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PLUMBING.INSPECTOR HECORD
<br />APPROVALS DATE ID/SIG.COMMENTS ()wN0R Irt ll,DER DUr,(,1R,\r'tON
<br />nftil'rxirrdrN'nnr\!hidcrrrlrxtrli.xtrrr)rrlrilNflrvolrortrr!crhrln.Iun(lr.ndollrr!($5rx)]
<br />-1.
<br />I owt, oalhc phrEdy. or nry .mpb)r.s wilh wr8.s as lh.t 5lc oml.nsdion. will & ltx rdt ,rd rhc srEi@ is mr
<br />inlcnd.n or of.r.d lor slc (Se.7044. Busires od Prote$iotrr Cdq Th. Cnnlrrrois Ltcns L{* dfts flor lpply ro d o*mr of
<br />rh. lmFny who lnild\ or nqlos dtmn. sd who d<Es s$h *o* timsclfor hcmlf or lhmu8h hh orhcro*, cmnloyccs.
<br />pmlidcd lhll such in{rohns s N mi int.i.lcd or otu tor $le. lf. t B(. tlt tdiuao8 tr ir{)fieftnl t eld sithin oft Far
<br />of.oopLriorl rtE Oser BuitLr qill h.w tte burdcn oflmvine rh6r h. or dE dA mr hiB or inprD* dE |,re,Ei! hr tlE l,ulb$ c,{
<br />_1. &{ o,rcr of rhe px,F.r!. .m cx.bsiv.ly conid in8 wirh li.en*d .oorr&to^ lo snmct tlE pDj6l (Sec, 7X4. B!$*s
<br />r.d Rrlc.ion Codcr The Conrrerois Licco$ k* docs nor orplyro anorncr ofproFny who blilds or imirrcvcs rh.r.on.rid *h. snlncls for s$h lroi{k wirh a C.nmco(st ltcnrc! p!^u lo the ConrBcrols Liens L!w).
<br />-lNcxcryru
<br />crS..rio. .1, &P( aitrrhi\ru{,n
<br />O$m.:
<br />.uaatr[&Si0utENtAll09
<br />DICI.A.8A.IIQN
<br />I hrvcrtrd *illnu rinr(.niltlrcoi(on\cnrr.Scll.ltr.urclartroAch.on{cr\rrtr .r\ tlnJlnlcd nr by Sc(rim l?ln o r rhr
<br />I:tr, (-odc.lor lhc pcrlnnnrncc oarhc work lirr !h'.I rhc |tnnii ir i$n.rl
<br />I hal. ,nd {ill minl,ii workos .onBnsal ion in\!ram.. as rcqlircd by Sel ion -l7m of lhc t ihor Codc, for th. pcnbmmcc of
<br />rhe w.rk ror whkn thir Frtoil is tntn. My worlcs' con{Ensllion insllec.Micr orn polky nudt r &c:
<br />in rh. p.rformikc of ih. *ork rr*httltisrrdir h issucd.l sholl nor .mploy lny F^on inonymnner
<br />h*s orc0lifomi!, and aBe. rhd itl slbuld hdoft slbj.rl ro ltr
<br />lh. lltff Codc, I rh,ll. ronhwnh $mdy *nh rh.* pmviiions .
<br />subjcct to lhc wortcs compctrslion
<br />w.tkcB' co'nrcneln'n rrovhions of Scclion 1700of
<br />WARNING: F,ilur. ro scur. workcs .onl,.nsrioi .ora6sc h unlawliil-ma *rDp<flo m-mfi,ytr ro aiminar ltBhir !d
<br />tr cfi't 4nv,<!t'^ d'tus$ f,i{lovidcd ro' rhc1-Zi c-z'O
<br />.iril fitrcs up to om huMrud rholrlnd dolltrs (Sl{D.m(). in r dir
<br />t n,|'l thc lilrrc{ie inrcrc{ lnd .r.r21.2,t
<br />^
<br />l2[lLlSrIIIO!
<br />.l rhc llr^i'rrs\ rn,lP^nc$n'ns Co,fu. trtrd trly liccn\c i\ in ln!lknrc rn(l.ll..r
<br />Cbto u
<br />-/.2?.ZO ..,",...'.'. !A Lz
<br />d
<br />I hcrcl'y ifir"r u olEnolryofp.rjuryth th.rch.snrrrucrinrkdinanlcnc,[nrhcFrfornunccorih!ro.kritrshthrhtpranrilh
<br />issucd (Scc.1097, Civ. C.)
<br />ASIIIIANI.DECLAAAII}N
<br />I ltEny {lm und., Fnolr, ollcrju,y om ofrh. fdlowinC dRladb.\:
<br />Dcmlirion Pcrn s^sbcsros Nollic.rion rtd.r,l R.solr'bns (Tnt {{).l,rn6r
<br />-RL!!tua
<br />bncr ol Norincirion
<br />:( Nruurrr^z 11 L U
<br />c,
<br />UNDER GROUND
<br />Waste & Vent
<br />WaterUnder floor
<br />Gas-Underfloor
<br />Buildinq Sewer
<br />Area/Storm Drain
<br />I nterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Piping
<br />Roof Drain
<br />Tub/Shower Test
<br />€ough Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />l\,4ain Drain/Pool Pipinq a2
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Gas Servrce
<br />Lawn Sprinkler
<br />Sanita Sewer/Cap
<br />Rough Plumbinq
<br />Final Gas Test
<br />t)I
<br />il4/trs ',tWitl
<br />Notes , Remarks, Etc.''l , --I: W
<br />)
<br />(./
<br />I h.rcby tmm undcr pcmlty of psjury om of thc followin! delmlions:
<br />Water Service
<br />Back Flow Device
<br />Meter Release
<br />FINAL
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