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PLUMBING.INSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS OWNER A!ILDER I'I'I.CARA'I'IoN I htr.by illtn und.r pcnih, ol pcr.Jury rh.t I .m cxâ‚¬nrtl fnnn rh. Conrndor'l-rc. s.1.r( f(tr rlE follosin!..ai'n (S.{7llll5 lrusinc$ xl Profes{on Cod.I Any Cily or Cornry slr'cl r.quics r Fmi b constnrct. .kci imrole. dcmltl or qtrtr anv {n'crurc.,rn.r kr trs issBm.. nho rc+r.i rh..pplcnnr for Nch !.nn b il.. ssnd slar.n rnarhcorsh.6l'..n\.d puN. ro rh. prcvG'onr oflh. contrcror s Li.etrsed l..r (chrri.! e, CornmcEiry \'irh Sc.rion ?0orr ofD'rson I ol'th. Buen.* .tu! Itotcs{on{Codll orlltrr lEorsht ir.r.ml rhcRion and lh. basis 16rrh..ll.scdcxcnrlltrn Anyv'olrrionofSccri.nT0ll 5hv..v amlrddlorir.nnilsuhl$rsrh..ptlimntto.crvilr.nillyotnol'er.rhdnnvchundredd.llih(s500) l. ., owner of rhc lnrlEny, or my cmlloyei w,lh wi3.s ,s rhtr rnc comncnsrrbn. wll no rhe wo* and ttk studuE N ni 'nifrlcd orolf.rcn for slcISE 7 4. ausins.abd Potasrcns C.dc lhtaDnlnctds I rcâ‚¬nkl.a*do.s.olnPplvIoin.qMrol rlicpmpcny wno tunds or ionn,ycs rh.6[ ad wl{ &'s sc[ ultrk hnns.llor hertlrorrhftnsh hf or her osn.rnrlovces. prorid.dthrrsochihrotmnFnrcmt'nrc.rlor.fl&.dloreGI[hotror.rtf,tudnrnSornnpm\â‚¬nEnr($klsihinnEvd .i conrrkrnu rhc Owkr Rurlder sill l[E lt. bun n ofPm$ns rh.t lr or ctre J an huild or inDmw Ih. pmPdy lili lhc puqxr{ of l. iso*nerolnrrrmrcny..mâ‚¬xcluqv.lyconticr$Ew[i licens.dcontr ckJNr)con(rucl rh. nN]ecr(Scc 71M4. BNinc$ . l Pmliacnncod.:lh.ConkacknsLi.â‚¬ns.l,awdo6*,arnlvro.n.*n.rotntupcnvuMbu'l.lsornDnror.irhcrnrn, nd wlN conlBcc fo! such rrrrcrs wnh . Commclo( n licensd DuNu t' lhc ( ofiicktrt l-E.nse l-!r') woRKtlRl' coll, PltNsarloN llEcLAsarlq! I her.by lmrn und.r n ndlryofp.rjuryon ofrlE folhwmS del,rtrion.: , lwe trd sill Dainr,in . Ccnifc.lc ofcdn*or ro s.lf_lnsurc for *orleu onrp{s0tion. ar i,nrvidcd for bv Selin 17rn nf rhe Lab.. co&, fo. rhc prf.ms. of rh. $ott lor s nich lh. ,*ft ii kscd rlr. \u litr*hEh(hLs|tn rs6scd ltly*o'lsE (n,ndrnr( N xDr. rrrrc. runl Fni.'" nunrh.r tc I'01'c! Numh.r-Irl -l.cnirylholi.rhcpofolmNeofrhcworkforwhtrhrhisp.rmnhis.d,I3nallmlemplov6n,p.mninonvndcr& as ro b.6m. sbj.rt lo lhc sttd' oDp.n$l ion Lss oacdlitomi.. t d lsr lhal if t rtbuld b.sm sbjcct to li" worlcF' onpmtion pmri ons olsorion l?0O oflh. Lsbor C.d.. I dDll. fonhwnt 6q,lv with llne pmvllioN \YARNINC l:rilurc ro *cnrc tr6.k.is' o ,ffntaro ..\tm-{c r\ unl3thl. md d$ll snbJ.cr !n .hpkrrcr l. smiml nt lrie and cNil fines un roonc hundrel rhoustrnd (lolla( (Sl0lr,lr(r01, rn addtr!'n h rhc c.* olcon'pcnsriotr d'nuses r! l,n'r rl r'rrhe sdtrn 1076ollhe l,rlx,r cdlc, mrctcs and,tunr!'s l!$ Drt.:_ Appll".nr,- I rcl'NSliD C()N Ill'{cIoR lll:cldSalra! I h.Ebv lmm under,,.Mhvofpertrrv rhar l0h licen*d und" pmvisio' ofcluplE 9(c'hnMcrnS wilh scctk'' 7000)'tllivhion l ol rhe Busi..$ B.d Poa*sions Codc, !ftI my lic.nsc ir in tull loc mt elt cr I enJc''( A.l.l'c$ - AIIUCANT.!}:CLAEAIIqX I h6tlry.flim undd p.n.hy olp.rjuryonc oflh. followins dcclaix.ns: D.nmlirion Pcrmils AriElios Norilicatio. l;cd.ol R.!ul.ridF ( f nlc 40, Padr, RcquiEd t..rr.r of Notic.thn -l ccnily thdr llr ted.ral re$htiods EE.rdins ashcitoi e6.vsl 6r. not apnli.abl. ro rhis fmi{t. -l c.n iry rhor I lEt. Esd rhir arplicstion .d Bral. rhlt fi. .iove infonMlion G comd I 6sra lo mmPl, eirh al Cnv and Colnrv orli.rrc* nnd Slar. tj*sElrint ro l,uildins @n{tuclio .nd h.r.nynurlnrir. r.pr.s.rx.rir6 oflhis C v t d C.untv to trl6 {l.n rrE ,tnc mdio..d tmFny for iqdion lulxB Appllcrnr 0r Agcnl siqn,rur. P.mllc n.n. {Drltri)r- UNDER GROUND Water-Under floor Gas-Underfloor Buildinq Sewer Area/Storm Drain lnterceptor/ Clarifier Waste & Vent Water Piping Gas Pipinq Roof Drain Tub/Shower Test Rouqh Water Heater POOL/SPA Ptrap/Drain Line Main Drain/Pool Pipino Fill Line/Back Flow Pool Heater/Gas Line Miscellaneous Gas Service Water Service Lawn Sprinkler Sanitary Sewer/Cap Back Flow Device Rouqh Plumbinq ///q///fuort /oz- Final Gas Test Meter Release FINAL u/9/rf rylDA //n Notes, Remarks, Etc. Contrt.lorl cQllr8llcrl0N-trNluNa{;-ENcr I hccty amrn undd p.nnlry of p.rjury rh.l $ft is ! on(ruc1nrn kndmS .8.my for fi. pdfom.cc of th. sork frn sti.h lhis pcmir ir Bsu.d (S( 309?, Civ. C ) L.r.i!.is )rrmc - Waste & Vent TOP OUT