|
PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE tD/srG COMMENTS
<br />Ihlt ()rrner
<br />\\1)RKllRSiarrrlrLNs,\ rl()r
<br />Dl:( 1.,\R.\llol
<br />I lrrcl,!.tlrntrn ci |{nr!r) o,Iri'r\ otrcofiltli)1.\flt(ldhxri(i\
<br />l h.\eand\rillDiiniai.a('drificir.oi(onsl lo Seltlnsurt nn\otk6 c.n,poidion.6lro\id.<llorbls(rnrn1700ofthe
<br />Lahor (tdc,lorrhc pcfomr.ncc oirlr \rod tu \rhicn lnc lnir is G$red
<br />Iha\cond\illn[i'.in$or[6i.o'npcnr ntn insur.n... rs rcqutdbvsccrn lT0(]ollhclaia)r(i)Je lor rhe P(ftnnanc' oi
<br />rlE soAro' \'li.hrh(ncnnn is isued M!\rc'Llrl c. rtx sar nu iDsur.nce qni$ d fnictntr rlEa'.:
<br />t ccniry rhar in lh. !6foronc. ollh. NorI lor $hich lhb pdnil h is!.d. I 3hall .or dtrploy anv p.Bon in
<br />"nv
<br />mmnd
<br />e 6 ro b..oc subjd to rhe "0116 .o,npo$rio' lnm or cllifonia. and !88 dDt ir I shoold b..om. &bjer ro rhc
<br />$o*a omFc.lion povi3ioc of Sdion lToo oaltc lrhor Code I 3lElL tonhvilh.onply wnh thos povilioB
<br />wARNrNcr F il!rc ro sur. eort €6 .6np@lio. covms€ is unla*tu|, md slEll subjd a dnPloys lo cioi.al Fdrt rnd
<br />OO.OOO). ii .ddirio. ro lhc os ol.onFelion. dnls6 a Foud.d for lh.
<br />t.t ( t:i\std)( oNtR\( t()lt
<br />DI(-! IllllQl
<br />I hd.,by amm !.dd p.nahy olD6jur, lhel I an li unde prevLn . of ch.|,6 9 tcomdcn in! *nh Satio. ?000) of Dirision ]
<br />I rhc BBiB dd Pmlsions Cod.. ed dy licd* it in anll aorc. dd clfd.
<br />7?Zo7 7bfr7
<br />I hd.b, amm und( Falry o f pdjury I
<br />tsu.d (se. 1097. ci!, c.).
<br />rhe t d hf,nrudion kndog a8@.!aorrlr. Ferlonn.... of the$ork tor shi.nrhis Frnril b
<br />AITTICANLDICIASAIIO!
<br />I ha!$y amm undcr Foahyolpoj!ry one ollfic follo\riis ddldari.ns:
<br />D.noliion P.rmit3-Asb6los Nolilicarion F.d6.l RcSulatioos (1 irl. 40. Pd6)
<br />Rc4uirql L.tlE of Nolifi cation
<br />r rerry rtra rtc tcaqd,crurrrro6 r.srdins slqr\ @o\rl r. nor.rpl'cohl. rc rhts pmld.
<br />, A,^^,\,4,r""!phc.,B\n, (,,.,hd,h.abovc iitomarb. is cor6r I asc ro omPry lvnh !r cnv 5.d colnr!
<br />Jt6'nancs..d sl'r.MsEld,nsro bd'ldrns conn d6n. md h6.1,turhoiz r.pttfrlnt6 oathis Cirved counrrro dr6 uporrlE
<br />"b"* .-,.".,r n,o/iif", .sptrnon pnryo*
<br /><.geL Fc
<br />UNDER GROUND
<br />Waste & Vent r tlb t1 bAmw il8?
<br />Water-Under floor >&ttr*,l
<br />Gas-Underfloor lr-
<br />Buildinq Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarifier
<br />TOP OUT
<br />Waste & Vent 1 dL
<br />Water Piping q Dtil,..t .4r ti
<br />Gas Piping I r'
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P{rap/Drain Line
<br />Ivlain 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 I
<br />Final Gas Test lt )L I brtnlov t47
<br />Meter Release I
<br />FINAL wbt e6g
<br />clflffia.ffi -)
<br />o\INER BUILDER DDI,CARATION
<br />I ho chy amnn undd ,,6illl. .r pcjury rhar I tun crcmPl fnm lh. C..tad.u LiccnF lj\v a.t lh. follo\rins rlen (S- 701 I.t
<br />Busnrss ind l'rofasion Cdic): ny Cny or Counry, shich req(ts a ponil lo .onsln'cr. ,h6. nnpo\.. d6$lish o, rcl)}n gflY
<br />srocrur€. rior ro ils issrs.., also reqtrt6 lh€ amlicanr i{tr srh r.nril l. lil. d siln.d stalonol lh6l lt or slE is licds.d pusuanl
<br />1o lhe Forisions otrh. Conki.rois Licc.s.l l.n\r (Ch{fl- 9. Com.Iscins \rirl sdrion ?ffm oal)i\isio. I orrh€ BNinN dd
<br />Preicssions(od.)orlhnrheorsh€irex.Eflrhe.lrommdlhthsistu(hc.llcscdesn ion. nyliolalionofsdionT0lll shvont
<br />.Drlicanr for ! r,.dil subjdls rh€ npDli.antloacivilp..alrrofnolmo.etha.firchundr.ddollus(S500)
<br />l, a3 osneroarhcporEny. or nyonpl.)t6 \ilt $486 as rhrt e'l..orrpdelion. \iildo rhc sort rod lh€ sIn'du. is n l
<br />i dd.n or oficr.d for elc{5<.7044. Busin6s and Prot<io.s Cod.r'rh. Conlr.ctoa3 l,ico* tiq do6 nol @pl) ro a o\f,dol
<br />rh€ rmpFly \h. hildr or inFrc!6lhsmn. a.d \no doei.u.h$oA niN.ltor h.&llor nmust his or hs o$t dnplircB.
<br />p! ovidcd rh.l such imlroffi8 6. noi inro e! o, 0fI6.! aor sL l( hos 6 6- rhc lnildina or imtro\ ffir G $l.l wirhi'r on. ,..r
<br />oa.ompl.rion.rheO$n.rBritldrillns\!rhcburdo.f[ro\inslhdncorshedidnolh{i or nnpro\ c rhc pmFrv ror rhc Puq$$ oi
<br />L is o\$e ofrhc nmp€ny..o.icltrsilclv.ontacrirls (nn lic de.1i .onta.ro rs lo connrud lhc preid {S(. 701'1. B6iiN
<br />atrd Eolhshn Cod€: 'I h. Conr..tu s l,icosc I n\ do6 or apl'lvr..no\nsofp.dPd!r"\ho btrildso, idpr.\.srhdofl
<br />and $ho .of,ta.rs tor such projds Nnh a (t,ntoctods) lico*d I'u*udr ro rhe ao m.loii I i.o( I 3\ )
<br />I m d.nrpt unddsrcrion - A & PC lorrhisrRson.
<br />l-l
<br />Miscellaneous
<br />Dfr nna_ l_*1
<br />Anlbw t#s'2
<br />i
|