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PLUMBING.INSPECTOR RECORD
<br />I hrcby amm und.r pd.lty ol pdjury rhd I ' Li@N! Law for fi. followi.B rten (re. 7011., asir6r
<br />ud Prclaid cod.), Any Ci9 or CMry vhich r.qui6 . tffiit ro @riu.q !trd, imprcvci .tchotth q r.rlir sy tEuclur., Fiq ro iliistuee, slro rquiE6 thc applicel ior luch pmjl ro filc 6 si8n.d sllr@at dEl h. o. 3hc is ticd!.d puuud io rhc Fovisio; of $.
<br />C@terdt Lictucd tlw (Ct.pra 9, Com6cin8 wi.h Seri@ ?OOO of Divilim I of U. Bsin* od prcf6li@ Cod.) or rhlr h. d
<br />sh. is cidpt $d.ftom ed $c bdn fa Ih. dlcsqd q.Dpd@ .Any eiolnio, orsacrion 70,1.5 !y sy appli@r to. pc;,t rubjccri $.oppliEt !o . qivil pa3lry of nor n@ $$ fiv. hudld .tolm (tJ00).
<br />_1, a oqd of th. D.o?Gny, 6 ,ry npL,yc wi6 vagc G th.t !ol. c@F...ri@, will do tn. wo* &d lhc iEu.r& t not inhd.d
<br />or off.rcd ro $1. ( S@ 704a, BEir6 Md Prcfsim Cod., Thc C..f!.lq.t U..e t * dod nor apply ro & ou* ofdE Fop.nyvho builds o. iDFov€ rba.on. ed sho da ,ucli wdt hiretf or h*tf d ODugh hk o h6 oM .lnployc6, Foli&d rhlr suciihprovdat! e iot i ad.d d oflacd fd,s1..I( towdd,6c blildins q inprovnor k lotd wi6i, o.a yd of cdphrio, $c
<br />oenq-Bqilda qill hlvc rh. bunla of prceing th.r h! m rh. .or blild o inprovq ror lnc pulp6c of!.lc).
<br />_1. a {m( of rhc prcpcrq, e .rdqBty @Erring with licos.d c@ro.ton ro onlhcr rh. p.ojd ( S4 7oaa, Euin.3r &dPbfdio Cod. Th. Cdr.dor'! LieNG Llr &B nor $ply ro & oqd olproFrry who buitdi 6 idprovE th.!M , Md who
<br />@E..l! for cuch proj6lt wid 6 cdE .ro{, li@.d purlur to tt. Corr&ror,s Lictu. Lr*.)
<br />_l e cxhpr uodlr Satim
<br />WORKERS COMPENSATON DECLANT{TION
<br />I hdby amfr und.r pdalty of Frju.y on. ot thc foltowins .L.t&nioN:
<br />_l hae. dd will m.i.i.in . C.ninca& of Coroar to Sdfiot@ ld wort6, chpas.ri@, s frcvid.d fr by Sccrio.l?OO ofih.
<br />Libd c.d!, ro $. Pdfdfu@ otrhc wort for *hi.h th. psmir ii i$u.d
<br />_l ltav. ad willhainlain w6k.6'! cdpnBaiion insu@@,6 rcquirEd by SElion 1700 ottc Labd Codc, for U. pdfotrfu* of t.wo* fd whi.h $is pann i! i$u.d My *orld!' cmpos.lio insum@ ceic ud poli., nmb.r e
<br />Cnid
<br />Policy Nustq: Bl!,tls
<br />Oni, sction rq.d Dot bc cmpl.rd il ih. ,mir ir for Onc hund'.d dolld (t I oo ) or I
<br />;fli,o, *, ,
<br />'n. oor*e or th. wdl rd shicr rhtr p.m E $u.d. rbLe. 3ubr6 ro ,r wortf, ' conpau.tlm ls of C.lif6i( ed rsE rh{
<br />@Dp.srti@ prcvi3itu of Sdrio. ,?00 ofrh. lrbs Cod., t rhdl, fdhwirh
<br />o
<br />\'VAXNINC: Fail@ lo @@ eo*6' qmFrlari@
<br />fii.! !p ro oh. hNd'ld lhMud dott@ (l too.ooo).i,
<br />|n. Lrhor Codc, inlad &d l!@.y'r fB., dMag6 a prcvidd for rhc Scclio 30?6 of
<br />und.r p.i.lty of p.rjury rhd I o licds.{t undd provilion of Chap6
<br />$c Buh6 ed lrolBioir Co&. ud m, lic.E. h in tull f6c. ad cf*r
<br />Lic@ Cler--- Lic@. NMbq>-z
<br />I hc.cby 3ttim ud.r Fn.lry of Frjuy lnar thsc i! a coEEudioD ladi.g agdcy th. p.rfmoc. of tlE wort fd which rhi! ,.Bil it
<br />issucd (S.c 1097, Civ. c)
<br />AIPLICANTIS DBCLAR TION
<br />Darclid@ PmiEAlb6t6 Nori6c5d6 r.dd.t R.tut.ri6. (Tirl. .0, ?sr 6)
<br />_R.quircd t fld olNotificiion
<br />.grcc lo comply wnn .ll Ciry &d County
<br />alovc m6do.d propcrty for insr.did
<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 />Water Piping
<br />Gas Pipeing
<br />Roof Drain
<br />Tub/Shower Test
<br />h Water HeaterR
<br />POOL/SPA
<br />P{rap/Drain Line
<br />Main Drain/Pool Piping
<br />Fill Line/Back Flow
<br />Pool Healer/Gas Line
<br />Misc
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Ca
<br />Back Flow Device
<br />&ugh Plumbing EXFIT rcu
<br />Final Gas Test
<br />Meter Release IEU U I {lliJ
<br />8-43 556
<br />Notes, Remarks, Etc.
<br />of lhir Ciiy Md Cooty to ata upon tn.FINAL
<br />DaIc OmF
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