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APPROVALS COMMENTS O,E-A{il(b D!.lraia
<br />I ha*, rfrm @rla F..lt, orFjury dtn I d dnpt fm tL cdE cc' Uc.c ln fd th. follNins r@ (c.?01] , Baircs
<br />ed Ptufaid Cod.): Aly City d Cajly ,nicl! EquiB . Fmil b .@nrEt .ltr, inFovg dholilh d EFn &y 6Eluq Fid io i!iMc.,.l& EqliB lhc lrplior f6 ru.b prmil !o 61. r rig!.d rt ratrot rl'a h. q rh! is lica!.d Fd@n b d. Fovidc ol0!c
<br />C@trddt Lic@&d Llw (Ch.F6 q cofficii, enh sedd ,000 of Divino 3 of 6. Auina ad !.ofdi* Cod.) 6 rl'r h. a
<br />3lE tu qdp. rtr@lilo &d rtc b.rir f(r O. sllcScd dEllDlia .Any nol.dd .f seti6 ?0! 1.5 by ey .pfli{t fd r pdni subjeE dE
<br />lpplic.rr to t civil pqdry of nd re iha liv. ho<H .loltd! (1100).
<br />_I, d om6 of thc F!'pqty,6 trry arrloyd silt xla6. dho. sl. cdnpqarjon, will.b Ih! wort lDd ln.5tudc ii .d hrqd.d
<br />d ofr@d fa $1. ( 56.7@4, Bui!* ed PrDl6i@ C.&: Th. Cdt-la! UclE L.w.b€ nd +ply ro a (mq of $. Fop6D,
<br />sho b{ie d imFDv6 6ad! &d who &6 tun wo hirelf a hdclf a $e8h ht 6 h6 @! an lqrcd Fovill.d lhlIiu.t
<br />inFfl.,Mt'e noti ad.<l s oftqld f6 rdc. If, hqd6, ln. bqildi.8 or i3prcva6r ir rokl ri|nin o. yd of 6Dlaid, lh.
<br />OMa-Build.r vill he thc hlda of prwins lh8r hc d rh. not blild d ioFw. for rhc F,'po.. of t l.).
<br />_1, s omq of $. Fqciy, D qcluiv.ly dr..lh8 pirt lieE d 6t&lm to cNrucl di. FDjdr ( Se. 7044, Bcinc ed
<br />?Ef6i@ Co&r Dr! CoEElort U@E ta.t6 roi rprly to r oMa of FEDaty who buil& r iftFov6 thtu, sd *ho
<br />6tt.n f6 3u.h p@j..n wirh . c@trr.lo(, li@cd Du!!@r ro r[. c-t !.to.t Li@s lrw.)
<br />_lh.Ihfl@it s..ri6 .B &Pc. fad iBo
<br />\ Ofu<fNS COMPENSAIIOII DECI {RAIION
<br />I hn !, !frm udd F..ty of rdjury 6. oflh. follNins d..l.rrja.
<br />_I h&. ed eill roinidn ! C6ti8o& of CoMt to sclf-I,!@ la wdt6' .@Fa.rio, a povid.d rc !y Sei6l70o of 6c
<br />rrb.r Cod., fn rh. Fftu* of lh. *ci fc whicl rn. Fnn ir i$r.d
<br />_l h&. &d ?illminl3in wctd' c6po!.ti@ iBudc.t a GquiFd by Sed@ 37Oo of lh.llbq Cod., frit. Ffor]r.@ of 0!cpot fq vhi.h 6n p6nit ir bu.d My qdtd' @nFBo,6 illllfue 6i6 &d polic, ,Mhs e,
<br />_l 6dfy lhll in dt. Ffolm@ of thc rat fa which lhi! Fmir t is&4 I ddl !d qrplo, Dy FH in tl, ltler o d iohdr .u!j.c to ll! edta! ' mpqsdi@ lm of C.lif@i., dtl lgrE ln, il I rluld bcc<4 $bj!.r to dE *at!i!'
<br />cnrcnllid prcytid of S.sic. 3700 of tic L{ba Cod., I .lrdl, fa6,ilh dlply wid! lh@ Fwi.iN..
<br />D,,., 5-/2 / ^pdt6t ----V.-/ j
<br />WARNING: I.il@ to r..w w6rE ' .!lnF stio @vargc i, lbletul, &d il$ll $bjet e dd.ra io .tinind p@dri6 ud civilfi6 lrP ro oi. tu.lnd tholt rd.bll&r (1100,000),ii .d.tiri6 r.rh.c6lof6iFnrid', &h.86! F i.ld fd ihc scal6 3016 of
<br />rh. rrldr Codq ir!@tl 6.1 .rldn r'. fd.
<br />UCIXiED.COItrBACI9XI.DTCIJaAUqI
<br />I h@!, .mm ud6 padq of Fjury tn.l I D liqrd odd Foviri@ of C[.pta e (clmaciD8 silh Se!@ ,000) of Divkio 3 of
<br />rtu Bqind ud Ptufeitu Cod., ed my li.a* i! in lull f@ &d .fIcct
<br />.+-/4 ,/D /
<br />colllslauclloN LnYnnIG-AGEracY
<br />I td!t,.rld urd6pd&y ofp.'jury dta U.r! i'r.. rlrndi(rt Lodiot.a.n!y fn AcFfre ofd!. wdt fariich fiir Ffiit i.
<br />iEr.d (s.0. !0r?, Civ. C)
<br />A'IIJCA\I'IS DBCI AXATION
<br />DaDliri@ P.tmil&Alb€td Noriic.rid F.ddd R.8ulritu (Tid. 40, Pm 6)
<br />_ R.qdFd rds of Notiicrtid
<br />_l @niry d, d:. f.dd.l E8ulalj@ E8.din8 ab6lc llmval e not sppliclbl. to lnii pojEl.
<br />_ I 6d& lh.t I h3vc dd $i3 epli..ri6 &d 3la. O.I ti. alorc hfmtlim b c6!.t- I !€c !o ffiply witl dl Cit, &d c{ty
<br />ddiM6 md Shr. hB chtiu to blildinS c4r.iEli6, od h@ty uddt! EFBardiv6 of thi! City ad Csnry !o 6r.r upoi lh.
<br />obo* lMriaEd FlF fdidpcti@ pupda
<br />^4licla.o:qqt,is.,-y')'p,tc i-zc 'al
<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 />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 />E\/EIIET =FrRough Plumbing
<br />Final Gas Test
<br />Meter Release
<br />5 556, 667
<br />FINAL
<br />Notes, Remarks, Etc.
<br />-hsp€.:{ofl Forms 03.31.06
<br />PLUMBING-INSPECTOR RECORD
<br />Roof Drain
<br />PolicyN@be Erpn,t:
<br />-
<br />Gti! Eii.. n d not b. dlDld.d if thG Fmit i. fd On f'edtd dolle ltloo) d ld)
<br />t ada". Adtr.: _
<br />DATE | !D/S|G.
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