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PLUMBING.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS ()\v:!iIiR ItttI_I)DR t)t.],( r\ Rr\ t't( t\ <br />I hcrcby afltm und.r pcnalry ol Frjury lhol I m .xcmpt fon rhc Co r"cro6 Lhn$ Llw for lhc fouowine ca$n (S.. 701 I 5 <br />Busincs ad Pmfcssion Codc): Any Cir, or Counry whth r.iuncs ! pcmir ro onsrucr. ah6. inll)ovc dcmlhh or Epan my . <br />studuE. ,.i,r 16 it Gsu*c, d$ E{tniEs rlE upplker for s!.h ltrml b frlc a si8rcd ed.ftd lnil hc or shc is licensd pur$oflt <br />ro rhs pmlisions of rhc Conlncrols Lice.sed Llw (Choprer 9. Conmming wnh Sc.rion 7mO ol Division ! oflhc gusincss lnd <br />P&rcsrioni Codc) or lhur hc.r ihc is cxcnpr rhcrcion,nd $c h8h for rhc rlhg.d .,cmprion. Any tiohlion ofscclio. T0ll5 by any <br />sppli.anl for r p.rmil subirls lhc ap,rliconl lo . civil p.n.lly of mr mr. lh.n fivc tundrcd dollas ($5m). <br />-l- <br />a\ owner of rh. pmpcny. {tr my cmplorccwirh *a8cs r\ rhct $L co'np.nsi n,n. qi[ & rh work d rh. stnuurc is ml <br />idc'{tcd oroflcrcd f{relc(S( 7044. Bu(in.\(rtrd th,lcisnm\ Cdlc: 'I h. ContNh s Li.cnsc t wdocsnol0nplyro!nownrrol <br />rhc Fopcrry *ho buikls or i,qrr'rc{ rhcrc.n- un *ho des nEh so* hinNcllor h(sclf or rhoo8h hi\ or h*.$ncnltllolc.s. <br />0nrvidcd rhd \u.h irytuknr r\ d. n nfcnd.tt oroltt(tl rbr sL ll now.rar. rlr huikhrs or irpiovcn. is rold wirhr nnu JrJr <br />ul ..'q'Lrior rhc Owncr Buil&r *ill huw rhc buidcn of pniint rhd h. or shc dit br build or in tuv. rhc nn,try fu rlE p!tF{ of <br />I. d o*ncr of <br />'he <br />tmFay, 16 crctusiv.ly co rerirg wiih li..nsd co mroN ro onslrucl lhc Proie.r (SN 7044- Buirc$ <br />lnd ProlLssbnCodc: Thc Conrrmlols Li€cnsc kw d@s nol apply to u owmr ofrop€ ywto buildr6r inDrolcc rhcrcon. <br />rnd who conr6.rl aor su.h pDicd4 wilh . coom.'o(4) lienicd puFudr ro rh. conra.roas Liccn* tj*,. <br />I en cxcnDr xod* Seriob . a. & P.C. for $is rcasotr. <br />l)rrr r}\n(r <br />laatrE8s:coMEElsArloN <br />DASAf,AIII]N <br />I h.rciy am.m und.r p.nally or pcrjury orc of $. followinB dslamlions: <br />-l <br />hdc Mdwill nun rir 0 Ccrl ilE,c ol Conr rosclf.ltrsurclorsorkcn conDcnn ion-$ p.ovidcd f{, bySern,.l70oolrhc <br />litxtr C.dc. fd rhc lf,rfoarr.. ol rhc work li, shich i h. l[mn is issucd <br />,l havc md will m.itrlain workcs com,'.nsalion insuEncc. 0s rcluncd hy Salion 1700 of lhc titi.r Codc, for rhc pdloruB oa <br />thc sorl for vhich lhis Fmir ic Lr$cd. My workBs orp.ndion insuma cMi.r un ,olicy nuhber @: <br />..Elat+ trunl <br />q 4 r3st <br />-l <br />ccniry rh in rhc Frfortume of fi. *ork tor whth lhis rrmir is i$ued. l shall nol .mploy .ny pcr$n in ony mMrcr <br />e as ro b.com $bif,r 16 rhe workcs .om,'.nsaiion hws ofcalifomi{. and.ge lhal if I sl'ould lE.om subncl lo r <br />wo*c.ooFrsarn,nnovasioniolsNrion17006frhctlborCo<tc.IdDll,fodh*ithsmplywilhtho$pmvGions.. <br />WARNINC: Faihrc lo soE *ortcn' smpcns0rion mvur.Ec is u.loutul. nnd shall subjcct an emDlortr lo 6ini4ol l*M[ics ud <br />civil flncs up ro onc nundrcd <br />'houslnd <br />doll6 (S|oo,UJO). in lddnion to rhc cosr of comrcnsario.. dlmscs * r,ovid.d for llE <br />S€rion 30?6 of thc ljtnr Codc. inrerc( lRl <br />u.. {. l}c I I 5< <br />[[CtAIAIION <br />I hcEby rmrm undcr r.nlliy or Frjury lh.l I !n liensn udcr Foli\ion olChuplcr 9 (comm.cin! wirh S*rkn 70ilo) olDivhio.l <br />of thr Busiftrsand Pof.e*i.nsCodc, md my liccnsc h h tull fd.c mdcftel <br />tal'tq3G <br />COIIIAIJqIIONIENDIN(i.AqE <br />I hcrcby rl lth undcr Fnahy ol perjury rhot lturc [ ! oNlrudion bndinS r8c.cy lhr rtc Nrlornunce of thc sork tor whi.h rhir Fmril G <br />h\!cd (Soc 3(n7. Civ. C.). <br />AfE[:rINl-I]rilL A{UQ! <br />Iluthyxlln rrndcr nciilry olt)crJry.trc.l rlr l('ll,)$i'rt d.rhnrtrN <br />l)cfn,lirnr Ponnir\ Asn no\ Norlicar()n lt,lcrrl R.gulxri(in\ rTn1c J0. Prn6r <br />R.qtrn.J I crrcroiN.ri,icrrion <br />-l <br />ccnily rhal lh. fcdcrsl rcAulations rcEordinB oshc osrcmwlee notlpplicahlelo thh pojccl <br />:41 ccn iay Ihar I halc rcad rhn applic.rion ud (arc rhor rhc obvc inlbmtnrn ir comcr. I .8M to comnly *ilh nll cily and counly <br />ordinances and Starc La*s rlrrinB ins consmdion. urn hcrcbyaurhtr@c rcprc*nrdrivcs or(his Ciryand Counrr lo cnls uFon lhc <br />atsrc mnlioncd rmFny <br />UNDER GROUND <br />Waste & Vent <br />Water-Under floor <br />Gas-Underlloor <br />Building Sewer <br />Area/Storm Drain <br />lnterceptor/ Clarif ier <br />Waste & Vent <br />Water Pipinq <br />Gas Piping <br />Roof Drain <br />Rough Water Heater <br />POOL/SPA <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 />Rough Plumbing 1lz/rz ,ttG\ <br />Final Gas Test <br />FINAL 1/t<//ts qdt <br />Notes, Remarks, Etc. <br />TOP OUT <br />Tub/Shower Test <br />Back Flow Device <br />Meter Release <br />t <br />-," xfrblrt----r--- <br />-------T------ <br />It-