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PLUMBINGNNSPECTOR RECORD
<br />APPROVALS DATE tD/stG.COMMENTS Ow.6.Auild!'r D.cle.do
<br />I h.r?hy rffi und6 pa.lty of pdjury lhllI rm exmPt f@O. Conrl.lolt'Liffic Ltw tdlh. follo*in8@d Ge,031.5 Bu!i!.r3
<br />ed iDrcrion Cod.): Ary City 6 Coury wnicn rlquirlr r Pehit to .@!u! r|ld, inFDv., dmllih 6 c?rj. a, tEu.$r.' Fd to is
<br />i!!@e, .lro EquiB th. ,pdi6r fd iuch Fmi! !o fil. ! tign.i, ttirhdr th.r hc n lhc i! licqn.d Pu6uot ro th. pt@i.i@ of th.
<br />Conn&r.! Licc!.d kw (Cbpl6 9, Cdlwncln8 eilh sclioi Tooo of Divtim 3 or thc Bsind md Pror4ioi co<L) d $r h. 6
<br />rh. i qonF th.cftoh ed $. bsi! f6 lho.ll.8cd amprid Any viol.tio. ofs.crion ?011.5 b, d, applicDt ror ! Dloir,ubj..! rh.
<br />.pplior ro . civil FDIi, of nor h@ $& 6v. naded doll6 (t500).
<br />_1, { M6 of th. Fopcny, or my 6ploy6 wlt w.a., s th.ir tolc .6Pa!!ri@, will do $. wo* Dd ln. tLuct . it nol intc.d.d
<br />d offfrd f6 [1. ( se,7oa4, Buils $d frof.rid c.da Tn. coE cd'r Ucd. tr* dc to. .pply to a om6 of $. p.DPaty
<br />*ho build. or imp@vd tha.d!, rnd *ho do€ tu.lt m.k him.lf or hcr.tf or,uouth hit d hd om oployEt, Fon.Ld $ tuch
<br />ioprovcm@E !!noti ed.d doficld fdi.lc.Ir, howcc, th.t{il.lng dinp.ov@6r it told * tiron.y{of @oPl.n@'lnc
<br />OMr.Buildtr will hrrc th. tudo of prcvlDi thrr hc ot .t. nor build or inprov. for !h. purP6. of t.l.)
<br />-I,
<br />! lMd of tn. Fop.ny, d .xclsl,.ly 4lr.rin8 ei6 lic@d @ttrfud !o .dnucl lh. Prcjet ( Se. ,0.4, Eulnd &d
<br />?tufdlion Cod. Th. Conrr.1d" U.4c ts.bq.oi lrply ro & ohd of Prcp.tty vto build! a ih!6!6 lh.t @, Dd who
<br />coftdi ftr luch prcjen eidt ! Coil.Erd(,li@sd,rEuat to th. conE&ror'3 Lic. . Llw )
<br />I n d.hd u.Lr satid .B. & P C. fd thi. Boi
<br />Dar.: Owr.r:
<br />}VOnI(f,RS COMPENSATION DECLAR TION
<br />I h+by afllm undd p.ndty otpajlry oi. of&. followiar daldion!:
<br />-I
<br />hw. {d will nuitrt in. C.nlfcn of C@6l lo S.lf-IEu. fot *titd' cotrPd.tim, n Fovidd fd by Sc.tion !700 of Uc
<br />l..b6cod., for tI. pdfdlm@ of lh. w* for *l d lhc Fnn t isq.d
<br />_l hw. dd eill m.inuin wetat' .olnFn !d iM.., s r.qqi,!d by s..rior 3700 of th. L.hG Ood., f0.lh. P.rfdtMe of $.
<br />wdk fd ehict thk FDil i, irru.d M, ,ott n' comP6!.ri@ isrJts.c crni6 Dd Policy nMbq @l
<br />Policy N$$6 &Pi6'
<br />Z*^^^^"
<br />Fono o6a ro rrrc
<br />b. c6pl.t d if th. pmn ir for On. hudr.d doum {S I o0} or l4)
<br />p6for,n.nc. of th. wdk for whic! !hi! pnn k tuuc4 I lhtll iot
<br />wdkd ' qompor.li@ 16* of C.lifmi., ud !8M rh.l irl
<br />ohpa$sdo p.ovi!i@ of S.cd6 ,700 of In. l$a Cod., I th.ll. aBlheirh
<br />I
<br />waiNlNO: Fsilu. to !+@ e6kd' cor!p... 6 @s.. i!
<br />fi!6 up b on. h6dr.d rh@.nd dolla {l10o,000),in rddidd 10
<br />rl& Libo Cod., iDrncn ed .nomcy! fd,
<br />6 provid.d fd lh. S.c on 30?6 of
<br />I heety ifiim wld pa.it, of !6jury lh.l I m li@d ud.t prcvnid
<br />orc B6ind &d Prcf..tid Cod., &d hy Iic.M n ii tull f@. Ed cr.cr.
<br />"6f V_7-ct _e4
<br />I h*b !fflm @&' poilry or prju., $n thd it . @ut!di@
<br />inu.d(Sd.3097, Civ C.)
<br />F.fomMcc oalh.work for which lnit P.nit it
<br />AIII.ICAtsTILDECLABAIIAI
<br />D6oliti@ PmjB-&b€t . Notilic.lid F.d.nl R.aul.Iid (Ttl. 40. r.n O
<br />_ R.qui..d L.tta ofNolific.lio
<br />.%""rh. f.d<al Esulatid! r.Bddi.B 6b4tor rcmoval
<br />I hav. rc.d this .rplicztion dd ttd.lh!(@Fply wifi dl City &d Cou.ty
<br />ordin&cq Md Slal. Lavg $t Ciry Md C@ry ro o16 lpon lhc
<br />Alovc oorim.d PloFrry fd i perio puQdd >-^('a
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Underfloor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarifier
<br />Waste & Vent
<br />Water Piping
<br />Gas Pipeing
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />P-trap/Drain Line
<br />Main Drain/Pool Piping
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Misc
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device EYDIE'Eh
<br />EVC'I PFN
<br />Rough Plumbing FEB - I 20t9
<br />Final Gas Test FFR:|'l
<br />Meter Release - .-,," "-u, zvu, c56, 667
<br />SAMU o'+.,' '
<br />FINAL
<br />Notes, Remarks, Etc.
<br />TOP OUT
<br />POOUSPA
<br />Gas Service
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