|
PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNIi* AUILDER DIiLCARA'TION
<br />I h.rcby !fltm lndcr pcnrh! ol Frjury lhar I N crc'nI ltun rh. Coftrrc!)n LiccNc tiw for thc loilo*ir8 rcrsotr tscc.7oll5
<br />Ilusinc\s 0d Prcrc\sion C lc) Atry Cir! or Counry uiich rcqun$ r Frtrril ro onsrrud. 0lrq, nnp()vc. dcnn,lth or Eplt ifly
<br />sru.rur.. ,tri,k, ir\ t\udc, aho rcqun.s rh.]nrlicanr ntr \uchrcmir nr nt a \isncd ($rcnur rhd hcorshc is liccnscd rrFurnr
<br />b rhr provist'n\ ol rhc Con'lacrors Liccnscd ,jw (('haprs 9. Commcn.in8 *irh Sccrion 7(x)O of Division I or rhc ltusinc$ trnd
<br />Prcfcsrn,nr Gdo)orrhrr lfor\hc N.rcnrfl rhcrcrflnh d
<br />'hc
<br />h6i\ to. rhc lllclcdcrcfrprion A.yviolltionotsccrionT0.ll5by ny
<br />lpplic$ ntr a rDxnit subjc* rlr rppli.rtrrlo r.ivrlpcndlryol noi rnoBrhdn livr hondrd doll*s(35m).
<br />-1.
<br />rs own.r of lnc pmFny. o. my.ryllores sirh wrgci ds rh.n n,b 6n{Ensarion. {ill do rmrk!d 0E fier@ is mt
<br />idc'ikd o oficrcd fu slc (56 ,044. Blsincs and Prof6ri.ns Cod.: Thc Clnrmlols Liee t w r!..s ml +ply lo sn owmr of
<br />ln lmpcrly who boilts or hphE ltEs.. atd who dG nEn w* himclf or hcMlf or rhmt8h hh o. her oqn cn9loy..s.
<br />lrovid.d thdl ru.h iml,.o\emorte hl hrcnd.n orotu Lr slc.It ho*!w. tlE buildin8 or inp6m.r i! $ld wiini. om )eot@n\t bIl. thc O*E Boi]:ld vill hlE lhc hodd of |,lving lh,l lE or r]* dil mr hild or inpmw the |,oFty lor f, nurFsof
<br />I, N 6w.er offte lopcny. um.xclusirclycontnclins with liccnrcd controcron ro oflnEd tlr ImFt (Scc. ?044. Bu\ims
<br />and Eoftsim Cod.: Th. Conhcror's Li.cn* lf,w doc. et q,rly ro d owncr of l)rop.ny who blaldi o. io,,r6h{ thcrc.n.and who onlfi.rs f(r $ch pmjsrs wirh a CbntEcrodI liccnsd puN$r brnc Conrrocrois Liccnsc tiw).
<br />-l
<br />m.rcnfl undcr Sccr It &PC fi,rhi(rc,$n
<br />MAI(U&I]TAUIf,N/UIAN
<br />DEl;l,rLBrtIl0N
<br />I ncrchy !lftn utrdcryD0rxyol lujury orc ofrhc tulkrwins d..hainntrl
<br />ll[vc ud slll unnri'rrCdir(rrcofCotr\cnrn,Srllln\urctnr\ukcr'con,Nn\rri{)n.r\ f0vidrd lor htS.rrn,n 17(X)ofrh.
<br />L'txtr CoJc. ntr rhr pcrronmmr olrhc {ork tur shl.h rhc t-..nn[ r i\suctt
<br />_l n.v. lnd will minloin work6 .oryrnsarion inruraftc. &\ rcqlncd by sNrion l70o of rhc txb6r Gdc. ro. rhc FrfomEr@ of
<br />Ite srk for whtn lhis Fmn is iss.n. My work6 ompcnsdrion insurlncc ceifi drd lolicy .uEhtr ml
<br />l .cniry lh{r in rhc pdrormec .r rh. *ork t6r *hi.h rhis lcrnr k n\ucd. l shlll not cq'loy ,ny pcron in dy mdnnf
<br />$ !s ro bccom sul,jd lo thc *orlcB' .onrlEns.l ion laws ol Crlifomi!. ,nd ngm .h,{ ir I slbuld bcco,E sxhicd to rhc
<br />*odsl comFnsti.n ,rmvhions .l Sdior l70o of lh. tntbr Codc, I shrll. fonhwirh strply with rho* pmvi\ions..
<br />\lARNlN(;: l;rlrtrc r, \..urc sorkr^ ro t)ctr\n on
<br />civil lincr xp k, otu honrlr.d rho!\rnd dour6 ($lq).(xD,.
<br />S..rion 1076 of rlr lihr Codc. n crdn md diormy \ lccs
<br />nion ro rhc cosr of cotrtl{
<br />I hcEby lffirn undcr pcmlty of pcrjury ltul I trn lionsd
<br />ol rh. B$incss d Pn,lcssi,nc Cod.. rd nry li.cnc a\
<br />n ofchrl)ln 9 (orlmnci.g wilh sccrion 7000) of Divnion 3
<br />I lrcnhy rinnr trtr(ld Ftrilryflt*rlury rlx rh.rcilron('tur
<br />\u.d rscc l(li)7 Civ (' j
<br />4cncv lnrdL Nnnnnrmcotrlt sork lnr whrhrlis Nmir tr
<br />AETUCANLDICLAEAI]ON
<br />I lrEby rflinn undcr ncnohy o, prriuy onc ol lhc lhlbwnrl dc.lahrionr
<br />lXnmlirion Pcrnrir$Astf,{o\ Norili.al r r{d.rrl R.eulrltunr (Ti(lc.l0. Pr'(,
<br />-Rcquncd
<br />Lcxrrof Norili.{idr
<br />I edifr rhrr rhc rircrulrcsullriotrs rsudinB astf,(os,cmvllarc not lpplico$lc ro thi{ pmjst.
<br />I cdilyrl l hrvc r. rhisrrpli. t'n {arcrhrr rhc *xNr infoimarnn, i\con..r I age t, c.mply sirh all Ciry rid Cou r!
<br />odtrEmcs 8nd Sr0rc Lxws rchring robui ot rhir Cir y and Counl, ro cnr* uFn iE
<br />,h,vc nr.rt'ncd Impcny aor inspcci
<br />Appliconl or Assnl SlsMluE:
<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 Piping
<br />Roof Drain
<br />Tub/Shower Test
<br />Rouqh Water Heater
<br />POOLiSPA
<br />P-trap/Drain Line
<br />It/ain Drain/Pool Pipinq
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sa nitary Sewer/Cap
<br />Back Flow Device
<br />Rou gh Plumbing q r(A,*.<.l 7,>)
<br />I Jt
<br />Meter Release
<br />FINAL lo lo K<ql41^yt\'€J49\r:Notes Remarks Etc
<br />UNDER GROUND
<br />Waste & Vent
<br />Miscellaneous
<br />Final Gas Test
<br />unIslul. rtrJ \h]ll {rht(r ai
<br />me,"r
<br />I
<br />I
<br />=
|