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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OIINER BUILDER DELCAR TION
<br />I hcrcby affim udcr pcnalry of pci!ry lhar I t.rch,r frln $e Contr.cro6 Lhns Llw fo. thc followirg EeD (Ss.7031,t
<br />Businc$ a.d Prcftlsio. Codc)i Any Ciry or Cou.ry whach rcqote ! p.rnil ro @N .r, dls. inpmvc dctulish or Fpan lny
<br />srdcruc Fior lo ns iqswc. aLs r.q Rs rh. +plaer lor s.h pemh to ,ik a sismd sl.rcmnt rh ln or 3lE b liensd t'!ls@r
<br />ro rh. pbvisions of tu Conrreror's Li..rcd Law (Chlpt€r 9. Conmmine with Secri.n 7000 of Divi3ioD 3 oflhc Busincss !trd
<br />P,ofc$ioN Co.tc) or thar tl or sh. is.rcmpr IhcEfion md $e bsis for rh. dLg.d crcmplion Any liolarion of SNrion ?01I 5 by !n,
<br />lplicanr for s Fmir slbtrrs rlE applio to ! .ivil pcnllry of nor mrc rhs fivc hlndrd dollds (3500).
<br />-1.
<br />s o*m, of rhc pmFny. or my coplotEi wirh wr8.s ar rhch slc oqE!$tio.. wiu &, tlE *ut md tlE slrEle ii tul
<br />inl6d.d or ofr.rcd ftr sL (Se.r044. Busb.ss lnd Pmacsionr Codc: Th. C,nlrslor's Licctr* L.w do.s ml apply lo e owE ol
<br />U* prp.rry sho boildr or inlma dffi., 4n wh dqs Mh *o* hisFlror hcelf or lhmu3i his m lrcr oun.tr9lor!...
<br />provtcd rtsr such in{mEmnlr e an in&'rH o,oftrd fq sL. li LcE rlE traldjrg o, inpmrcrd n $! *hhin om ru,
<br />ofco'rddn[ {. Osr Builtcr *ill IEE th. hd6 of pmunS dEr lE or sll. dA bl tu d or i.qDr dE r.rclory fo ft purFs of
<br />I. Nown.rofthc tmlcrly, 0r cxclusivcly coftaclin8 wnh li.cnscd cofllmdoBlo consmcl tl* rmjccl (Scc. ?O44. Bu\inc*
<br />!'n hDic$iotr Codc Thc Conrracrol s t,i.cn{ l-aw doc\ tur ot Fly lo an o*ncr of l'6p.ny eho blilds o. improws thcron,
<br />Md who onbJ.8 fttr such pmj.lk wnh a C.n'h.ti(s) Iil.nsd ,,!Bu!n' ro rhc Co.lractois Lien* L,*).
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<br />M crc'npMdcr Scclion- A. & P.C. lor thh rcason.
<br />WORKT'{(' COMP|rNSAT(TN
<br />DECIJIAIII}N
<br />I hcrctly !fiiih ondcrycnohy of rcrhry one of lhc folloviq d.cltrBlions:
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<br />hlvc afrl s ill nuirhi. a Ccnific c or Con\cnr ro sclt ln\uru t, sorkcr' coqrn{ri, , trc ,rtuvidcd ror bt Sccrtutr ]7m.t rhc
<br />L.tq 9,a hr thc rtllorruncc otrhc sorl fn'which rhc n._n,ir tr i\Jcd
<br />I hJlc Jfrl rrllmoinrJin tr,trkcn' .i'nrncnsJriin insurr'tr., a\ rcqrircd btsccrinl?o0oirhc L.bo. codc. for rhc l,crloi,Mrcc of
<br />h hsucr My sorlcc' conw.slrion iosuraM cutr md lblhy numh.r m
<br />/n
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<br />ccdilythar in lhc ,.rlormrcc of thc wori for whkh this p.rmit k issucd.l shsll nol "ffi;ffi;".,*$ N to heam s!bj.i-r lo rl* ,ortsl conq*trqrhn laws of Califohi!- and lere lh r if I itDuld tNm $bj6l lo llE
<br />workcs'smFnsalionpDvisn,NofScclionlT00oath.tjhorC{xlc.l.JEll.Ionhwirhomply*ithrh.ePovhbns..
<br />WARNING: F ilurc ro su. srkc6 mq*ns,lion o!c6e. is un t.and sltrll slbj.rl an cmploys ro (idio,l FMlri.. tnd
<br />civil fincr up r, om hundrcd housnnd doll.rs ($100.Ux)J. d ion. damgcs ds Dmridcd for rhc
<br />I hcrcby!finrundcr pcnrlty ol'pcrjuly rhar I !fl li(tr undcr pmvhion otchlprd 9(coonftncirg wnh S.clion r0tl0) olDilision l
<br />of lhc Busin.sr Md Pmfcsionr Codc. ! ny lk.ns is in tull loE and d.cr.
<br />ATILICANI.IIEII.AIAI]AN
<br />I hm{,yrtrmund$ p.tr,lry otp.rjuryonc of rhc ltllowin8 ddldarions:
<br />D€mlirion Pcrmih'Aslf,slos Nolificatio. r{dc.al ReEllal ions ('rnb &, Pan6)
<br />-ltcqutcd
<br />Gtts ol Noiifrolion
<br />I ccdiiyrh rhc fcdcrl
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<br />cpl,ti.ns ngddi'U asb.{o\ rcnr,valrrc nor artli.rhlc ro'his pbjccr
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<br />ccnify thal I hrw E.d lhis rpplic.l ion 3nd slatc rh0t rlrc !hov. i.fornur ion is coret. I lsN toomply wnh aU Ciryand Counry
<br />ordinanscs !.d Strlc bws rcLlin8 rcprcsnt.livcs oilhh City
<br />abrc nf, ri.n dptupcnytd ii
<br />Arpli(nl or Aaenl Sl*nut
<br />UNDER GROUND I
<br />Waste & Vent 7/2/./tt ,o%,h
<br />WaterUnder floor
<br />Gas-Underfloor
<br />Buildino Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Water Piping
<br />Gas Piping
<br />Roof Drain
<br />Tubishower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />Main Drain/Pool Pipinq
<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 Plumbing
<br />Final Gas Test
<br />Meter Release
<br />FINAL /o/>z/t{ a *qr
<br />Notes, Remarks, Etc.
<br />Waste & Vent
<br />Fill Line/Back Flow
<br />lrsle: Orn€r:
<br />I
<br />(NIIAUCUOIIENDIIGIC.ENCI
<br />I hcEby ,flim xodcr ltElry of prrury rhd $m Ls , snsrrudio. bndioS sgcFy for d. pcrformrcc of lhc so* fot whhh rhis Fmir ir
<br />i$ucd (56. 1097, Civ. C.).
<br />t ndcis N.mc
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