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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.OWNER BUILDEN DEL(IRATON
<br />I ncEby lftun udn F lry of p.rrlry rtlr I m.rcnpl fioi rh. C,nrtuIoE Lim* ka lor lhc followi.g Esf, (Se.7031.t
<br />Bnsines*id Profcssio, Codc)r Any Cily or C6u y vhich r.quier a Fmn to .o[nN.t slld. impmrc. &mlnh ot;qEn u,
<br />slro.ruE. r,rior b irs i$!.ne. cls r.quircs rhc sfi,licdr for sh Fmir ro fih a si8li$ sr.remfi 0ul lE or shc is li..ru.d drud
<br />ro rh. Jroviiions ot E Conr6.roas Liencd Llw (Ctul,t( 9, Con@EinS wnt Selion ?OOO of Division I of lh. Susic$ rd
<br />PtoL*ions Codc) o. rh h.tr3lE is.reofl llErctDm6.d rlE hGi! for tlE.[eg.n q.mplion. Any dol.lionofserbn 7031.J byrny
<br />lpplic.nr aor a pemir subj.ch thc llplicantroacivilp.mlryoanor mErhu five hudod dollas ($5OO),
<br />Laiownrorrhc]norny..rnucnr.yccswilhwr8csi hcirslc.nnlpcns ion. \'iU Jo lhc s'orl ud rtr ndrm is mr
<br />i cndLn (irolttrcd n, lrlc (Ss.?044. Busincs ud Pn)fcssions Codc:'l'hc Contrcroi\ Li..nsc Lrq d..\ ior lll)fly to !tr owncr ol
<br />rhcpmrnt lho huilA or i'npnruds rhc($n. dd who d(r\ lurh \r)* hnnsulfor hcrscll or lhronah hh nr hlr owncmflotc.r.
<br />pr)lidcd rhrr {rh i'npn)v(nxnL xflx inr.' cd or oflircd lnr $L ll ln\ cv$. rlr h{ildi'rE or i'npn*$E[ h n,h withtr' onc )cr
<br />oiconlnldinr. rhc O*ncr Inrildcr *ill havc lhc hunlcn.t p'ovinr rhll li or lhc did ton hdu or in1rtut rrr P$Fny ior rhc purlFs ol
<br />_1, a! owmr otrtr preFnr, m .rlusivcl, co.rdhg *illl li.xr*d .onrtrroB lo ondrucl llrc [rcix1 (S<. ]044, Buifts
<br />aln EoLsiDCodc: Tnc ConrEckn s Li.cnsc tr$ des nor arrly ro u ownc.o[lroFn, wn builds or imt,Dvcs ttc..on.
<br />and who .o n k f.r smh F.i*rs with r Co.rr&ro(s) lic.n*d pursunl b th. Codrurols Li:cnE Liw).
<br />lrmrrdnrnr udd.rSccrn,n .ll & l'](' turrhl\ rcr{nr.
<br />l),lr (hn$
<br />SQ8IEE!:.CAMfjISAIION
<br />DECI.AXAIIOX
<br />I hercby a,Iirn under Fn{lly of pdjury oN of rhc folowir8 del@lioNl
<br />-l
<br />hlE e,rd *iU mintain a C.nifrorc of C,n*rr ro SclHnsurc for worlcB .onFnsio!. rs rmvid.d ror by Sslion 3?m of th.
<br />kbor Codc. for ln pcrfo'r1!re oallE wort for wnth llE pcmn ir isucd.
<br />_l hlvc rnd will tuinkin *o,kc^ .oqEnqario. jnru$tu.. s1 rcquir.d by scrion 3700 of lhc L.hor Cod., for lhc p.,forMc ol
<br />Lr Brud. M, work6' @qEn.dion iBuEm. ffLr &d lDlty nunbd @:
<br />a
<br />-l
<br />€cniti rhbr in rhc pcrfortutrcc oirhc *o,k for shi.h rhn rcrmir h is3!cd.l shrll nor coploy.ny pttro. in uoy manacr
<br />o tr ro be6m subjd ro $e rc*c6 .onr.nsrion laws ol California. ud rerc lhal if I should bcroft slbFcl lo llt
<br />sort66' conp€nlarion ,ovisioB of SNrion ,1700 6f rhc L3tnr C{nc. I shrll, rorlhwiih cohlly wirh lh.s [ovisions,
<br />WARNING: FailnE ro $cur. srtc6 ompctrslhn mvcm8c k unbwtul. ud sh.ll suhjccr M cntlort. ro rininal lEruhis a.d
<br />civil 6ncs up lo orc h!.dEd lhousand .lolhE lsloo.rDo)
<br />Sccri.n 10?6 of th. L{bor Cod., inlcEn and dromy r lccs
<br />in addniotr ro rhc cosr ofco4r.nBi
<br />?
<br />IhcEh) ailnrundcrrE rlryotrrrjurrlhd Ium liea{J un(lcr rovisi{nr of Chatid 9 (co nNn irlS sirhScdn T0Olr ) oi Oivi\iqr l
<br />or rhc Busnrcssnnd Pr,rc$i{,n\ Grdc. Md.ryli.cnsc i\ ir nllrarcc rnl.r'r.cr
<br />I oo114o..,?.c.t€
<br />^.tar..,--
<br />caNlirf,llllall.litDt!.qdg :r
<br />I hcr.hy dftm tnd.r ncnrlry olrrrjrrr rhd rh&. is a.unjnciinr kndin! r$c .y itr Itu |xrLnrwrc ollhe *qk lar qhich thi\ JEnnir l\
<br />issucd (Sc. 1n97, Civ. C )
<br />APILISIINTDEgI,ABAIII}!
<br />Ilmhylnlnnu crpcnihyof pcrjlr,oncotlltrfi,lLsinsdd!,ali'nr:
<br />D.molirion Pcrmirs.Ash.slos Nolilicotion ltdcral Rcsulutions (1nk {,. Pd6)
<br />Rcquircd L.ncr ol Nolirr.tion
<br />-l
<br />ceniryrhnr rhc fcdcrll .csullrion\ Eeddins !s hc\lo\ rc'nola I rc urrppli.ablc h rhis !tu ccr
<br />lal..n'b rh lh,rr (r, rhr xmL'mh'{r md {rrc rh. rhcitx,vc irl.irndion trcotrccr Irsret,.o'nprysihrllctryrndL.unry
<br />odtrn cs iDd srdc Lrws rlnrina lo btrildirB consructnnr. ind hcrc$y oflhornr rcpres.nhri!c\.rnri\ Cnr r d counryro cnrc, u!.n lh.
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor
<br />Buildino Sewer
<br />Area./Storm Drain
<br />lnterceptor/ Clarif rer
<br />TOP OUT
<br />Water Piping
<br />Gas Pipino
<br />Roof Drain
<br />TubiShower Test
<br />Rouqh Water Heater
<br />POOL/SPA
<br />P{rap/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 Plumbinq 4/tt/t,t 5\sx
<br />Final Gas Test
<br />Meter Release
<br />FINAL lo /q /,,t ;Aqf{
<br />Notes, Remarks, Etc.
<br />COMMENTS
<br />Waste & Vent
<br />t.\.F-
<br />txnd.ac Addrcs!:
<br />-
<br />rbovc ftntioncd Dmmnv for inlmcrioD.-riti!--
<br />;-;;;;-"'@ ,,"," a. Lf€
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