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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE tD/stG.COMMENTS Omd-Buildd Del&atid
<br />I hcrby afimuddpc,rlg oflaju.y$ l m cxmpr am lh. Conft.los Li.ds.liw fo rhc follovins Bd (sq. rol I 5 DBina
<br />Md Prcf*ior Cod.) A.y City or Coury *hhh Equir6 . F6il ro @nrr!cr. lltcr, itup,or., ddotish or Ep.ir ey suvcturc prior to il,
<br />i$@@,.bo r.quiB th..ppli61 fd,uch F6it to filc. siSn.d ll.rmdr lhd h. or stu i! liqr.d puBur lo lnc prcvision! oath.
<br />Cos&1ot Li6cd kw (Ch.plr 9, Comocins silh Setion 70OO of Dividon 3 of !h. Bui.s &d Prcfsion! C6r) @ dr.r h. or
<br />3hc k ddpl rhfrftoh ud th. blir f6 rh. .ll.g.d .xmpti6 .Ary yiol.tio" of S.ction ?03 I 5 by My applicel fr . pomn rubjer lhc
<br />applidr ro ! civil p.n.lry ot nor o6c thu lie hu&.d dolle (lJoo)
<br />_l6 oM6 of 6. pr.p<ty. or n, @do'6 eirh q.gs d rhcir &1. cdrpcllaim, will & th. wqt ed th. sEetur ir not inrdd.d
<br />u otrq.d fd !.1. ( s...70aa. Bwiid ad P.ofdioN cort : Ih. C@r-&tqt Lic.@ t w do6 Dor lrpty ro s Md of rhc prop.rry
<br />wno bril& d inliDB thcrloo, od who do6 ru.h wdL titudf d h6df n thr@8h hi! d hn oq dploy€, Fond.d $c !rch
<br />improvmdls e nor inltnat d o oflqld fs islc, If, h*cvd, tn. buildin8 q improv.mdt ir !ol<t within o. y6 of cmpldion, $.
<br />Own6.Builda will hwc th. burd6 of plovins $d h. d 3hc .ot b{ild d imFovc td $. ru.p@! of i.l.).
<br />_1, a oMd of d& For.ry, e aclcivcly c..t&rir8 with li.rucd @r&106 to conrEuct rh. prcjccr ( S.c, 7044. Bsind sd
<br />Prof6si6 Cod.: Tnc C@nrd6t Li6sc trw d.€ not .!ply lo & oMc ofFopdty who buil& 6 iop.ov6 thtu , srd vho6Eeri fd ruch projdt' eilll . C6E&ro(r) lictucd p@u&i ro thc Conri.lnt Li.cn& Lse.)
<br />_I o qnF d&r Setior
<br />WORKENS COM}ENSATION DECLANAT'ION
<br />I h@by afiim udc. pa.lry ol pdjury onq of0t. follopir8 &.hrariod:
<br />_lh.'!edwill@i lin . Carincll..f c.or@t to S.lt-lrEW fd w6kd, @np.n!.i6, d Fovi&d 16 by Sccliin 3?oo ofrhc
<br />L.bor cod!, ror $c psfmecc of lnc {dl fd which rhc p@ir i! isE<,-
<br />_l h.v. ud vill minl.h *dt6' c@par.d6 iBume, B rcquir€d by s€crjm l?00 oflhc Labo Cod., for thc prrmo.. ofrh.wdt fa qhich lhk pmn is i$ucd My qdtB' @mp.narie irolec! @iE dd polic, nomb.r &.1
<br />,{*o*,^^,
<br />bc @mpldrd if rh. p@it is fd Onc hundr.d.lolld {ttOol dl
<br />p6folr@.c of th. wd lor whid lhis pdnit is isu.d, Iqdt6 ' .mpoacim l.s of C.lif@ia ad aec th,
<br />compa.arion prcvi.iom ofScctioo l70o olrh. Lsbd Cod., I lhrll,
<br />WAINING F&l(@ sc.WMrt6 @ftrFNdrd @va!S. r d nployd ro dimiml pcnalrid and .ivil
<br />nn6 up ro dc hundr.d dDc d &lle {ll0o,00o),i. addirj@
<br />tlc L$o. Codc, irrc'clr sd lnoD?yt 16.
<br />, dam!96 a prcvid.d fB rc S@rion 3076 ol
<br />I LICENSED (OIIMCIqSiDEEIAEAIIO!
<br />r hd.by anm unda pa,rry or p<qu'y ri uiiEiii;ii una- p'oron ofcr,acnl;ftn.,
<br />th. Buios od Prcf6li@ Cod., od my lic6!. is in tull f@! ed .Sc.l
<br />I hfcby afim und.r pd.lty oipqjury $d tnd. is r consFu.lion todiie aemcy fm rh.
<br />issu.d (Scc 1097. Civ C)
<br />of dc wqk i,which lllis pmit ir
<br />A}PLICAIIT'S DECLANAT!ON
<br />Dmohior PmiE-A3b€rd Nolifio(o f.d.ral R.gulriod Gnl. 40, Prn 6)
<br />_ R.q!ir.d Llti oa Norifr.ado.
<br />ro comply with dl Ciry sd Co6ry
<br />of thi City ed Counry to 616 uDon tt.
<br />aboyc Mrion.d prcpdry fd irsD..tid 224-
<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 Pi perng
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOUSPA
<br />P-trap/Drain Line
<br />Main Drain/Pool Piping
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Misc
<br />Gas Service
<br />Lawn Sprinkler
<br />Sanita Sewer/Cap
<br />Rough Plumbing EXPI tED
<br />Final Gas Test
<br />FE,E U I IUIU
<br />SAMC 8-43. 2!
<br />FINAL
<br />Water Service
<br />Back Flow Device
<br />Meter Release
<br />Notes, Remarks, Etc.
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