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PLUMBING.INSPECTOR RECORD <br />Oma-Boild.r Dccl.rai@ <br />I hacby afllm udd p.n.lty ol pdjury th.l I m *npr lorn $. Col'!.t6' Li@r. lrw ro. &c aollowirB rc&d (rcc.?O3l .5 BBinBs <br />ed ?rcfBin Cod.): .{ny City d C@ry whi.i rc{riE . pdmir |o c@cr.!, ,lr6t ih!rcvc, dcmtiBh or rcplir y .ru.r@, prio b iEis6c., al$ EqriE dlc a?pli6! foriu.ll PGEi lo filG. iig.d srll@6r thc hc or thc k lhtu6d pr@r io dE prcviriotu orrh. <br />Col'r.rdt Li@!.d rrw {Ch.Br ,, Cdtt,Mcitg *irh S&ri6 tuo of Divi.io r of dl. BNi.* {d p.of*idr co<r.) d r\{ hG @ <br />sn. k dopr thd.froh &d th! bsit f( !h. .ll.8.d .rhpiioo .Ary violdio of Scdon 7031.5 ty ey .pplitur fr I pcrn;n ilbjeE $c <br />e?li6t !o a cieil Fdty ofr.. nor. 6.n fiv! hundcd doll6 (l5oo). <br />_1, a om.r of thc FoF ry, amy dploye6 eirt w.g6 a $cn sot. ceFE tior, will & rh. wsk ud iE stNcle i! not inhdat <br />o olIcE l {d t.l! ( Se.?0]r4. Baitr* e.l Prof*i@ Cod.: Th. CmE&tcir Li@c bw do6 nor .pply to u omd of th. prcpan, <br />who buil& 6 imProe6 rhdon, &d sho ilod $ch rnjt l @df a nd.tf d 6turn tir 6l'doh dploy6, Elvid.d Utc auch <br />ihprcv@aE c.ot inra<!.d d off6.d f6lalc lf, h@.G, thc buildirs 6 im,troic1mr k rctd vnhi. oi; y;of 6Dl.ri@, fi. <br />OMa'Bullda will hN. tt. bu&r ofprcviis rhrr hc d rh. nor build d ihDrov. for rhc DurDd. of sal.) <br />_I, 6 omd of ln. Pllpsv, @ dclcivcly 6nF.crjtr8 wirh ttos.d Mr&rN io @nrEEl dc pbjan ( Sa. ,04.. B6ins ddtrcfdia Cod.: ft. Coni_&lor,t Li6s. lr* do6 not .pply b s om6 of FlFty *ho boild! 6 imFov6 tnc@n , &d lho <br />@nrrEs td iuch Foj..ti wirh r Cor..lo(o li6r.d puqr lo 0r. Coor&ort Lic6r. t w ) <br />_l e .xmpt edr sdro <br />-8. <br />& p C for lhir r.$6 <br />WORKERS COMPENSATION DECLARANON <br />I h@by ofim @&l padty of p.rjury onc or rh. rou@ins del@io$: <br />_l fav€ qd will mirrli. r C!nifi.{. of CNot io S.lf-IBw for wdtr6' @mFN.don. s Fovidcd for by S.cdon 3TOO otrh. <br />kbd Co<L, fd dE pqfdr@a of d. wo* for which th. p6nn E i$u.d <br />_l har. sd pillmindr wdtd @Fr.raon ituUm@, s r.qun d by S.ati@ t?OO of th. L.bor Cod.. tor fi. Frfo''Mc. of rh.wdk rtr shid ll'is pemn h i$u.d. My wo*a' @npo$.rj@ irs!6@ tria ed loticy nuhb.' dr <br />Cmo <br />#;,;d;ffi;for Onc hudrcd doll6 ltl0o) q lds) <br />whicn rhis pcmn i5 isru..I I sh.ll nor <br />of Cllifmi., Md agra $al if I <br />1700 of rhc l,!q Cod., I 3hsll, tslhwirt <br />-o <br />WARNING, lailurc lo souE wo.t6, conTcns.rid <br />liid !p ro oi! hqdld rhtu&d d.n6 G I oo.ooo),ii addnio b ln. <br />lll. Llbd Cod., i.G.Bt sd !tlm.y! f6.a ptovid.d fo. dE S@d6 10?6 of <br />t h@by .ffift u&r pallty ofp€jury rha hli uda Fovijo of Ch+td 9 <br />thc BBi.@ sd Prcf*ioc Cod!, od ny lictu. is i. full ad.. dd.fccl <br />I h6.by .flim ud6 por.lty of pajury Ihlr rl* ir r orllaim I <br />it!!.d (S.c. !(D?, Cir. C.). <br />AIPIJCANT'S DECL"AN TION <br />Ddnolidon !miB,A$6ta€ Nolifi.di@ F.daal R.rut.!i@ (Tid.40, plrt 6) <br />_ Rcqutcd lrndofNo ficario <br />ro conpl, sirh dl Ciiy od Colnry <br />of rht Cny Dd County to ar.r uron rh. <br />DATE COMMENTS <br />UNOER GROUND <br />Waste & Vent <br />Water-Underfloor <br />Gas-Underfloor <br />Buildin Sewer <br />Area/Storm Drain <br />lnterce tor/ Clarifier <br />TOP OUT <br />Waste & Vent <br />Water Piping <br />Gas Pipeing <br />Roof Drain <br />h Water Heater <br />POOUSPA <br />Main Drain/Pool Pipi <br />Fill Line/Back Flow <br />Pool Heater/Gas Line <br />Misc <br />Gas Service <br />Water Service <br />Lawn Sprinkler <br />Sanitary Sewer/C ap <br />Back Flow Device <br />Rough Plumbin <br />Final Gas Test <br />Meter Release <br />SAMC 843,, s56, 6 <br />FINAL <br />Notes, Remarks, Etc <br />-o <br />2 <br />APPROVALS <br />Tub/Shower Test <br />P{raplDrain Line <br />EXt,](E.IJ <br />rtrD <br />r--__l <br />t- <br />ID/SIG. <br />I