir &y 5tructqq pnor ro iE <br />is@G, d.o Fqoicr th. apglier for tuct Fmil ro filG . !i8n.d slaloMr rh.r h. d sh. is li@.d puFudr ro rhc provi3ids 01lh. <br />Cmt&ror'3 U@cd L.w (Clt.pr6 9, CmMcing oith scdon 7000 of Dvirid 3 of th. Bcin.i! .id P6rci@ Codc) d $.r hG o <br />ihc is .xdF rh*tm Dd lhc b.ri! fa ln. .ll.scd .ranFioi Ary violrlor of Sdtjon 7ol I 5 by s, lppliot fa ! Dmir llbjdr $c <br />appli6r io i cinl F.lt, of nd tle th& fv. hur&cd doll$ (lJoo). <br />_1. E oqs of tn. p.!p6ry, o my fiplord vilh q.86 a th.t sol. @mFndim, will do 6. worl rDd thr $rEruc is ,ot int.n&d <br />d oltcr.d ad t lc ( s4.7044, Buin6 rd Prcf*id Cod.r Tt. Conlr&1d'! Lacd. Law dc trol lpply b e o$q of 6. proplny <br />*ho boil& d imFov6 tha.oi, &td *ho &.r 5uch wdt hiMlf 6 h@lf ( lhrcu$ his d hr om mdoyc4 Fovi&d rh.r s8h <br />ihproveddtt e not i.bd.d B oftd.d for s.lc lC howd6,lh. building or improvcnat i5 sold virhin oi! ycd of@mpldioi, rhc <br />Os.r-Buil<Lr will h.v. th! brd.. of prDvins lnar hc d sh. ior build d inFov. rd rh. purpc. or sak) <br />_1, B om6 of $G p.oF ty, o .rclGiwly dEEdra *i$ li@i.d @rE.16 ro @Broct lhe Fojccl ( Se 70a4. BNin6 sd <br />Prcfdion Cod.r Thc Conn-dd"r Li6k ti, dd nor rppty ro s omd of propqry who bun& d improv* lhcen , ed pho <br />@tro. fd ocll Foj6t' eirh . cdtrrd(, lieE <! FE@t ro $. C@8 .ld,' U.qe r&.) <br />_l e dl,nF u.L, s*ric,r <br />-8. <br />& P.C. f6 di'r6l6. <br />WOT.KERS COMPENSATION DECLATIATION <br />I h.r.by afim und.r p.n.lty oft dury oc oftl. follovina dccledions: <br />_l h.v. hd pill tui aii r Cdtili.t& ol Cotrldt io S.lf-lBuE lor *dt!'r' Mpd3lrion, sr Drovidcd fo. by 56{0 3700 of tE <br />t$or Cod!, f6tl'G p6foru.c of rh! *ort fr whi.t' O. pqon is i!$.d. <br />_I h.vc dd vill @intlin waid' mFEllid in.u@e. B r.quirEd b, Sctio.3700 of lhc Lrbo Codc. fd thc p.rfolruc. of $. <br />wo* f6 whicn $is p6nn n isrucd My wdt 6 @nparrli@ i.ru@e 6ia ad poliry .!mb.r tu <br />P.l,cy NEb6_&DiB <br />il$.Fmir r! fd Onc hundrcd dolln {tr0o} d lG) <br />ofth. Labtr cod!, I ih.ll, ionn <br />lho6.trddoll6 (tl00,0OO).in.ddnion dm.s6 s providcd ad tnc Sei@ 10?6 of <br />LICENSED CONTRACTORS DICLARATION <br />I hq.hy .fiim un&r p..alry of paju.y rh, I o li@!d !.dd p{oriii@ of Ch.fld 9 (ffin!"cinE ,ith S6rio '7000) <br />thc BBinB ed Prcfdidr Cod.. sd licai. ir in flll f*c. ud.fiEr <br />pqforucc of thc eo* for which this pcmi ii <br />3097. Civ ) <br />APPLI'ANT'S DECLARATION <br />Dnolirion Pcmi6A.h6l6 Nodli.rid Fcd6d R.gul.r@ (TnL ao,!.fl 6) <br />_ R.qui..d l,lla olNodfi..tid <br />I agE. to @mply widt all City od <br />abon ndtid€d prcFny fo iNp6tioI <br />=