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PLUMBING.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS or!Nt)a allt,tlEll t Dl_cAll^l'roN <br />I h.rehy amfln unner pcnally of ncrjtry rld , rnr etc.,fl lmnr iht Contr.cto6 l.rcflse LiN tor lhe Lllosin! reihn (s{ 70115 <br />Busin.$ r Pnrlc$m codc): Any ( iry or Counry w[ich rcqtrire! 0 p.r!]ir lo coDdtucr. .x6. nqn'v.. d.mnhh or rcl.r .Dy <br />struclurc. pnorro ils issuance, nlso rcqutcs rhe.prlicmr lirrslch pem b iltasigned sartDenr rhar heor dtc F licenred ,uNanl <br />lo rh. pn,vtnnr olrhr Cd.r,rcro.! ticen*d tjw (Chirrer 9, connncDcin8 lilh Secrnn 701)0 olDiyr(,n I .lrh. Busincsr.nd <br />PF L$lros Code) or thd hr.rsh. n.r.npr rh.r.fnnn dnd rhc b.$s turrltrrllcs.d er.nrplion Anyrioltrroh.lsdri.nT0ll s by itry <br />sFrhm4lt?ftr r I{m cuhjar\rhc anlircrnr rn.'.,qlt.hlry., r{ nrrcrhr fi\. hunrl'.dJi,11tr.(\ro"r/ <br />Zl, * .**,"i't'.nn'n ny,"rrn) rnrlo!..s I' q'r-*(e rs rh.t sl. comr.hrd ion, wdl& rlk {hi( inl rh€ nrucru.c is I <br />inreid€J or.,ficrcl r,trsl.(s( 7lil4, Bu{".\iJnJ rn,rrin.nsc.de Ihe( onlracl't s l-ic.n( l,awdosd,nilytu.nownerof <br />rlEnmpcny who hullJs or inrrmrs rhtNe,nd \1yt ocstuchso*hnnr.lfurlEmell.rlhouslrhnorh.ro*ncnpn,yc.s, <br />nnndcdrh.rsuchrmprorcnms.rFrinr.ndedorofis.dlor{leI|ho(d?r,rhehuildinrorrmnnnmEntis$klwirhilr.nelur <br />.t.-.n{ldra rtu oq kr Brild( uillh,w rh. htrdm.rFivin8 rha lror lhc dd rn burkt or inr,,nnt 'tllsn ny tur fit purtntof <br />_1, NoNn.rofrt pmD.nx lhcxclusivclym dtins rirh lic.ded @nr@roar.6nrdd th. pmj.d (S<. ?0,14. BuriK <br />6nd Pot r!{ C6d.: Th. Conlr.ctol r Lic.ns. Lrw do.s mt apply lo an osn( of pmpcnr wh6 builds.r improv.e thcron, <br />6nd who conlocli f{,r sch pmJccrr wirh a Conrturo(, li..nicd ll! ufl !o rhc Co.lr.clorr LrcNc t!w). <br />_l am ex.mF und.r se!II <br />Lo Lo".*.11) <br />DECIAIAIIO! <br />I hftby 0mro und.r p.Mlty of!4ury on. ofth. followins dtclelions: <br />-lh:rer <br />lsrllnr'nrxinaCcdrn.flrofConscDrtuscliltrsrtrciorsork.rscotrT.nsrrnJ.,rrptr,lidtdlorbys.trionlT(l0oarhc <br />Lnhor Codc, nr rhe rslhm$ce.f rhc *ork ftt wh'ch rhL l).rm[ n {cu&l <br />I haE snd will nainr.in pork.d coqEmarion iN!mnc.. 6 ..q!iEd by strbn lT00 of rlE Lthor Cod.. for lh. pdfo.rrrse of <br />the *ort fo! *hich this pcdil i3 iNEd My worlf, Fmp.ndhn ln{atu. cmicr dn nolicy numbs ec: <br />Policy Numbc-Ext'ires <br />-l..n,Iyrnar,nrh. <br />!.rformm. ofrh. vo* aor whrh rhis n rmn is iss.<|. I sh,ll nor .otloy .ny !cm. in anyn rc. <br />m .s to b€em sb].cr lo lhc triGl hmr.nqlhn hB ofcalaomia, 6nd rsE. rhal if I stFuld b.se sbj..l ro 0E <br />w*c6 onD.nsfllion pmvisiotuols.cri.o 3700 ofrhe lrhor c.d.,l shll,lodnwirh comnlywilh ttFspovisions <br />IVARNINC: |.ilur. to sur. srk s' omp.Mlion ovds. h lnlaq,tul. .nd rh,ll sbrcl er oplorq lo simiMll.E[i.5 and <br />civil finca ur ro on. hu.drd llDu€.d dotlm (ll00.o0o). in,ttdnion ro rlE coi ol comp.nstion, .t tug.s t. povid.d aor th. <br />Sdion 10?6 offi. Labor Cod., inl.r.( !.d allonty i <br />FeJro,"n, / - /9170 Zo ^*9q/<s e? <br />r ri:I rw:rr rtn uurr_r <br />DICI.AtrAIDN <br />I herehy rntn und.r p.Elryolp?rtury rhd I .m n..nkl utul.r Drovision olchnFld I (snmerrns *[h s€t.n ?001r) oiDivknn ] <br />ol rhc Susincs, .nd Pmfcssions Codc, afi! my l$c.sc n in []ll i,nce dl elf(r <br />l-ic.6.. clsr <br />-Liccac <br />Nlmll.i <br />CONS'I'IIIIC'!'ION Lf, NDING AGf NCY <br />I h.eby amm und.r !.Mny ol p..ju.y rhat th(. is n con(ruclion ledins cgcncy lo. rh. pdfomnc. olr hc trn* fo. whi.h rhis Fm'r 6 <br />6{td (s(.l0r?, civ c ) <br />aSfugANLD[CLrlEAIlO! <br />I h.e$y alI@r undo pdaky ofr,.rlury on. of lh. folhwin8 ddlaEt ions: <br />Dcmlirhn P.mns Arh.rto{ Norili.anon i.d.6l R.Snbrions ('rnlc40. Pan6) <br />-R.quiEd <br />L.trtr olNolinerirn <br />-l <br />c.n iry rtdl th€ Ld.El aslln! io6 Egrdos a3h.n.r Emohl .r. m' inDlic$lc to this PoFr. <br />lrfcdr' I (hd I hk Edd lhts ,pplrartrrn arxl $ar. rhd rh. sh)lc rfomulion * cordt I aBB ro smDry wnh lll Cny rnd Counry <br />dfu'Mnftc.nd srsr. Ij$ FLr,ns h burldrns coNrucrnl\ and hcr.bya(ltrria r.pE.nlariv.s .f rhis Cny tnd Counlylo 016 !l(.llE <br />ah.r€ menrtnEd lmpeny litr inspe.rtrnl <br />Appllcrtri or ,\Brtrr slsnh.u a.a9 2o?o <br />Waste & Vent <br />Water-Under floor <br />Gas-Underfloor <br />Buildinq Sewer <br />Area/Storm Drain <br />lnterceptor/ Clarifier <br />TOP OUT <br />Waste & Vent <br />Water Piping <br />Gas Piping <br />Roof Drain <br />Tub/Shower Test <br />Rough Water Heater <br />POOUSPA <br />P{rap/Drain Line <br />Main Drain/Pool Pipinq <br />Pool Heater/Gas Line <br />Miscellaneous <br />Gas Service <br />Water Service <br />Lawn Sprinkler <br />Sanitary Sewer/Cap <br />Back Flow Device <br />Rough Plumbing <br />Final Gas Test <br />Meter Release <br />FINAL a '6lzo Dh.nn a .f-r'1 <br />Notes, Remarks, Etc.rI <br />UNDER GROUND <br />Fill Line/Back Flow <br />E <br />LetrJcr r <br />^Jdi.{