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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE COMMENTS o\vNtiR Bt ll.DLR DUt,(',AR/1lI()N
<br />I h.rcby aflnr under lcmlry or pcijuty rhd I m cxcnrr rio'n rhc ('onl,sct a Licns. Lrw rd rht f.llo$ins rcnwrn (sN'?oll'5
<br />Busimss $d Eor.\sbn culc): Any Cny or cou.ry which rcqunc\ Fnnir lo mnsrtu.r. shci. imlrovc. d.molish ' Enut trtrv
<br />srrucruc. ritr t, ir\ issurncc. 0lv, rc+nc\ rlE lprli.ont i,i such F:rnr b lilc s sietuil {a!.nE.t lhll hc or \h. i\ li.cnsd pursanr
<br />ro rh.8)visnnls oflhc 0,nractuis Liccnscd liw lChrfl.r 9. Comnr'(ing with Sccrion 7(xx) ur Division 3 orrh' Bu(in'1s nnd
<br />I,tur'crsii,ns G'dc) or rh,l hc or shc ir cie'tr rhcrcaron,trd rhc hrsi\ nn rtu 0llcBcd crcnDinrn Atrvriololionotscc'hn?0ll.5hv!n,
<br />lpplicanr tor sI.hrir srhjLtls lhc lptlic, rtorcivilpcnrllyofn rnx"crhln iivc hlndrlJ dolltrs (S5@)
<br />I. N owncr of rhc ,roFny, o. nry c rtn,ycc\ sirh wdgcs us rhcir snc conlr.sarion. will &r rht w.A ad IIE derG ii n
<br />in'cnlc,l "r.ll.dd n; $lc (i.t.70r4. BrsiNrsand Pnlt$io.s Cod.: Thc Gnrrn t, (Lrcn$Insdo$60r amlvro"oRnqol
<br />rhc lrnrF_ny sh' huiit\ or innn)vcs rlEren, r l wh.
<br />'lLEr
<br />\u.i $l, lnnsclf or hcisclf or rhmu3t hi\ or h'r orn cmpk'yd'\'
<br />p",viaia rru sucrr i'nPIolxftrh dr. r, intcnicd .r dfctu\r ro! slc. ll hoqdlti rhc txildiis or iflrn)vcEnt is $kl wilhir otrc ,!u
<br />;i coDD[ihn. rhr ol,ncr Au]Hcr vill hrvc rl[ t{(kn ol p orins lha rf, ot $. dn nor hlild or nllomrt lhc lolElv lor rhc N4DY of
<br />-1,
<br />n\ uwndr.rrlr F)!rny. !m.x.lusntlycoorr&ri'rs $irh li.cn\crl contdors to consrrucr rlt pmiccl (Scc.7or'r. au\i"c$
<br />rnd }tofcsir Codc: 1h. CDnracxtr s Li.cnsc Lrq d(B rcl nnr ly l{, r ovncrofroPc lsk)buil or nnprovcr lhcrcor'
<br />and *ho $nrdcls lor such pojccr$ wnh , Conn rckn(s) lilrn*d putsurnl io rhc Contrrois Liccn* l3s )
<br />-l
<br />mcr.mp! undcr sBion-. B &
<br />'/k oum.
<br />DEOABAU!]N
<br />I hcrcby afiid xnd.r pcmlty of rErjury.m ofrhc followin8 d(ldtrbns:
<br />-l
<br />hnvc aJB will minlain ! CcnifK,rc of Conrnr ro Sclahsxrclor soikerJ .omlcns.tion. d pmvidld ruhvSccrion:t7(x)olthc
<br />L$o! Codc, aor lhc pt loflMncc of fi. wotk ror wtich lhc l]m,i h hsucd.
<br />-l
<br />hrv. and *ill Mirllin work r'.onwnselion i.$ra.... d* rcquncn hvSsliotr 1700 ollhc bbor Codc. for lhc p'rr'rmncc of
<br />rhc wort ror which rhG p€mil is issld. My worl6s conf.nsation insllonc. .nicr a policv nx hs rc:
<br />-l.cniay
<br />lhal in rhc pcrfor@rc. oflh. eort for whht llis pcr. l is i$ucd.I shall nol cn9lov a.t Fso. in a.v mnrcr
<br />s &s ro h.Nm ubjei b lhc wo't n' .onpcn.arior hws or csliromh. ond !8N rhd il I snouk tccom subiNr ro rlt
<br />wortm'@nqxMlionpoviionsofsdion3?OOollhctiborCod..Ishatl.fonhwnhmnplvwilhrh'elmvisions
<br />WARNING: flilurc lo surc workcs conD.nsdtion cotcEss is unlr*tuI. lnd shrll subj6t M ml'lottr lo dnninal Fdhic. tnd
<br />.ivil fincs uI b ooc hundrcd thous!.d dolltr( (SI00.trO0
<br />S(!onllrT('n,lhc l 3hor('odc.floNanJi um, \fe.
<br />rhc cosl ot.onp.nstion. damgcs as ,tmvidcd for lhc
<br />I hcr.byrltimuid.,,.n0llyotpcrrnryrhd I n lien*n ;Jq l".vnnn] of Chapr$ 9 (c.nnlEncin! snh sNrion ?OOo) or Dilision l
<br />.f lhc 6u\inc( lnd Pn,fcsionsCodc, dd myliccnsc is in full lorN,nit.rle.r
<br />C(INS'TRU(TION I FNDIN(: A(I1'N(:Y
<br />IncrcbyrfltflundcrpcnrllyolI'crjxrtrhdrnclcisrcon{ru.ri)nlcndin-gaAcnyiorlhcFrto.mRUo,thcqukr('shichlhispcrmiri\
<br />,\sucd lse. :1097, Civ C.)
<br />r.dn\ Nrm:
<br />L.nder, Ad.lrs
<br />-
<br />afpl l( IANT DFCl,All,{T!(}N
<br />I trnhy lmm utulcr pcnnlryolF.jory onc oittu nnhNing.Lcl,rtrions:
<br />Ixnnrl[ion Pcnnilr Ash.ios Notili.ori,rn Fcdcrdl Rc[uhtioN (TirL'10. Pdr6r
<br />Rcquncd l,Iq orNorin.diin
<br />-l
<br />.dify thor rlrc acdc ! rcguhlions Esddirg &{rEnos Enrwl arc rct arplksble ro thn phjer'
<br />I cc il-vrhrr I hr!. rcndrhis rnpli rn,n md srft lhol lh. ublc intomrion h corel L8te lo cotr{tly wnh !0 Cny lid Cornrv
<br />odinlnccs and Srlrc hws rchtinB lo olrhis Cir, x.d C.unrylo corcr uB,n rh.
<br />,tbvr mnlioncd ln,pcfly tr
<br />'.2 ^ t ,^*,k'?>1,/-/E
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under Iloor
<br />Buildinq Sewer
<br />Area/Storm Drain
<br />lnterceptori Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Pipinq
<br />Gas Pipinq
<br />Tub/Shower Test
<br />Rouoh Water Heater
<br />POOL/SPA
<br />P{raplDrarn Line
<br />Main Drain/Pool Pipinq
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbing
<br />Final Gas Test
<br />Meter Release
<br />FINAL 9-?1-t8 v/,/.t,n ;@D
<br />Notes, Remarks, Etc.
<br />ID/SIG.
<br />Licen*Class: Li.cnsc Nutnltr: --_'-
<br />Gas-Underfloor
<br />Roof Drain
<br />Miscellaneous
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