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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE tD/stG.COMMENTS OWNEN BUI t,DER DELCA IIAI'ION
<br />I hcrct! nlfifln undcr pcnrlly oI ncriury rh l !n crc'npr rmm rhc Conka.t,^ Lien* Ijw i(tr thc lollo*in8 rcavD (sc.70:rl5
<br />llu\ircss od Pi{'rcsion Cod.): ny Ciry or Counry whi.h rcquircr r pcnnir k' lrn}]ruci, alrcr, n {'vd, ddnnnish .r tFn rn,
<br />eo.lrtrc. ltrinb irs isulncc. lho rcqntcs rhcnnplicurr i, \!(h F(nnir b rilcr \]strcd ( cnrd rnd hcor shc is liccnscd prdanr
<br />h rh. prolrions or rhc (htrlncroir t-iccnrcd Ljw (Chrptcr 9. Comncncing *irh sccrit,n 70([ of Divisi.n'-1 oi rhc Bu\inc$ lnd
<br />Profc\iotrsCodc) orrlrl h orshc hcxcnpr lhcrcfronr d lhc hr\i\ tu.rhcallcsrd dc.llnidr AnyvnnirionofSdinr T{r.r.r 5 hy,.,
<br />!pplicn rbr rrcrnril suhjec15rh. lpnlicanr (' acivilpcnalryolnornkrcrhrn fiv. hx.drcd dolltr((35(m)
<br />-1.
<br />as wM ol lhc nftpcay. .r my .nl|)Llrcs wilh w,se. ,s rh.n $t onrFn.aliotr. will do ltE wodr a.d dE srErh is tul
<br />i.lcndcd or oficEd for elc (3(.7044. Dusircsr and Profcssionr C.dcr Thc C.nl$cbls Lheis L{w dms not lpply lo e oso ol
<br />rh.lm|Edy wtb ttrikls or nr{m$ rhcm[ a wiodc!shh him.la or h.Mlf or lnmugl hit or lEr oq ctrployecs,
<br />providcd rhdr Mh iq'mwnts G ml inlcnded doifcisl ftr sL. lf. ho*E ltE hildinC tr inpmwmnl Ls sld *nhi. oe Fd
<br />of codpkri,D. rhc O**r B!ild.. wil hee dE hnlcn ot !reving lhdt ts d {E dn d b'ild c in{eE tlE l,oPgty fd rlt puF* of
<br />-l.
<br />rsopncr.irlt nmpcnr- rrcr.]usivrltc.nhdi,,g wirh 1i..tr\.d.onki.kns h cotr(nrcr rlrc lojccr lsc.. 7ol.l, Bu.i'rc*
<br />tr l,h)t*ii, Cid.r l hc Co ntr ckx's l-lccnsc l,au do$ nor !|tly ro an o*nrr of F,Nn! a ho builds or iDporc\ rltrcon.
<br />a.d who conr(.rslorsuchpx'jcrhsirhrG,ntknrirli..tr{druNun k' rlE Cotrhcntr \ l -i(i\c kw)
<br />-lrnrcicnlnr
<br />und.rssrion .a &PC li,rrhisrrlnr
<br />-
<br />Ortr.i-
<br />laBtr[8l:CollSENlArIAN
<br />DECI"Af,AIIQN
<br />I h.Eby.flirmundcr ll.oahrolF,juiyonc of rhc rollowine d&lrorions
<br />-l
<br />hoh drrl will tuinrli. a Ccni6.ar. ol Cons (o scllltrsur.lo. workcn conqE.\arion. as FDvid.d ror b, Scclio.3?00 otrhc
<br />tib Codc. for lhc I.nbmncc o{ thc solk lor which lhc pcmil ir issudl
<br />_l hovc aDd willmainrdi. workdc co p.trsalion insnrarc. os mqutcd by Sccrion l?00 6flhc L!&rCodc.lor lhc pqlornuncc o,
<br />mFnsarion hsurre caFi6 dn Flby numbe. ft:
<br />/3 L ,/>/rq7(
<br />-l
<br />c.nify rhal if, ihc r.rform@ of lhc worl for Bhichlhis0.rmn is irsucd.l stull nol cmployanyI'cson in any.unrcr
<br />s s lo beom slbiEr ro rlt w*w onpcnerion lM ofc8liiomin, and a8rc. lhlt if I sholld b.com subjel ro ltE
<br />workEl onlt.trstior lturiiionr 6f Secdo. :1700 ol thc tih.l Cod., I shall. fonhwith omply wnh lnoe povisions..
<br />WARNING: Failur r. wurc *.rkcr'
<br />civil fincs up ro om hundrcd thousand
<br />scrion 1076 olrhc tihor Codc. inrcrcsl
<br />corchsc is nila*rnl. Md sh.ll eubirl n. cmplorcr lo oimnll Fmxix and
<br />i. addirbn ro rh. cosl olconpcnslion. d!rusci xs ptovidcd rot
<br />'h.
<br />o,r,' --1'o'gn
<br />l)r:cl. tslllQl
<br />I h.rhtrr,-rmundcrptnrllyotPt,ilryrhd I sfl lienen u!,lcrrn*hn .rg!I/J,kr 'r iorn{R irr8 w h\c x,n7l{r0rrrr)ivisintr1
<br />ol rhcBLik\\a Pn',c\, un) CuJc. .nl N h.r.{ s n lnllnrcc mJ (Ifc\r
<br />B Vz/a s/*"*n,
<br />-'?-=o-/ /;#o
<br />(.ONSTRII(.TION I flTDNG A(:ENCY
<br />t hcrcby afam lndcr |.dlry of ,.dur, &rt fim t a oirrelbi hndine .8.ry aor dE Pcrfolr1m. of P m.t for *hih rhis Psmn b
<br />ksucd {se. 1097, civ. c.)
<br />AIILICANI.IECIdMIIAN
<br />I My !trm lndcr pcndry of |leriury onc of dE tollowing deherions:
<br />Dcmlirh. P.rnil!-AstEsros Nolific.tion tu ol Reslkrion. (Tirlc 40. Pdr6)
<br />Rcquind t llcr of Nolilimlion
<br />-l
<br />c.nify lhar Uc rcdcnl tgllntions rgddjn8 &sbesbs ,cmvsl !rc not 0pplicobk lo lhh loirl.
<br />-l
<br />ccnify rhlr I hlw Eod rtn alrlicdio. a.d ll'rc rhd lnc ab.v. irformrio. is coral I lsE lo @nrly with .ll Cily and Counly
<br />ordiMnccs snd Slorc b*s Ehr iotr .rn h.rchy luthmiz rqrc$nmiw. ot rhi3 Cny fld Counry lo cnlq ltDn l,E
<br />ahovc ntrnlioocd pmFny for
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor
<br />Buildino Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Piping
<br />Rool Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />Main Drain/Pool Pipino
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary SeweriCap
<br />Back Flow Device
<br />Rouqh Plumbinq
<br />Final Gas Test
<br />Meter Release
<br />FINAL
<br />Notes, Remarks, Etc
<br />Z6HqL-4---
<br />Lrnd.l\ Addr€rt.
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<br />4A **,'12:-J(
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