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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE tD/stG.COMMENTS OWNER BUILDER DELCAXATTON
<br />t h{i.by !fftrm !trdcr pcMlty of frjury tlur I m cxnqn 6om rhc C.nBroR Liccns Law aor thc fotlowin! res. (56,7011.5
<br />Blsin.ss !d Prcfcasion Cod.): Ary Ciry o, Counly wthh rcquies s p.rmit lo onnto( alla inProw. d.mlilh or EPln .ny
<br />strude, Eiri to tu irs@. .b. rcquiB thc q,plic&t fo. sEh pcrril lo lilc r si8ftd $alemfi th lE o. rhc ir lic.nsd pumanl
<br />ro rhc Imlishns of rlE Conrracblr Lice ncd t s lch4to 9, Coomncing with Scctio. ?0m oa Divisio. I of llr Buim$ !.d
<br />Pm{casions Corlc) or lh.t h or rtE ir crcny th.rcfmn md rhc tnsk for lnc aIcE n .rcq,tion. Any thlatio. ol Scdion 70]1.5 by lny
<br />R,
<br />lortrtcmilsubr.clsthc.pplicantloaciljlpcnalryotnorhorcfianliacnund&idoll&s($50o).
<br />.*.$otlhc lroFdy. or sycmplo)es sirh saSes $ rhcn sbcomlcnsarion. sill.lo rlr *or* drd rh. { luiiml
<br />or oilcrcd for slc (Sa.r044. Busircss .nd Profcasions Codc TIE G,ntr'ors Lkc.sc t w dcs nol amly lo !. owner .l
<br />rhcpmtfiy wfu) hiilds or impmB ltrNn, onl wh. dc seh slk himsclfor h.r*lforlhDlsh hh or h.. osn cmplortcs.
<br />,rovidcd th6r such inloowmnrsm d t'rcnd.d orofrcE'd forsL.It howcvcr,lb. huildins or iryoEtnr t! $ld wiihjn ok rtd
<br />lc'btr rh. Ow.r auilhr eill haw rlE hrdcn oftovirS hlild or impRn€ rhc pmp.ny for rlt puqrM ol
<br />-1.
<br />!sowftrof lhc Imp.ny, amckhsilclyconl
<br />!d l\'f.asion Codc: Thc Conrdcror\ Lic.nic
<br />nnd who .onh.rs for su.h pmjels wirh
<br />a
<br />I hcrcby .flirn undcr Fnalry.f psiury orc of lh8 rolbving delull ionr
<br />I hn\. xid tr,ll ri rhrCcnficircofCon\cDrroScllltrsurcfitrs.rLcr\'cofIf,n\!rn,n.r\In'!idcdf(trbySLtriLnllT0Oollh.
<br />latxtr Cod.. i, rhc p$tununc. of rh. $brk f,r whi.h rlrc Jxnnir N isuc,l.
<br />-l hor ond will nrainrain *orkcs .oqr.r.rion anslrance, s aalircd by Scrk . 3700 of llE Liror Codc. aor lhc !s|,mm. of
<br />thc *o for which rhis pcfrir is nsd. My w6rkd cdnlc.$iion an$rmc cri,,!d poli.y nunbs @:
<br />rhur iD rhc |Erlb uncc olrhework turwhi.hrhi\ll rcr cnploy any IEFo. in .ny @m.
<br />s ac ro b..o@ s$jecr ro th. workdc .ompcnsdlion laq if I rhould tftonr subrc.r to rhc
<br />wo*ds coq,.nsation [ovis
<br />IVARNIN(: l:J' ur ri s..u'. *orkrr
<br />cilil nncs or lo onc hutul.cd tho!\ad
<br />urllliliD_(],lNrSrEroaplilJdalrlQN
<br />I hcEby.llirnundd Fnlhyoalcrjory rh l an lier$t unikr povirio. otch,pld 9(onwNinS wnh S.dbd ?000) of Divisioo 3
<br />.f the BusiBs {nd Pbfcssions Codc. od my licctr€ n in atll fore lid cff€t,
<br />COISIBUqtrIJNIENIIIICSGDNCT
<br />I h.Eby ,Ifro u.dcr pcnllty of pc,jury lhd rhcrc G s con(tucrioo lcnding dgcrcy for lh. psf()lmftc of 0E ert f6. whkh lhis pernn ir
<br />issxcd (S.c.1097. Civ. C.).
<br />AIILICAXLDICLAXAII!]N
<br />I lf,rcby,mnn xnd.r ,.nnl(y of!..jury orc ofthc followin8 dalntrlions
<br />Dcneliion Pcrdil\ Aqbcst,! Norirr.,rion tudcral Rcgula'iotrs (Tnb,lo, Pd6)
<br />Rcqutcd Ixacr of Norifi .arhn
<br />rcnsvsl,rc nor imlifuhlc lo lhis pmj.rr
<br />rgm h.onPl)_ wirh.llcnyrM counr,
<br />w docl nor aflrly h anow
<br />Pcmite,{me(pnd)
<br />b
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor
<br />Buildino Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarilier
<br />TOP OUT I
<br />Waste & Vent u",r.r.o!Ll}-I.zs- t$flinz.,\* *+b
<br />Water Piping r
<br />Gas Pipinq
<br />Rool Drain
<br />Tub/Shower Test e[tt?ltl'G U,-,- tf t
<br />Rouqh Water Heater )l
<br />POOL/SPA
<br />P-trap/Drain 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 pltvltz 1,-r^t^,2)6)
<br />Final Gas Test DI
<br />Meter Release
<br />FINAL ltltlt$ -ltIt4u//l.or^{->a)
<br />Notes, Remarks, Etc.
<br />UNDER GROUND
<br />Miscellaneous
<br />g
<br />Sccrion :10?6 oI rh. Ijhnr
<br />=lt
<br />trliJ '. \ i,h''
<br />ba-o
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