|
APPROVALS DATE ID/SIG.COMMENTS
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor
<br />Buildino Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif ier
<br />Waste & Vent
<br />Water Pipinq
<br />Gas Pipinq
<br />Rool Drain
<br />Tub/Shower Test
<br />Rouqh Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />Ivlain Drain/Pool Pipino
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitarv Sewer/Cap
<br />Back Flow Devrce
<br />^=\fl,st,,-{z'l/Rouqh Plumbinq lo-zurE,.
<br />Final Gas Test
<br />Meter Release
<br />2e,stz zas Av)FINAL /-)-/?
<br />Notes Remarks Etc.
<br />tr-
<br />.rr\\I;R rrr ll r)rR r)rrr ( \R \ I lr)\
<br />I hcrchv ifinn unds E.ndry (n Frjury rhrr I sn .icnllr ttun rhc Conrr(t)N Lt.n{ Lrr tirr rh. f(nhwitr8 ttrvrn rS" 7011 5
<br />Bu\inrs rnd Pn)tc\\i(n C,i.): Any Ciry.r Counry nhth rcqun.s , fanir ro cotrntu r. rlr.r. nnPnrc. dcni,l6h or tNn sv
<br />{ru.rurc. itrt, ir\ rfl'anr. el$ qutc\ rlk lpFlicanr l,n \x(h Fnnir k' tikariSncd qurcn*nr lhrrh.d shc i} li..n{d ru^uinr
<br />ri rhl lnri\i,'ns ul rh. Conlrurttr\ I-i.ctr{d Lrr (Cluprur l. Co rnrminS nirh Srcrn,n 70([ ol l)ivili(r :] ol rh' Bu\int\\ rid
<br />P lrr\n,nsCodc)o!th.lltor\hrrcrrnlllrrE+tlronrrfttrhcbavrlorlhclllcsctlcrcrlrotr Atrvri{rltuonofs(tin?0.1l5hytrny
<br />0fDlicrnr lor 0 pcrnrir \uhjcrh rlt tptli.inl lo ncivilpcnrkt oln.r mrcrhnn livc hu Mnl dolln^ ( !5lx))
<br />-l-
<br />otrturofrhcnn'Fnr.ir ry.mPb)rN trilh $!Scsr\rtun vrh c.nn(tr\$on. srlld. rlE q'o* xnd rh.{tu]urc ilrtn
<br />c td ornlitrRllor {lr(sd 7ol-L llu\ircs rnd Pfl,fc$i,)nsc,xL 'lh. Cohkr.(tr \ I-iccnE Lj*irr\ mrlPplynr o$Nrot
<br />thc In,F-.ny rhr hoild( nr ir{flrr\ rhcdnr. ml *h, cr{.hso'khiar\clforhertllorrhn,ushhi\orh!rosntn9[Decl
<br />tovid.drhnr\rchi'npn,vcnrnke,inrcldorlliNlli'{l.llh)*ctr.rtrturll'Uori,\xovcrnrNhl(l* hin.k,r.
<br />of.on{'lerinr.lhc ()*rrr Buikhr sill h(rc rtE hrdcnof Im vi,rt r rh.or \h. dxl mrhlill ot iryrtE ilk r,l'ldv turrh.Ifu lr'eol
<br />l. rs owrcr of rh. FDp.ny, m .xclusivcll contMring Pirh lic.n*d conr,rtuu ro on{dcl th. Frc}rr (ss 704'r, ahim(
<br />!.d P!,i:rsii codc Th. ConrEd s Lient L.w dN mr !ml, ro rn owncr of nrupeny vrr buildr or inltrots rhcro..
<br />lrd qho contEd s nn sEh FnFts enh a Conimbn O lt Md t'uF@r l. rhc Contr.crois l,i..s rjw).
<br />I hcrcby !rfim und$ !.nixyol
<br />DETITXAIION
<br />lhr\crftl*illaui' rdr (cdrll rcol (in,*nrn) Scll lnru,s lol *orLc^' .tn,l{o\ri(in r\ nnr'dtJ ktr hvS'(rit)n 17(X)olthe
<br />trlrtr (lxlc. l,tr rh. |inn rufrr ,'l r]f, qork tur *hrh rh. Frn n tr{nt
<br />-l
<br />hrcandwill mrinrain wortcir' onp.n.dion i nk . !s Eqlitn b, sdion l?00 of lh.l,60r Cod.. torllE Frf.frre or
<br />rhc wort for whhh lhi. pcmil i issEd. My mrk6' smrrnurbn in lm .stt atn Flk, numb.r cl
<br />I.cnrl!rhrrinrhdprrfornuN!.1rtE{orkkn*[](hrh'\lrrdhi\urdl\hJllnorrnlnl()vrnylt'(rttrtxtrr_n'rtrtr
<br />(' ,ntuh(( r hjrd b rlrc sorkr.iro it^_n\rr(r lirs l(rlikm,r, rid r!N. ri r lll \h ltl tl..rN {'hl..r h rh.
<br />wtrk*'.otrrNn.rri({t'ni\i,,tr\olS..rtrinrl(xr"lrhcLnhtr(iil..lnrll.n,dhtrilh.onlPll$irhrh.{Pnivi!o.\
<br />ciil fincc ut to om hundr.d rh.nsnd dollm ($l
<br />DIIII.ABAIIA.]
<br />I hcrc$y d tud ukrcr Fmhl or p.rj0ry rh undci pfvisio. oiChlnlcr 9(omBRinS *nh Sc.rb. 7mo) ofDivi.io.l
<br />of llE BusiNis srt Pmfcsions Codc. dd ry lic.rc L in tull foK 3rn .fid
<br />CONSTRT'('TIIIN LENDhIG A(:TN(Y
<br />I h.rcby drrm undr If,Mhy of F.jury lhol lhs. is ! on{rudirn Lnding ls.tuy for rh. Frfolmd o, rh. w.rk nr whi:h rhic Fflil is
<br />htrd ls.c.109?.Civ C.l.
<br />l,nd.r'i AddH:
<br />drtul;aNl.IlE(Lrx/ullr!
<br />IlErhy dlinnundrr Ntrrlrt ol|trtur!.trc uirhr tnll'$ins ,fu.lrrrxnF
<br />D.nr)lirrnr l'.nn \ strros Nori6.rn)n IrcdcrxlRc!tr1 rtr{r\ ('lirl. {,.1)rn6r
<br />Rqun.J I. cr.l NorifirJrir
<br />ri rcmvllarc &r amlarblc lo rhi\ p!,J.d
<br />flh)lc inr,trmrion i\ uo'r^'r IsENIo$nlPlyuiiht Cn,rndCoonry
<br />rcprcsmdiws of rhir cny !.d ci nrylocnl(ufln'rrE
<br />4 1"/t/ la
<br />PLUMBING.INSPECTOR RECORD
<br />TOP OUT
<br />Policy Nlnb.r-EipiEr:
<br />I
<br />I
|