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PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS oMf-Buil.Ltr D.cla.ti6
<br />I hB.!y lmm uda Fnrlly of Fjln) lhrl I m crdnpr f(rm rh. CdEr.r6' Lic.M l.rw ror ilc folloeint l!.o (G.?01 1., Buitd
<br />rld Prcf.!.ioi C.d.) Any City d Couty whici EquiE r pqflil !o contl,llcr, .lta. imPrcw,.!.moli.h d Ep.ir l'y ttu.titc Fn lo ilt
<br />isae, sl$EqriB th. pglisr foriuch p.frir io lil..lit dlrdaMr lh.rh.qlhe i.licdt d Poul lo 6. P.ovbi ofrh.
<br />cmtr&1ort Li@.d La (Ct.B' 9, Cdt@$ln8 qld! sdrid 7oo0 of Divilio 3 of {8 Bqir6' ad Prcr6lion! cod.) d ln.r hc d
<br />rh. i! q6pt ir@&on sd th. bui, fd tn. dl.B.d d.ftFio .Any viol.d@ of S.crid ?031. t by oy lPPlic&l fd . pmn .objer' 0E
<br />lpplicut ro . civil Farlry of iol ftoE $& fir. hun&.d doll4 (3500).
<br />-1,
<br />a om6 of th. FoFny, 6 my oploy€ *i$ w.86 ..tar $1. cdp.n'.ri6, willdo {tc edt ud t. !lr!cia. t nor i.&..b<!
<br />or o6c<l f6 r.l. ( Se,7oaa, Aqin.r srl Prcferi@ Cod.: Tt. CdE .l*'! Li.4c trw dd not mly ro s om6 of th. Flpat,
<br />wlto b!il& d ioFovd {Eroo, rnd *ho.L€ tun wnl hitu lf d h6.lf c truqh hb or ha 6m 6Plor6, Fon.hd $.t $ch
<br />ihp.om.nr, E tur inrddcd or off.rd fd r.l. If, howffi, rh! b{il<t ns o. idFovdd n rcld wi$ir onc ,.r' of mrlcdon. t.
<br />Ou.FBuild. will h6v. th. hlfdd' of provlng th.r hG or in. hor build d impr@. tor $G pqrp6. of !al.).
<br />_1, g omd of $. F!?cn .6.xclaiwly 6E.cins wilt li.d.d c6u!.rou to @rEucr |n. prci*r ( Sd ,04a. Baita ud
<br />Prct6.ioi Codc Dr. C6st lor', Ucaic l* do.l nd lpply to e oMa of prcp..ry eho buil<b d ih,rovc! th.non , !d who
<br />.6nrnd atr luci proj..r, with . c.ir&(o(, li6lcd p6uDt to lhc Contetor'! Licolc Lw )
<br />_l m.xmpt undd S.ciion
<br />WORI(ERS COMI'NSAAION DECLARATION
<br />I h*by smm !nd.r pel.lry of pdjury onc oflh. follorin8 delrrlrio,ll
<br />-thrrtudwillmd
<br />!i. r Cmifirrl. ofcds.')r lo Sdflse f6 wott6t' .dnp.ntrdot, a Fiovidcd fo by Sedoi l?00 offi.
<br />h!rfc"d., fd thc Ffdrue of &. wqt t* *hrch itr. Fhtr ir isu..L
<br />-/_l h.v. ed will hrnr.,r *dl6l' 6rpaui6 l u:r@, u Gq!i.!d by Scction l70o of ln. Lrbd C.d., for t. Ddfffie of $c
<br />vo* f6 vti.h dii patnil k in!.d My *o*cf!' .ompatllion iNlme 6id sd policy nmhd ei
<br />CA
<br />I )-3?370f
<br />-1",,u*^
<br />b. cmplclcd if th. p@n i! ror On. hun.lr.d.tolld {t100) d ld)
<br />rhc p6fmsc. of thc wo atr ehich $n Finit k isu.d, I rhrll ,ot mploy &y P6o'l ii 4y tMne !o a lo
<br />tqmc fubjar to lhc wd6 'lN' or cllifnia, &d .$e $.t il I ih.lld b.@w iubj.cr
<br />oarh. tibd c.d.,I !t.ll, f6rhei0!
<br />ro t@l! wdlGr' chp66.rid cov6.g. i!to 6imin.l F..Ud rd civil
<br />fis.! up to oo h6d!d $oled dollc ($100,000),in &ldi6on b rh. coll of cmFr!.rio,
<br />iE Lrbo Cod.. i @r ed dtomcr'r ld
<br />q provid.d f6 rhc S.c on !076 of
<br />LICEI,IP.CIITI8ACIqESDECIAEAJIIqN
<br />I hftby .ffim udd p6.19 of Fjlry thlr I e licd.d b.,.r Fwni6 of Ou9l.r 9 (cMcina *iln Seiion TOOO) of Dirnim ! .f
<br />rlE Bqind! ed Prcf4id! Co<L, ed my li.a& h in tull loE
<br />'Id
<br />.lIer.
<br />undd pd.lty of Frjury $at thqc is ! .on5hction l6dir8 trnc, ld |hc p.rfomMc. of thr wdk for which thn Pmi n
<br />is!cd(S@.3097, Civ C.)
<br />arlllc4Nl:il.Dlga8Aga!
<br />Domliri@ ?miE-A!t6r$ Notific{ion lcd6d tuSuldonr (Tid. 40, ?at 5)
<br />_ Rcqlira Lat r ofNotificdlon
<br />r.mvd e nor .ppli.a!l. !o lhir r.oj@t.
<br />lhc $ovc i.fm!i@ ir cftr. I .gre ro cdpl/ eit.ll Ciry md Couty
<br />.bov. molim.d prcp.ny for i p.cti6
<br />rcpr6otdivd of thb Ciry dd Couity. io 6tr uloi th.
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Underfloor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarifier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Pipeing
<br />Rough Water Heater
<br />POOUSPA
<br />P-trap/Drain Line
<br />Main Drain/Pool Piping
<br />Fill Line/Back Flow
<br />Misc
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />EXP'R ED
<br />Rough Plumbing
<br />Final Gas Test reE : I ZUIJ
<br />Meter Release AMC H3, 29(r, 556, 667
<br />FINAL
<br />Notes, Remarks, Etc.
<br />Roof Drain
<br />Tub/Shower Test
<br />Pool Heater/Gas Line
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