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PLUMBING.INSPECTOR RECORD
<br />APPROVALS COMMENTS
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Underfloor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptori Clarifier
<br />Waste & Vent
<br />Water Piping
<br />Gas Pipeing
<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 />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />riiEIFA
<br />Rough Plumbing
<br />Final Gas Test FFI]t'l I ,-"n
<br />Meter Release
<br />o^Ivlu d.4:r, aN', 66e, i
<br />FINAL
<br />Notes, Remarks, Etc.
<br />Owrd-Blil& D.clE i6
<br />t hd6y.flia u&r radty of pajury thi I o cxanpl fm thc CoIE&1d' U6s trw f* lhc follaitr8 E6 (!e.?031 5 Bsir.s
<br />md Lofeio CodG), Aly City d CMry whicl Equir.r r FDjr io .@8k1 .lrq, imFoe., drnolkh 6 rplir &y rE!.tE, Fin io itri{ecc do Equi6lh. l,tli@r fGr@t Fmt lo filc ! !i8rd rtr.o6t ln, t. a rh. t licaE d pllt!@r lo $. Foviai@ otolc
<br />C6r&ldt Licd.d t& (Otpla q cdmdirs wirh sdri6 ?000 of Divid.i I of rhc BuiilB sd PDre$ioB C.dG) a thd hc cr
<br />. it qo9t d!@tm &d lh. batir f6 d'c 3[.8.d qopd6.Any lioldi@ of Scli@ 70]l 5 !y oy rppli@r f6. Fmn iubj.ca rhc
<br />,tpli6r to r civil p6.hy of n r hol! iie 6v. tudld &llr (1500).
<br />_L a oMa of $c FlFt , d my anployd will| w!96 a rh.ir sl.drFrlrion, will.Lr d!. w@t D.l rh..nu.ne i! nd inraxi..l
<br />G oficld fa ul. ( Se.roaa, auir< Dd PofBi@ Cod.: TIE C6E-rd'3 Licag t v da ro. lpply ro & om6 of dE Ftfqr,
<br />wlD buildt d imFlvd lto@, od *!o do€ ra! rdt ni@lf a h@lf d 6hgh ht 6 ha M 6nploy..d FDvid.<! $.r 3u.h
<br />imFo!!tE!! e not iiladd 6 oftald f6 3rL. lf, ho*.€, th. buildii8 d inpiolEMt it $ld *ioin d y.i of .mplcridr $c
<br />OsM'B!il&, will hlE 6. hab! of Fovins $I h. 6 .h. not boild r iDFor fd th. purpo.c or3rl.).
<br />_1, r omd of th. F!p(lry, m crcluivcly csfi.rjnS pilt li@$d @tErq! ro c@nucr $. Foj6r ( S@ 7o!4, BEinB sd
<br />amf*i@ Cod.: nE CotErcl Li6r Lry .b6 !d @ply io e Md of Fop6t, who b!il& 6 inF@6 thaw . !d *ho
<br />@relr f6 rud Foj*n wilh . cdr&ro(!) li@.d plll!@r ro rlE c6E!.1tr'3 Li6* lrw.)
<br />_l m cx4r u<!r Sci6
<br />woll(Ens coMpENSaaroN Drcr axATtoN
<br />I h6.b, !fiim 6dr pdElt, ofFjuy 6c oflh. foll inad.cl.r.!id!s:
<br />_t !lv. .rd siu rui.ui. . C6tinc.l! of C@at lo sdf'hrc fd *ctd' @@qt!ai.'o, a prcvi<Ld fa b, sc.rid l?0o ofrh.
<br />rrhd Cod., fdthc Fforoa of th. *dt frwticl' rlE Fnir ir i!u.d
<br />-l h.v. ed will @inEi. wdl6 @pa5'rion infu&c, 6 Equird by S6ti@ 3700 of rhc Labo( Co&, fs thc pdf(l]@e of $.qct fd uhich tht Fni i! isucd My rort6' cmpcnsslim iEUm@ cMia ad policy nmbd w:
<br />Policy Nmbd: E-!piEs:
<br />(Thi! 6ri@ ic.d nor bc codDlctcd if th. p6nit i! fd otr. hu(H dollffi {1100} or ld)
<br />I enify drt in th. p.rfmde of $.,6t fd phich th p6mir i! t!k4I shdl nor dploy ey p6on in uy @nFio s to
<br />b.c.m subjd !o $. wdl6 ' csp.N.rion lls of Califmia, dd agE lh.r if I should bem. !ubj..l 1o rhc wdr.E'
<br />ohpcMlid PIovisiont of Sdion 3700 of d:. LlbG Cod., I ihdl, tdrhrilh 6nply pili lh6. F!vi5iN..
<br />o",, t'-/2, /.a ' tppti@. \ ' -- -
<br />WA.RNINC: F.ilurc !o !4@ wortd' mp.tulrion @vr.AG is uhwful, ed ehsll subjar u adord 1o 6imin.i p.n.lri6 ed .ivil
<br />6.d !p ro o. Itudrld tholed &lld (t 100,00o),in ldditio ro rh. ccl of c@pa!ati6, &un g6 a prorid.d fd rhc 56 on 1076 of
<br />th. titd Cod., inrEr ed mncy'r fd.
<br />UCESE.CONISACPXIDICI.ASATqN
<br />I h4ty dEm @d.r F.lry of pcjury thlt I h liGucd u.&r F!vi.id' of chr@ 9 (clfuacirs wirh S!.tioo ?o00) of Divirid 3 of
<br />rt. BuinBl ltrd Prcfali@ C.d., Dd oy lic@ i! i! tull fdE &d .rd-
<br />CONS?IUCrIOIY ] hIIIING AGENCY
<br />I tdlby rfEE tEdd par.lty of pajEl O.! t@ ir r daarcid ladiry tq!c, fa O. FfdltllE of 6c wt f.. enicli Oit Fril i.
<br />i!u.d (S.c. 3c97, Civ. C.).
<br />APPLICANT'S NECLAXATION
<br />DqNIid@ Pqmir&Atb€tc N.rjicaio !.dd.l R.8d.!@ (ridc ,lo, P't 6)
<br />_ Rcquird Laa ofNorificrio
<br />_l clniry $c d. f.d6rl E8olatiG EE.dilB 6b6r6 tlmril e nor .ppliciuc !o 0!i! Foj6l
<br />_ I .aliry tt.I I hM od lhi. rppliodd ed ltrl $!r rh. $ov. i qm,rim il on (r. I raE to mrly rilh dl City xd Ctur,
<br />odM6 ad Sr . Llq El.d.t to buildint c@ru.ri6. ud ho$y slhod& cp6doriv6 of di! ciry ed ctut, io 6r.r uFi $.
<br />lborc m6li6.d Fo?.ny fa ialetio F!p..a
<br />.f-Zo.s"/
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<br />Word\wp5luoms\Pemit.nnsp€€ on Fo.ms
<br />DATE tD/srG.
<br />TOP OUT
<br />t" ;n*.*"td:,^l' -t/Z>f ,2.1- ,
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