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PLUMBING-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS <br />UNOEH GHOUND <br />Waste & Vent <br />Water-Under floor <br />Gas-Underfloor <br />Buildinq Sewer <br />Area./Slorm Drain <br />lnterceptor/ Clarif ier <br />TOP OUT <br />Water Piping <br />Gas Pipino <br />Roof Drain <br />Tub/Shower Test <br />Rouoh Water Heater <br />POOL/SPA <br />P-trap/Drain Line <br />Ir/ain Drain/Pool Pipinq <br />Fill Line/Back Flow <br />Pool Heater/Gas Line <br />Miscellaneous <br />Water Service <br />Lawn Sprinkler <br />Sanitary Sewer/Cap <br />Back Flow Device <br />Rouqh Plumbinq <br />Final Gas Test <br />Meter Release <br />FINAL Z'f <br />,%i%ta <br />Noles, Remarks, Etc <br />OWN!]X BTIILI'ER DEI-CARATIoN <br />I hcrchy ilfinn unlcr ncnllry {n ncrju't rhd I m crcnfl nom ihd contdcr*{ Liccnsc L.* lor lhc n,lb*i.s r,vtri (sc.?o:rl5 <br />llusinc$ r l Ptr,nssi{rn C.dr): ny Cn! .r coumy trhi.h rcqun \ d Nrnrit ro con(tocr. 3lrcr. nnln^c. dc'mlish .r rc}'ir lny <br />dciurc. priffn, irs isurtr.c. rh. rcqtrncs rhcapplicrtrr lor $.h lEnnilro nb & sismd dsi.nEnr rh,r tror shc k liccnsn purunnr <br />lo lhc F)risi(nN oi llt Cotrrr cttr \ t,iccn\cd l-aw (Chrlns 9. Cu nftn.nrg (nh Sc.rion Tlxrr ol Oiri\ion I or rhc autin.\s dnd <br />Pnri\\i{n,sCoJc).rrh hcor \hc iscxcrpr rhcrclioniM rhc hr\is ltr rhc lllc8cd crcnDrion AnylidrrionofSccriotrr0ll.5byrny <br />rfrlictrtrlLr0Ernrirsuhlccr\ih.rprlicanrrorci!ilncmlryottrorrmrediifi\.hundi.ddollds(X5U)) <br />_l. rs owncr olrhc totEny.,tr 'nycnDlorre\ sirh Nr8cs r\ rh.n d..onrNrq!ion. trilldo Ihc *ork ad rhc rlBruto n Rn <br />inrc d or ollircd tur {lt (S( 7l|rt, Bu\ircs*nd Prorc\snnN Codc I h. Conrrlol\ Liccnr ljw doc\ nor llrl} t, xn o*rcr ol <br />rlrrmEny vho hullds or inDtrn$ rhcBxr Md \ h. dm\ smh $o hnns.llorhcrsclforrhhughhi\orlrcro*n.nrPloycc\. <br />p('!idcd rhrr \uch impovdh-nh rn nor i cnlcd .r olfcRl na $h. l(. h.$vdr, rl.d hni{n[ or i'rl,R,hntd n bk| wilhin onc )qr <br />ol conrLrior rhc Oem, Buillcr sillhr\r rh. hurd.nofF)vnrg rh h.orshcdd norbuild or imomw Ih. loFty for rhc pu$)s of <br />l. N own( or rh. pmp..ly. !m .rclusivcly conhcl inB wilt liccnsc{i con[a.lo^ lo .onrrud rlr pmjcd lscc. '7014. Burinsr <br />!d Pmltsim Cod.: Thc Conr@roas Liccnsc Ljw ddi not nprlyro d owns olproFnr rho blilds o, inproks ihcrcon. <br />lid who.0.rB.6for3ucnp6j.dswith.ContE€torltliccnsedpuNairtorhcC6 ra.roas Li..n* L!w) <br />-l <br />addcnpr !ndc, Sc.rnin- B. & P.C. fo. rhG rcason <br />IABf,D8S:.cllMTJllAION <br />DFCLARATION <br />I hcr€by rf6.rn undcr p.Ehy of tdjury om of tlt followins ddlar,rionrl <br />IhnR rlwilltrsnnrndCcnilrarcoiConsdtoSelflnlulcfor*orkcr\'conltsdriun.dsIovidcdiorhySclt,n37(.rrhc <br />ljhtr Culr- r(tr rh. lr.rfonrumc ol rhc *o nx shth thc Frmil i\ issucd <br />ar hrvcurd willnrnrrin srrtcfi cor.p.nsrrion in\onncc, as rcqoir.d bysc.Lon3Turoflht titor Codc. ftn rh. rtYrdnDN. or <br />lhc trork ni $hichlhn ptnnir is i\su.tt My sorr.ri .o.rr.nsar io in{ututrcccrri.ruadliolicynlmhrr e: <br />L <br />*st-<a <br />-lenifylhal <br />in lhc FrfornErcc of lhc wort for ehich lhii Pcr6i' is i.s!.d,I shtrU.ot.nploy any I'cr$n inMy@mr <br />r, dc ro h.6ft *ublrt ro lhc sorrcr' conpcnsrion l!*s of Crlitonia and aEr rhar if I .h.trld h.ftm $bj.tl lo ttr <br />qo*cd coqEn$rnrn pmvkions of Sdion 1700 of rhc &&r Codd t sh.ll, tonhwnh @Eply wnh rtfs pmvthni. <br />WARNING: FailuE to surc wntcs otrp.nslion .ovcEsc is lnh*tuI. t.d shall flbj.rt & cmploF lo qihitul |Edlri.s ,rd <br />civil finc. !p ro6nc hu..licd rhous! dollN ($100.0m). in addilio.lo thc c l of@.p.n$lion, &m8.s as prcvil.n for lhc <br />Sccri.n 1076 6t rhc bb.. C.dc inr.Bi ad allomy\ aes. <br />o.,", 8-l?',8 n,or-,. <br />DECLASAIIO! <br />IhcrcbyalllrrundciF.,lryollcrjurylhllIanrlienstundcrlB)lisnnr.fCharrdI(omnrtrcinSwirhScclhn70G))orDivi\nnrl <br />of rhc Businc$nnd Pof6si.nsCod.. axl nry li.cnsc is in full lb!c. .nd cff(1. <br />CONSTRTJC'TION I T'NDING A(IENC9 <br />I h.rcby artrm undcr !,cmlty of pc.jlry rh'l rh* ir . oinMtion kndinE !B.xy for lne pcrro,rj@e o( rhc s,k for vnih this Fmn t <br />issu.d (sc J09r. civ c ). <br />Pemile tume(prtnt) <br />-_ <br />8ru8 <br />Waste & Vent <br />Gas Service <br />K-t1^)K <br />l.rr.hr'. 'll'cs <br />ATSLTCANLDECI.AMIION <br />I hodry altm undc, Fnllry of Frjury onc of lhc followin8 dNhrulions: <br />Dcmlirion Pemiis Aslr o3 Norin.{io. Fldcr.l R.BUhlions frnh 40. P.n6) <br />_R.qnir.d Lrtro.l Norifralion <br />-l <br />.dify fid lh. fcd.rll rc8llllions rcsddins asbcslos rcmlal !r. Nr lpdkabk lo lhn pnj.tt. <br />-l <br />c.diiy rhoi I h,vc to{d lhis omlicotion dd srdre thar rhc abov. iniomrio. Lr.orel. I !8rc to comdysith all Cnya.d Counry <br />ddirlf* lnd sr.rc Liws rlalinS ro blildinp .o.sldclion, {d hcrcb, ullhortu Eprcsnlolivcs of this Cily and Co!trt, l. cnro q$n rh€ <br />ffi,-:ffi,-.Vry //tl^ *," Y-,t? )6