|
PLUMBING-INSPECTOR HECORD
<br />APPROVALS DATE IDiSIG.COMMENTS ()rli\I,:R It t)tiR II.:t,(,\R,1 t()N
<br />I hcrcby alfi.n ud$ D.nrlry of lEriury rhd I .n d.h0r liom rhc Cofteto6 Lbcnc bw for rlE tollo*ing rcMr 1&<.'7oll,5
<br />Busin.ss .nd Profcssion Codc): Any Cny or Counl, }hi.h rcquiB o Ff,n to oicroct. rltr, irlpovc. d.mli\h or EFn ey
<br />sltucl!rc. rir lo ils isslmc. als EquiB lhc lpplionl for luch Fmil to fih r siSmd sllt.mnl lhor lE or shc i lianFd putur
<br />ro rlf, lmvishm ol rE Co crol3 Uen€d tlw (c|lupro 9. conftrcins yirh Sedon 1)00 ot Daviston I ol tlE BBims &d
<br />Pmfc$ions Codc) or thll tE d tlE n.x.npr tlEEfrcm ond thc b6ii tor rhc alLgld .rcmplion. Ary vaohtio. ofscrirn 7011.5 hy any
<br />rpplkanl for s pcmil subjels llE lprlica to r.i!il p..!lly of ml mE rfiar fivc hundrcd dolles (!5{0).
<br />-1,
<br />es owncr oflhc preFrlr. or my chployes wilh Nlgcs a lhcn bk onpcnsrlion. sil .b t t *$t sd llt {tu|@ i! ml
<br />int nd€d ororcad for sh (56.7(xrl. Brsincs. nnd Profcsioa Cod4 TIE Conrkroas Lietrc Lr* doci Nr aprly lo do*G,of
<br />lhc rroFny wtro toilds or inprlc d.mn, $d wtF d..s scn w* hiNcr or ndsell or rhFud hir or h.r own cmployccs.
<br />providcd rhar such inprlEBtu N mt inrcndcd oror'.En f., sL.lf. h.wcw( Et ildir8 or inl!reEm hsklvilhinoRr@
<br />ofoq)briotr ,E Ownr Builhr will hrlc rlE hdd of!rcvin8 tlEr hc or lhc did tur hild or iqhE dE lmtEny tor rh. pBpoc ol
<br />-1.
<br />trs own( o[ th. p.pcny. M cr.lusiEly co.lBcling sirh licm{d coorr&roR 16 oiscl rtE p6.i*l (Sc. 7044, Busincrs
<br />lnd EoGsshn Codc: Thc ContBdnt Liccnsc l-I* dcs nor !t'pl, to an owncr ofnropcnysho blilds or ihprors rheEon.$d vno .onlrdr rtr such pojels wirh 0 Conlmdo(, lhcn*d p!6@.1 lo rh. Conr0dols Li&nF tiw).
<br />_l ! crchpr uMcr S..rirtr , B. & PC. tor rhh rcason.
<br />Drlr: O*ner:
<br />]!AAf,EE5:IQMIEN!A]]AN
<br />DECIJXAIION
<br />I h.rcby lrfirn undcr pcndty of !.rr!ry om of th. lollowinS d(lardrionsl
<br />-l
<br />hnvc ond will minr n. C.niff,dc otcon*nr lo Sclf-ln$r. for w.rkc* comp.nsdlio..0s providcd n hyScclionl?00oflhc
<br />litx, Crnic, ad rlE Frfo@mc of !h. w.rk ror uhi.h
<br />'hc llcmi, i! nrudd
<br />_l htrvc ond*ill,n0intdn workcrs conrr.nssrio. nxur0mc.0s rcquir.d by S.clion 3700 ofth. Lahor Codc. for rhc lcrfrmrcc of*€lxlfi n insurucc cMicr ond ,olicy numbcr m:
<br />Qo19.o o7V o I \
<br />I..dily rhll in $c p.rfor@n.c olrhc work ror whLh rhir p$rU is h.ucd. I ihrl mi c,r{,loy a.y F(oh in any rMnct
<br />s .s to bcsm slbjcrl to llE uoltss'onDcn$lion laq, ol Cilifonin. !d !3N lhal il I should b.!om sbrcrr ro itt
<br />qorlGl mn{Enetion pmvnion$ of Scdion 1700 of $c Llt'or Code. I sluu, ao hwnh d'n{rly wilh lhos lhri{irni.
<br />WATNINC: Failurc to suc workcn orpcn$tton owssc k unl$tul and shall sut'icr d cdpl'rg ro oiniDlp.Bxi* dod
<br />to orc hundrcd rhousnd douan ($100.{D0). in addirion lo fie con of codlcnsrt,n. drrogcs ,q pi.vid.\t toi rhc
<br />Sftrn,n 1076 of rhc I fior Code inrcrcn and d ;rd r\:ch-lltQlls
<br />I I UTILAB,L!rcI
<br />.l rh. hri'u\ rr(l ll.fcsi,nrs Crd.. mi n,t l..f \. i\ i'r lnll l;n..nl !lt.r
<br />lob
<br />I hcrchy lmrm uadcr Fn,hy of ,,crjury lhd rhcrc k a mnstruction ,cndinS !8crcy fo. th. ,'.rr'orNmc of rnc sark for whtn rhls Ismir k
<br />isucd rs(. ttr97. civ. c.)
<br />AELICAUDICLAXAT!,IN
<br />I llriynlltnruMcr pcn,hyolpcrjlr, om ol rhc lblb,in8 dahrdionsl
<br />l).mlirion PcnDih-Asbc$os Notilicolior Fudcr0l Rc8uldiotrs (rnt.1o, PunO
<br />-Rc!!ircd
<br />Lcxcr ol Nrifi elion
<br />I ccnili rhrt rh. fcdcd| ngularion\ Elddi[8 d\trdo\ rc x,v!l @ i.r rppli..hL ro rhN poi{
<br />-l
<br />ccnity I hll I h.vc rcad lhis lppl is corar. l.sre xrd'noly wirh rU Cnrrnd Counry
<br />rcFecntarivcs of thisCiry!.d Clbunryro.n'cr utbn rordinares ond Slalc L3ws rbr
<br />oqrnrion d prcrcny for
<br />AppliLnl or A*enr si*nrro \q t!
<br />UNDER GROUND
<br />Waste & Vent
<br />WaterUnder floor
<br />Gas-Underf loor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Pi ping
<br />Roof Drain
<br />TubiShower Test
<br />Rouqh Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />Main Drain/Pool Pi ptng
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Gas Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbing
<br />Final Gas Test
<br />Meter Belease
<br />FINAL 't/r/tr ?n6'q
<br />Notes, Remarks, Etc.
<br />knd6\ Ad.lEts:
<br />-
<br />Water Service
|