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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under Iloor
<br />Buildinq Sewer
<br />Area,/Storm Drain
<br />lnterc eptor/ Clarif ier
<br />TOP OUT
<br />Water Pipinq
<br />Gas Pi ptng
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />IV ain Drain/Pool Pipinq
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Gas Service
<br />Lawn Sprinkler
<br />Sanitary SeweriCap
<br />Back Flow Device
<br />Rough Plumbinq
<br />Final Gas Test
<br />Meter Release
<br />FINAL 1 bl/+b4arz /62,
<br />Noles, Remarks Etc.77-
<br />tC--(f '1o,^,stEZIfr O- -^, Y,tilLtrm 7o'lGtt n,teuEssh,oa
<br />\ 2c,st 'or-s(2D
<br />owNiti EutI_DFiR DFtL( aRA-l-toN
<br />I hcnby rlili u crp. lryoI t^-rjury rhi I u.rcnr hnn rh. Conka.r)^ Lic!tr* b* nn rhc taftrwi'rg rc!\on (Scc7011.5
<br />Busnn\ ral Prolision Cod.): Ary Ciry or Cou ry rvhtch rcq!rc\ r lrrmir k, c.nqrucr, !hd. nnpro\c. dcnrrlsh or epd r.y
<br />!fl.lurr, lritrx, ir\ i$rmcc, rho rcqrircs rhe llptllcrnr Lr sx.hFirnir r, filon \i!iL{ {rrc'tunr rhrr hcor !h. is lnuscrl ru6u3nr
<br />h rhc nmlni(nr\ ol rrE Conrm(rn'r Li.cn\cd bw (Chrpr.r 9. Com'ncncins trirn Sccrion TlXn oi l)ivninn.l o, rhc Bu:incss itrd
<br />Itolt\sn)ns Codcr or ihir h.or\hc i\crcnrDt lhurclron d rhc bs\i\ turrhc rlldgcd c{cmpri{Jn Any!iololionotSc.rionT0.ll5hy!n,
<br />lmli.ror f.r trNnn[ suhjc.r{h. lppli.anrr, a.i\ilpcnrhyofnornrrcrhM fi\. hundrcd dottr^ (9500).
<br />-1.
<br />os owrcr ofthc prcpcn, o. ny .rlr,loles enh w!8$ s thcn sb o"{Ensdion. *ill do tlE sdt .ln 0E n@rm h mr
<br />inici&d trof.rcd for $L (Se.7044. SusiEs ood Ptofcsiors Codq Ttc Co rachis Lisrs t w docs ml spply lo !n owmr of
<br />rhc !op.'ry who boilds or allIrcB dEen. ltd *tD dB trh wd( hinc.tf o' h.Mlr or $Dush ti" or hn.w; eilpby;6.
<br />p.orihdlhar slch iqmvmnrse mr hrc,n.d o.ofrsrd for sb.Ii lF'fu. rlE l,uildinBor inplNm Ls $E virhin om J&
<br />ofonphlbn. lh. Owncl Builto will har thc hndo of |'olinB th.r hc or sh. dtl mr build or inrprow 0E !6,Ely for *E purFc of
<br />-1.
<br />I owrer of rh. llq,cny. d ciclurircly contr.crine rirh liccnsd .onrsdoB ro mnsh.r rlr p..irr (Scc. 7014, hses!Br hrft$ionCodc: Tte CofllEctols Lic.ns. Li* d@. nol !0ply to ownf of prcn ny *ho buil& or imFmws thcrcon.and who conrreh lor skh F!}rts wnh r ContEtor{, lic.rcd pu6Ml b lhc C..rdols LkcrE tjw).
<br />I iDcxc rt, untfur Sccr B & P.C. lnr dis rcasotr
<br />wof,r(Fts,coMPE{saTroN
<br />DECI,If,AIIOII
<br />I hcrcby !ffirn urdo petulry ol pdju,y onc of rhc fouowin8 dcltralions:
<br />-l
<br />lrvc dtrdwill nhn .in rCcdilicurcolco!\cnt lo Scllhsurcl'or workc cotrrtctrernnr.nsproviLdnrbySccrn,n3T0Oolrhc
<br />ljhor Cod.. tur rhc lcrfornEm of rhc sorl fir*hichrhc nqn t h\!cd.
<br />_lhatandwilltui ain wortcn comF.n$lion in,umnc.. &r oq!i&{ bySdion l?00of tlr Libor Cdc. for lh. pcrf()lmmc of
<br />rtc worl for *hi.h rhis pcmn is hsicd. My qorlGt onlPcns.tion i.suMe @tr dBt polt, runb.r e:
<br />I c.dityrhar inrh. lcraortunccofthc work fo. whih'hhtcrnl h iqsmd,I ahau mr cdrloyanylcd,n inlnynunrts rs to hrsm subjN' b
<br />'h.
<br />w(,&ds conFnrarion hk ofcalifornir, and a8m rhal if I should t com subirr ro rrE
<br />worlrcs'o'npcnsoliohpoviri,on\orSelion3TO0ofthcL{tnrC.dc.ls\!ll.forth*ith$ry,lywithltbsImvhio.s..
<br />WARNINC: F.ilurc lo Burc workcm .odpcn*rion olc
<br />civil fincs u! lo on. hundad rhouslrd dolla {Sloo.mo)
<br />lor.r lo aihiMl Fmlti.s trnd
<br />&mr8d .s pruvid.d aor ih.
<br />Sccriotr :1016 ofrhc tilxtr
<br />I2[!:I.A&!LIIAN
<br />, hercby !i_'rn undcr pcnrltyol'ncrjury lhd I nn! lians.d undcr pn!ki(n, olCh fld I (.omnrE-ins silh Scction 7Ul)) or Divisn,n 3
<br />.I rh. Busir.ssrtrd Prulc\sn,n\Codc, l nry liL.n\c i\ inTullfo(rudclttct
<br />I heeby rlfrm und.r l.tulry of r.riury rhlr rlErc is . o
<br />irsucd (Scc. 109?. Civ. C. )
<br />,sc..y rdrrh.r.ifore.ccofrhc*ort ru which rhi\ lcrnir rs
<br />AETLIQTNLDDIIABAIDN
<br />I lftby alitnr undcr Fnihyorp.rjurt onc orrhr aol!,wins dcclarations:
<br />l)cmlirion Pcrmnl^sb.nos Norin.ari.n Fcdcrul Rcs!larions (Till..l0. Pon6)
<br />-Rcqlircd
<br />t lrcrof Notiticario.
<br />I.cniryrhtrr rh. tcdcrd rcgulario.\ rcAardin[ ^hcios l3r. nor orplicablc
<br />'o
<br />rhh lrojNr.
<br />-l
<br />ccnify rhol I h,vc rcad rhir rp karion dd infomrion is.m.d. I agre ro 6nll)ly wirh .I Cny lnd C6! y
<br />odinlnccs atrd Shlc tr*s Nld ine ro bu
<br />sv. ftnriofld pell.dy for inrp.ction "uhorize
<br />rcprcscnloriv.s ofthn CilyMd Counryro cnt.r utxln thc
<br />Appliclnl or Arent Silmlu
<br />Gas-Underfloor
<br />Waste & Vent
<br />Miscellaneous
<br />Water Service
<br />$.u. '.-JLs ) "ijia,
<br />Policy Numb.r:-Eidrcs: _
<br />.-''-)
<br />c-'-"*4
<br />Pemilee mnc (prinl l:
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