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PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE to/stG.COMMENTS oWNTR AI]ILDER DELCARA'I'ION
<br />I hcr.hy itftm utrdcr pcnllly ol pcrjury lhrr I rD cxcmnr In)nr rhc C{nnru.nF l-icci\c llw ntrrhc k,lhwinB rc.v (Sc.7(}11.5
<br />a!\i'rc\\ rtr,l Pnna$i( (inlo): nt Cirt or Ci irt shich rcqri'c\ . pcnnir ro .DtrnnEr. rncr. irynrvc. dcnnlish ,tr rcnrn Jtry
<br />{ .turc. [idro irs isunmc.0ho rcluncs rh. rlplicinr lnr nrh tj.nnirto fi].r \irncd (aremnr rhll hco! shc n lccnscd fuFurr
<br />t, lhc pfl,vni.ns of rhc Conlrrckn s t,i.en*d lr{ lchlprcr 9. (irn'Nncnr! sirh S(rn,n lux) of Divr\ion I .l thc ausnrc\s 8trJ
<br />Profcs\nntrCo.)orrhrrh.or\hriscx.r,ptrh$.!romrndrhrban\nrrhcrllcgcdcxcnUir.Anyvi,nnrnrol'S(li[7).rl lhyrny
<br />!pphcarlirrr nirsuhlR-.r\rhc a,rplicint l,' r.ivrlpcniltyotnnlnrrcrhln fivc hunJrcddollars(S5(I))
<br />L $ owncr ol lh. poFny. or my .oplorrcs wnh s!g.! a lhci. $lc cofrr.nsalion, *ill {k thc wo* {d tlt sEan@ is mt
<br />inr.nd.d or ofrdcd for sL (Se.7O44, Busimss &d EDf$sions Codc Th€ Cona.dm s Ltcnsc L.q (t6 Nr roDly lo in owno of
<br />lhepreFny wh. hikti oinp,bBrlE6E arn whodG ch mrt hireror h.rclfo. trmuah his or rEr ovn ctrlPlorNs,
<br />Fovid.<l rhil i&fi imroEm.ts @ hr iircrxl.d qoftcd lor slc. lt tneq. il! hildog or i,{,mEml b $ld wihin oE ).s
<br />of conpLrioll. dE Ogftr Buib.r will h.w tlE b'irkn of FDving 1h"I li or sh. dn d bitd c iryow rhc FDIETy fo. rlt Fo.po.6l
<br />-1.
<br />$ owmr of rhc pmp.ny. am crcbsiwly conthcrins uilh liccnscd contturoN ro coosrDd tlr pojco lse. 7014. Bu.irc$
<br />rrd Prof*rbr Cortcr Thc Cootrdctoas Li.ens. ks dns rcl opply ro m owncr .f prcp.ny *lD buildr or imptuws lhcrcon.
<br />rnd eno conr,!.rs aor such psjccrs ,irh 3 Conhcror{s) li.rns.n puMnr ro rhc Co 6.rors Liq* llw).
<br />-l
<br />ameicryt undcr Stlion-. a &
<br />",G42/-
<br />I ncEhy !flnm und.r pcnally oipcriuryonc o{rhc lollowir8 de.-l urbns:
<br />Lnhtr Ci r,lnrrtu Porloflnrnrcrlrhc *o lnr Nhrh rlt !rnn( '\ A{r.d.
<br />_l h.vc lnd *ill minrain *oll(cc comDcnslr ion in\orarcc. er rcquircn b, Ser ion :l7m of rhc Lrb., Cod., for lh. r,.rloMc of
<br />rlE work for whicn lhis ll.mn is t{cn My worl(6 onwtrerion in\r@ .arif srd Fllty numb.r m:
<br />_l.cnify rhf,r in rh. p.rliirEtu! 6frh. work tor *hkfi rhis Nnrn h iqsucd, ! shrl I nol .nrl,loy a.y IEBon in any mnNr
<br />e as
<br />'o
<br />tEsB srbid
<br />'o
<br />lh. wrtc6 omp.nsrl ion laws ofc.lifomi!, lnd aBrc lhal if I rtnlld tic.om slbiil ro th.
<br />wo*cB' cotrqf,nsalion pmvhi.ns of Sdion 1700 of lhc t inr C.dc. I dElL fonh*ilh .or{,ly silh ihor lmvirions..
<br />WARNINC: Failur. ro scuc wolk.tr sqrcns0lion coBnSc is utrkwful, snd shlll subject an cnl,)loltr ro.rinurl Fnlrics and
<br />civil lin.s up ro om hundEd rhousnd dolla (SI00.000). in addilion lo ofcon{rnslion, drMgcs dr povid.d lo, {hc
<br />S€rion 30?6 of lnc l:bor Codc. inlcrcsl and arlomy r les.
<br />D,t , g-a /- /F
<br />^PPt-
<br />t
<br />Contrctoi-
<br />coNirru.q )NlJiNDt!(;_dti[lil.I
<br />I hcrcny if&or utrdcr Ntrrlry.rp0rjury rhlr rh.rc i\ r consrrucrirn lcndir8 rsrtr.y ru rhc |frrorttrs orrlr sork lor which rhi\ IEnni n
<br />hsucn rS... :ll)q7. Civ. (: )
<br />AIIIICTLNLDIILAf,III0N
<br />I hcrc5y dlt'n unlcr |Enilry of t)crjury onc nlrh. foln,$ing dc.ltrBrnn,\
<br />ocnnliri( r P.,tr1irsAsb.{os Norilicrrion I;cdcrrl Rc8uhrnnrs rTirlc,l0. PnnC)
<br />Rrqtrt.d lxncr of Mrih.di(rr
<br />I clnilyrnd rh. tcdcrll rcguhrion\ ruglrding Drh.no\ rcnDulsrc nol arpli.ahlc (, rhn l)n).jc.r
<br />I ccdily thlt I h,v. r.ad rnh $tli.arion d st0rdh0t rhc abvc itrfonmrion k .orc.r I 0EN ro @nrply wirh all Cnt ud Counry
<br />ordi..rccs ad Srar. kws El,linS ro h{ildinS h.rcbyrD'horn reprcsc olivcsof lhhCitylndColnryroc.lcr!I!onth.
<br />,bow ftmiomd pmFny for iNtsrion
<br />Appli6nl or AA.nl Sigrdlo
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor
<br />Buildinq Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Water Piping
<br />Gas Pipino
<br />Bool Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />P-trap/Drain Line
<br />Main Drain/Pool Pipinq
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbinq
<br />Final Gas Test
<br />Meter Release
<br />FINAL 9-24.t0.))clil 'w
<br />Notes, Remarks, Etc.
<br />Waste & Vent
<br />POOL/SPA
<br />I hcrcby atnn! rndcr pcnllry ol p.rjrrr rhdr I d lidn\.d u.d( !r'$n orChupr.r 9 (.onnm.cnB uilh Scdion 7O0O) olDivnion l
<br />of lhc Busircs atrd Pmlc$ionr Codc. arn my liccne t in flll rbN and cfi(l
<br />kdd r A.ldrcs:
<br />-
<br />Pemilcenom.(prl ):7;T F-)r-<t
<br />I
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