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PLUMBING.INSPECTOR RECORD <br />DATE tD/stG COMMENTS OWNER BT]ILDDR DI).CARA IoN <br />I h.rehy a mrn' undcqEnalry or Frrory rhd I m .r. pr rroi rh. conradom Lic.nsc Las Int rhe toll.wn'3 rsN)n ( ss 7a.l l 5 <br />Busrn$c nnl Ptul6non Code) Any Ciry or CouDly (hrh rcqurEs . ,snnl ro condtucl. .l(c( 'nrthvc, <br />d.nmlish nr nnin ntry r <br />srucrure. p.inr. ris rssxrme.ilsrcqureslheappl'c.nlf{x{Gl,nemirofil.a$3n.d$ar.'n.rrlu'hcorsh.nhccnsednursrd <br />b rhc r,n*i\ionr .trlp c..mch.s t,iccnsd hw (C,mntd 0, Co,nmencins trirh seclion 7000 of Drrishn I ollnc Busirr.ss rnd <br />l'rulcsione Code) or rhd heorsh. n.remnlrher.frooandlhchnsn tu rhcallcB.dcro on nyrnl.ti,,nolS.ctiotr701I5hyrny <br />.lphcmr fora Dcmir suhjcls rhc lptlica.r t,3cililp..rlryofnor tu,Rrhan fie hunded dollns (55001 <br />_1, s oRF of t. pop.nt or oychploFs pnh *asB a rh.t $lc ootr.trelioll| silld6 rlE wo ddlltrnd@i{mr <br />inl.i(lcd or o,IcEd for slc (Sd 70{4, Blrin* .nd Pmldsioni Codq Thc Con|[.lols Lic.n* Lrs (h.s nol sl,ply to .n ow6r of <br />rh. lhrdry wts hil& or ir!,mB dEEl\ r'd wh. &.s sch $bi{ hiN.lf or tr.Rlf or llmlri hi! or hd om .nploy..s, <br />provid.d $ och imrmmnts oE mr int.ded orofliftd t r sL lt lh$@r. rh. hildilg 6r idpmwtrd t sE wnhin oE Fr <br />ol6nlplaio.! rlE o$mr Build.. wiu IeE tE hor&n otpmvii8 tld hc or $c di, ml hiild or inoo\t lh. ler.dy 6r th. I,urlrE ol <br />I, Bown.rofrh.Dmp.ny, amcxclsirclyconttucrins wirh licetr*d conrmcr.Rto mnsirud lh. pmjet (S(.7044, BBmdr <br />lid PDGsih Cod. -l'h. C.nlnctor s L r.n* L.q dB mr .|)rly ro an owm. ofnnpcrly who [uilds or iotm]s rhdon. <br />rnd who contmdr for ruchrmj.crs wirh o coitmdong) lic.N.d p!6uinr r. rh.conrr..lois l-rc.m. Lrw). <br />_l am .r.mpi und.r S{lio <br />uoaf,EBtrtor4tDltallaN <br />PESIi/TBAIION <br />I kdby lmd undd r.ehy ofpdiu.yoe olth. hlbwors &chnrioN: <br />I lEv. o will minrain ! Ccnif@t. of Consr 16 Scll l.!& tbr wrkd @mP.nslioi, .r prcvi(|.d tor by S<thn 1700 of lh. <br />t thr Cod.. forrh. p(fo'mE of lh. h for which thc t dhil is iriu.d, <br />-l hav. .nd *ill mainlain wort ( @6p.ns.ri.n ins@.ce. 6s r.quiEd by S.ct ion 3700 of lhc Labor Cod.. fot lh. Pdfomtu. of <br />rh. $ort for whi.h lhi! ,.mii ir isr.d My wortd oq).Mrion inflr5E. ori6 ald policy nuhbc. Gi <br />-l <br />ccnilylh t in th. pdhmB.offi. wort aor which dh p.rmil is is$ed. I dEll mr .ntloy a.y Fren in an, turEr <br />$ aErob.6n subjet to th.w 6'.lnDmetion hq.f C.lif.miq end .s@ thrl if I slnuld b..omc tultJccr lo lh. <br />m&d' oqEMr ion pmviiioni ol s.sion 1700 ofth. Latbr c6dc, I sh.ll, tonhsnh omdy oilh rth* ptuvi.ionr . <br />WARNINGT lail@ ro ..@ rcrk .d onlPdslion 6vd8. ic unLetul. &d i,tslt $bj.cl o otthrr lo ciniBlrd![ix.nd <br />.Mt fiB urr to oB hu.d.rd thoud doud (t100.000), in.ddirion lo th. con ol@oFMdor.btu8.t u Dmlitcd for $. <br />Sdion 1076 ofthc L.bor Codc, iltcGn ard dt@!y! f.6. <br />uc[lsl;llsgNr8Al]la <br />DIigrrBAIrOX <br />I hcrcby alttrm udcr DcflalryolFrluryrhar I an lie&d und.r pmynion.fchapt( s (@Mncrne wnh Serbn ?000) ofDilFion ll <br />of lhe Busin.ss.nd PsrcsionsCodc, anl oylic.ns. s in tull for.e,nd.lI.cr <br />cQxlrBrcuoNlrllMJcrNcr <br />I hcrcby 0iltrD u.dcr rcMlty of per.jury rhd rltr <br />'r <br />t con{tucrion l.ndins asency tor lhc p6[oro*e oithc so* ri'r which lhis !€mir ic <br />n.ur (se 1097, cN C) <br />ATIIICANIIICLAAAITO! <br />I b.diy sn'm trnd.r p.nalty afrsjury oft olrlE followins dclmr io.r: <br />D.mlirion PcmhsA$.lto. NolifMlion i.d.El R.8]lLlions {.rnt 40. P6n6) <br />Itcq!tr d l-trr$.lNon[.nn.n <br />I c.ni& till the f.d.ml r€slhrions E!.rdiu Nh.sror r.nnvtrl .r. nol arrlicabl. ro this pmj(l <br />-l <br />ccnifyll-or lharEadlhirapplicaronand3r.t.thd rheahove inlirm.rion h cotr.cr I .!1ft ro .oinrly r [h all Cily rnd o'umy <br />ordmmes and Srrle L.er Ehxne ro nu,ld,n8 co.slrucliot\ lnd hcreny iuilFria rcpr.s.dtriv6 oarhil cny..d C-ountyfu..(d ulonrh. <br />,novc mn..rcd nmDdy lor insp(rion poqxx.. <br />Appli..nl or Ag.rr slgnattrr.:_ - lr.t <br />UNDER GROUND <br />Waste & Vent <br />Water-Under floor <br />Gas-Underfloor <br />Building Sewer <br />Area/Storm Drain <br />lnterceptor/ Clarifier <br />TOP OUT <br />Water Piping <br />Gas Piping <br />Roof Drain <br />Tub/Shower Test <br />Rough Water Heater <br />POOUSPA <br />P{raplDrain Line <br />Main Drain/Pool Piping <br />Fill Line/Back FIow <br />Pool Heater/Gas Line <br />Miscellaneous <br />Gas Service <br />Water Service <br />Lawn Sprinkler trYPIRED <br />Sanitary Sewer/Cap <br />Back Flow Device qFP 13 2013 <br />Rough Plumbins s\MC u'4r' 'rv.' x' --_ <br />ttilY,,@ <br />Meter Release I WV'rz't <br />FINAL I r-)/ <br />Notes, Remarks, Etc <br />APPROVALS <br />Waste & Vent <br />Final Gas Test <br />-------T------