|
PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />UNDEB GROUND
<br />Waste & Vent ./i\
<br />Water-Under floor 4..,441
<br />Gas-Underfloor
<br />Building Sewer
<br />Area,/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Pipino
<br />Gas Piping
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />Main Drain/Pool Pipinq
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler 1
<br />Sanitary SeweriCX I ,V.q)Lt
<br />Back Flow Devic6
<br />Rough Plumbing
<br />Final Gas Test
<br />Meler Helease
<br />FINAL I
<br />Notes, Bemarks, Etc.
<br />OWNFI AUILDER I}ELCARATION
<br />I hcEby trftm un.ls lEnally of p.rjury thd I m crcnpl frlm ltf, a,ntra.lo6 LitN kw tot $c lollowin8 @en (Se ?01 1.5
<br />Busiics aid Profcssion Codc): Any Cny or Co!d, which ,cqlircs , Fm0 ro .onstocr, dr6, imrrov.. dcmlish or Etan any
<br />srudm. prtll ro ir. irsu&c. sho EluiEs $e lpplio! lor su.h Fmil lo fiL a si8ftd strlcmnl lhll lt 6, she is liccnsd putsua
<br />to rhe pmvhiors of rhc Conrrdoas Limnert t 8 {Ch!pte. 9. Conmrcing wilh S(lion 7000 oa Diltion I of llE Businc$ and
<br />Profcsions Codc) or rhor rr or sh. k cr.mpr rhcrcfrom and rhc blsis for rhc alL8cd dcqnion. AnytioluionofSe'ion?03l.rbyony
<br />ll'Plicanr for al,cmn subj*r rhc apnlic.nt ro r.irilFnalryofnot mr fian 6rc hundrcd dolhrs (SJ00).
<br />L rs osmr.trhc pmlrn). or nry.trdoyccs wilh vrscs us rhcn {r[ conrpcn\di(nr. *illdo rhc $ork otrd rhc {Mlm is ml
<br />idunlcd oroflarcdntr\alc(S(TlEl.rlusincsnndPn,fcr\idNCrxlclhcConta.ttr'rl-iccnrtrNdocs.orqrplyro!no*icrof
<br />rhcDmFdy $ h! lrrild\ or i'n|k)$s rhcR,n. ond who dB such woll hnnscll .r hc cll orrhr.ugnhis or ncr osn cmtlo)tcs.
<br />,r'vidcd rhxi such i'nnn cftnrs m nor inicidcd or olT.ruJ lar {k lll hoqcvcr, thc huildii!.r i'nrcv.nrnr is vni $thi',d . }rr
<br />ofconfldi, r,lt owncrBuiuc.sillhtrc rhc ti{i.lc tr ol ln,vn8 Ihal ltordrililnor huildor i'rptuv. rhc pn,Fdy ror ltr Nqrc ol
<br />-l.
<br />aso*mrofrhc Eopcny. !mexclusivclyonrroctins wirh lk.nsd conrdcro^ io otrntur
<br />'rE
<br />p,o.id (Scc. ?041. Businc$
<br />r P,rftssim cod.: Thc Conlmcrols Lic.ns. Low docs mr opply lo an oNncr of rmFrr y who l,lildr or inprows dENn,
<br />and *ho conrocrst{trslch tFjc.t wirhaC.rh.G'nr,.rois Li.cn\c liuJ
<br />-lfln.xcmrl
<br />lndcr 36l
<br />I2Il.Lr\BlIMI
<br />I hcrchy afiin undcr r,€nllry of pdjuty
<br />-l
<br />hrvc axlsillmrn rin!Ccdili.arcorCon\cnrroscllln\trcfttrNorkdiconrpcn$riotr.N p$ridcd for$ySccin,n:1?(x).rrrr
<br />Lrh.tr Cdc, tu r lE rcrhruncc .l rhc sork for *hich thc pcrnil i\ h\ucd
<br />_l h!v. and will minhin workcB comFosa'ion insxhncc. as (9!iEd hy ser ion l?00 of rlE t t.r Codc. itr lh. Frlomfte or
<br />rhe work t r qhi.h rhk rfimh is h$cd. My workch corrcn$lion inlumn.c .ari.r sd policy numb.r E.:
<br />I.cniiyrh.t in lhc p.rfoirmna of lhe work lbr which lnis pcrmit is Gsucd.l shall nor cntby rny Fnon in uny ftt.ncr
<br />s ssto hc{.tu irbir'
<br />'o
<br />thc }od{dc6mFn$'ion lrvsofcllirornh. rnd.gB thd irl shuld h.rom ilbFl ro th.
<br />s!tr*.6' confcnsarn,n tovhbn. of serion 17fi) of
<br />'h.
<br />Ijt r O)dc I sh.ll. fonh*ith comtly wnh thoe l,mrlrions..
<br />WARNINC: tjlilurc to surc srkeN'
<br />civil fincs !p lo onc hhdrcd lhousand
<br />S&ri.n i{rri of rhc I atrr C.dc inrcrd
<br />shlll subjer m ftplo)er to niminal [Eolis..d
<br />d{ro8cs as pmvidcd au lhc
<br />I turcbydfirmtrndcrFn t ol Frlury lhll
<br />DECIdAATON
<br />und.r Foviion of Cnlpr6 I (onmmine wnh Se.lbn ?000) of Divishn 3
<br />ol rhe Busimss lnd Prof6rions Codc, snd my lic.nsc h
<br />Liccne Nrnb.rl
<br />C(TNSTRTICTIoN I FNDING AGI]NCY
<br />I ltrby rfin'n undcr Fm]ryof |x jury lhlt lhcrc i\ n.ons'!diotr Lndina llctr.y rr rhc pcrrod&.c nl rhc work rhr qhich Ihn Pcnnir n
<br />i$ud is.c lr)97. Ci! C )
<br />8.8TI,I(JTTLIr[(:I,ABAJIU!
<br />I h.1r{)y rnn r undc' t^-frlrt.l I*rJUry oi. ot rhc ii,lk,\ n8 delrfuri,trN.
<br />I).ntrillri.tr l,cnnns A\h!{o\ Nori,l.rri,,n fc .rrl R.guhri(r\ ( airlc 10. Pi6)
<br />Rcqun(J I.nrrotNorilicrrkrr
<br />--J dc nor trptlt,hlc h this pmlccl
<br />_l I agre k'e,rtlysirh rllC
<br />l!ssclarin! ro huildi.e co;
<br />PE )o/f
<br />3-{
<br />x,VIr6lf-v
<br />trndcr. AddrcsY
<br />-
<br />KT,WT.
|