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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE rD/stG.COMMENTS
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Underfloor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Pipeing
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />Main Drain/Pool Piping
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Misc
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Er.rr
<br />Rough Plumbin s rirft -ltaltLa
<br />Final Gas Test F}:'II
<br />Meter Release
<br />€AMU U.4I,290, 556, 6 t7
<br />FINAL
<br />Notes, Remarks, Etc.
<br />Omd-BdE.. D.clar{on
<br />I hdcby lffim uda podlr, or p.dury thlt I @ cxmr fm &. Cor.&r6i' Licd. ti* for lh. rotlowins r*o (*.70! l. j BBins
<br />ed kofsid cod.): Any City n C@ry *,tich l.quir6 ! pcmir ro colrdd, .lrcr. ihFovc, dalotijh o ,cp.jr dy iructuE, pris ro ir,
<br />i$uar.c, stloEquiE rhc sppli.lrr fnluch pamirto 01. a3i8n.d 3t.lano rhr! h. or rl& ir li@cd puEu! !o th. prcvirioii oflhc
<br />Conrlde! Licelrld lrs (Ch+ia 9, Ctu6qin8 wnh S@ii6 Tooo of Dvilid 3 of $. Bsind {d profBioir Cod.) d lnd h. or
<br />she i, dmpr th6.Amedrhcbai! f66..ll.scd q pd6 .{iy viol.tiotl or S..tion 7o3l 5 by dy appticst fd ! pq ntubjccB $.appliot to . cieil larlt, of io. tn* ln8 lirc hur'dr.d .lollq {sJoo)
<br />_1, a oMd of th. Fop.ny, r my @ployd ailh q.g6 B tncir sol. cmtftlrid, witl do rh. wort ud rh.3Eucr[. it nd inrad.d
<br />or ofrd.d fd !d. ( 56.70.14, B6in@ Dd Prcf*i@ Co<t : Ttu Conr..ro.! Li.@. L.p do6 nor.!ply ro D oMr of rh. p.op.n,
<br />pho buiLh G imFoB 6tun, snd wno d6 Nch wo* hidclf c t@lf q rlEoldr hir 6 h6 om 6ptoyd, rioyid.d ti.t $.lriorovmat! e notinl6l(kd q off.cd fd !.1.. If, howd6, rt.b!ildi.8 inprovanc k loldstii oc yo;ofconpt.tion, $c
<br />OME.Blildn eill hw. th. burdo of provin8 thlr h. d rh. nor build d iDFov. fd l,h. puQ@ of s.lc)
<br />_1, a omd otd'. p.!rcny, e dcluliv.ly @oredn8 virh licdrrcd @nr&loE ro conrmcl thc proj.cr ( Sc 7044, Bsins sdPDfdio Co<L: Tn. CdE .ldt Li6& l:w .bc .ot spply ro e omd of Fop.ny ,ho buit& d imprcvo $ffi , ed whocoF&ll rd ruch ,.ojcr *nh a CoFa.ro(s) lic@d pE@t ro tn. Con!@lof s Lic.tu Law )
<br />Dd.: Or.a
<br />WORKERS COMPENSAION DECLA&{TTON
<br />Ihdcby.6imudaF .lryof pcjury@.of lh.folloqinsd..t@rioB:
<br />_t h.!c ud *ill nlintrin . Cl.tifclrc of C@s6t to S.lf,Irsc fd *6t6, mpdsdion, s !rcvid.<t fd by Sdion !7oo offi.
<br />L.bor Cod., for rh. pdforMc. of th. wo* fd phich lh. pshil ii isled
<br />_l he od will minlain wota comp.rsnionituqrucqs..{!irdbyS..lionl?Oootth.LaldCodc,fortt.Frfmseof6c
<br />work fo whicl lni! p6lni is i$Ed My wdtd!' cohp@.rio insu&e cdiq &d potty nmb6 d.
<br />Csi.r
<br />P6licyN@b( Eipirt3:
<br />(Thi! iftriotr n..d nor b. co6pld.d i( th. pqhn ir fo. Onc hodrcd dotl@ l$ I oo I q
<br />$.r ii rtc psfffie of O. wo* for whicn dit t&mir is i$u.d, I
<br />lubjd lo r,'rc wdtc6 ' cmpcn!*ion laws of Calif@is. sd lsM rhsl i
<br />@mptuarid prdidoE ofSedon 3700 of6! L.!a Cod., I shatl, fcowidt
<br />'oL
<br />WARNINO Flilur. ro seurc sort6' compcs.ri
<br />fina up to on. hu&.d thosud don@ (l t OO,OOo),
<br />thc kbor Cod., inrdar ed lnoncy'r (:6
<br />md lhall lubj.cr e nployr ro 6irii.l p@alri6 dd civit
<br />in lddilim & rh. c6l ofcompc,sarioo, dlnr€a s provid.d fs rh. Sccrion 30?6 of
<br />I h@by atlim uda Fnalry of F.jury lhd I e li.m.d unda prcviii@ of Chapb
<br />rh. Bcii* ed P6f6i@5 Cod., Md hy li.6. ir in full f(e nd .fiEt
<br />I hfrty .ffm undd p<dty of p6jEy th.l ths! i! I cdt'uciim todinS .$nc,
<br />i$ud (S@. 3097, Civ. C.).
<br />Frfodd* otlh. qork f.r which dis perir is
<br />A}PLICANT'S DECL\RATION
<br />Dnolirio. PmiB-Arb<lc Norificitid F dall lcsdadoN Gnk 40. PEl 6)
<br />_ R.qun.d Lcnr of Nonfic.rion
<br />_l c.ni6/ lnd d. fcd.r, rqularioB ..sddins sr!616
<br />.onply with.ll City &d Counry
<br />ttis Ciry ed CMly ro ara !p@ rh.
<br />2-rq-
<br />lnterceptor/ Clarifier
<br />POOUSPA
<br />P-trap/Drain Line
<br />_l m dsnpr ud.. s.ltim
<br />-8.
<br />& P.c. fd this l!er.
<br />Lddcr'sAddr6s _
<br />thar I h.v. Ead lnic.ppli.rri6 sd
<br />ad St rc tis EhrjnS lo blildir8
<br />mdti6.d prcpcrty for in pctioi
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