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PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OlVNER BUII,DEII I,,!]LCA'U ION
<br />I hctuhy rrfird unltrr Fnrlry or p.rjury rh lmdxc'np' fn,nr rhc C(firk,s l-iccnsc hw ior thc t)lbenrs ea$n (s.r7orl5
<br />Busincl\ ind Pturosrnr cdlc) Any Cily or Counry wlrErh rcquncs n Fnnit lo .on\rrucr llrcr. imtn,vc. {h,nolnh or qtst rtry
<br />stru.rurc. Fi,, r, irs tsurn.c, lls rcquncsrhc afplicud lor surh I'c inir ki filc ! sisi.d \rlrcrft rhxr h.or shc i\ licctr*d Dumuinl
<br />ro rh. B,vi\iois.r rh. C.nrn n s L'..trs.d tiw (Chrprf 9, Co rnr.ncnre wirh Scdion ?O(D oi Divniotr 3 ofrhc Bu\incs\ and
<br />Pmlc$ions ( odc) or rhrr h.orshc kcicnrlrh.rcfromnnd rh.blsn lor rh.allcscdcicmprn,n Anyvirllrionofs..ri,nT0rl5hrrny
<br />xprli.anr aor rpcmir \ubjcchrh amli.an( b d.irilpcnahroa.or frtrcrhrn lif. hundrcddouus($5U))
<br />-1,
<br />as ownd of thc I,DrEny. oi hy cnOIoFs wirh wasd d thcn $k oftOcnrlriotr will do rlE B.rt ,rn i& srnriN is mt
<br />i .d.d or ofcr.d ro, $1. (se.?044. Busimss a.d Preicssio.s Code Tn Conlreltr s LtcnF L3w d..s nol al)ply lo d oen.. of
<br />ltc FmIEny who builds or itrpDrsds&Ir &d,ho &s Mn m hinsclf or hascl,or rhhueh hh d hc, own coployds.
<br />phvid.d thar fl.h inp@vmnrs @ mr i.rddcd orofrctd lor elc. lf.,!os*6. tlE boilding o. inprckmnr L sld winin onc r@
<br />otdrplcrb( rlr OwM Aui&i will har ihc hndcnofl,hvhs tlDr hcor c did not hrix or iqmw dE pDFny ror ttE ptrrpos.f
<br />l. N .wno .t rhc thpcdy. u qclDsivcly conrra.lhg wiih liccnrd .oorrdon to onsrtocr rhe !reFr (Se 7044. Br$rcsr
<br />ard l,hErsion Cod.r Thc Conhctols Liccns. L,* dcs nor {t'ply ro .n owncr of properry qto blilds ol inprcrcs rh.ron.
<br />lnd $no onrBcls for such l,oirr! wnh a ContBchi, licctr$d t rNuin ro lhc Co tuiois Lcn* tjw).
<br />I aicrcmfl und.r Sccrion- B &P.C fd rhis Elion
<br />II}Bf,E88IAIIIENIAIAN
<br />DECIAf,AIIIIN
<br />I hcrcbyainrmundft I,.6,of Frjuryomof llEfollowingd.cLmlions:
<br />I-rhtr ('{dr. nlr rhc l[nn'iu .c rfrh. w.rk tur shL.[ rltr ll.n] a ^nrJ
<br />-l
<br />holc and $ill maintlin qo*eh codpcnrarion inslnnce. os requncd by se.lion l7([ or
<br />'hc
<br />Labor C&c. tbr rhc ,'.ndnErc .l
<br />pcml is hsucd My {ortcn' d)mFns.lbn inirdne Let. srii ,olicy numh.r m:
<br />t
<br />\^l o t
<br />I ccdily lhar in lhc pdrorrorcc oflhc work r{r wnth lhk F.nil is issucd. I shrll nol crnrloyany pcren in !n, nanmr
<br />s $ ro hcam subj.{l ro lhc krlsl NtrlPcnsrion laws of Cllifomi!. .nd aBE rher if I should b.ioE quhj.{l lo rh.
<br />wrkdl omFB.rion pmvisions of S€lion 3?00 of lt tjbor Codc. I slull, fonh*irh conpl, wnh lho$ rovisio.s..
<br />WARNING: railur. b *m w.ik.^ .omFnsrio. covc6Cc h unhwful. and stull subict atr cmploy.r lo aimitul !.tulrici,nd
<br />civil fiic\ !p i(i on. hundrcd rhou\md ttollrs (Sl00.UD),
<br />S&rion 11076 oflhr l:txtr Cod.. nrkr.r rnd oimy \ fc.\.
<br />in dhi.n tr rhc .dn ol slion. dom8cs !{ tmvid.d ,or rh.
<br />I hcnny.mrmundcr p.nohyrf!.rju!yltur I n indcr pmvision olchapts 9(conmrtins wirh SNri,n 7O(x)) ofDivhio.l
<br />of rhc Bnsiocs 0nd Pi.fcssiooi C.dc. &d ry li.cn$ is in fuu lor.. &d clltcrg LO a*1.qa-
<br />D e, a,G
<br />CONIIBIJI:IIO]iIENDIII].ACENCI
<br />I hcdby ,mro u6dfi Fnalry ol D.ijur! rhd' rncr! is . $Nrudion l.ndinS ogcncy lor lhe rE.f.nBrcc ol ihc *ork ror whkh rhh lrmn i\
<br />i*ucd (Scc l0r?, Cir C.)
<br />AITL(:ANLIIICIAAAIIQN
<br />I hor$y a,lihr u ndcr Fislr, oltffiury onc of$c foll.win! deldrarnrnsl
<br />Dc nlirion Pcrnir$Asbc{os Norificntbn Fcdc.rl Rc8uhrions I lirlc.l0, Pan6)
<br />-R.qutcd
<br />L.rtcr of Norilicllion
<br />I(nilyrh rl{ ,tdrirl rcsulihrnN Nlrd rgrsh,\n\r.in)vrtrrc or $,'li.rhlc h rhi\ Dni['cr
<br />ahovc mnrioncd pmtcny lor in\lsrio, purrn*s
<br />ADpll.,nl or ,{sml sknnlu E:4. 1.tce
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under lloor
<br />Buildinq Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Pipinq
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<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 Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbing
<br />Final Gas Test
<br />Meler Release
<br />FINAL brulc ;[ ?,1
<br />Notes, Remarks, Etc.
<br />Gas-Underfloor
<br />POOL/SPA
<br />o,,", t'b'lo,
<br />ts4\*?^^a-
<br />14;4,
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