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PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER EUII,DI:R Dl]r-CAR-{TION
<br />I hcrchy imirn u cr pcn ryoflrrjuryIhrrIoncx.mrrn.mrhcCotrh.cror'LiccoscljwforrhclbllowinB,casn(S.c70315
<br />Brsi'r.s afrl Pr.lcs\io. Cql.) Aiy Ciry or Counly rvhkh ruqut \ ! IEnnir io conn cr, !hcr. inll}mlc- dr' ,li!h ,tr rldn Jny
<br />(ructurc. pnorro irs is\um.c. iho lcquircs rhcaptlicrnr fd s[h Nnnilro l,lc r riSncd nircmtrt rhd tror dr ir liccn*d puruanr
<br />ro rhc fn,vNn)ns of rfic c(,nhktr \ l-ilriscd Lrw (Ch{lc. 'r. G'nrmcncitrg wirh Sc(rion 7(X}0 ol Oilhnr I of rh. Aoti'r.s nn
<br />Pmn$i(nrs Cod.) or rl hcor\lE i\ cxcnrfl
<br />'turcfi.mdnd 'hc
<br />h*is Lrrhc dLlcd.rcnpiion Anyvid rbnolsccliotr?03l.5byrny
<br />upplicllllt)!rF:nnirsubjc.rrth.applicurt()dcivilncnalryolnornMcrh.nrivchund!.ddollm(S5(x)).
<br />-1.
<br />as owffi olrrE pmFny, or my .nploF.s wirh s,8cs 4{ rhcn sb @nFnsdion. *ill do llE est and llE ndlw is mr
<br />inre,{H or otrrrcd lor elc (Se.7044. Ausircs rnd ProfcssbN Codcr Thc Conlmloas Lian$ tiw &Es ml q,tly lo & owmr of
<br />lh€ pmlEny vls tdilds or inproK tl*Mn. &!d who d&s sh Rrlt hinsll or heMlf or ihmuSh hir or h.r o*n c.qrloycs.
<br />provid.d rh{ such j,r{mrcm s e mr bltcBhd orofi.Ed fo, slc li t eB. th. hlildang 6r nipo\tmor k $H ahhin orc rrs
<br />ofcor{,lcrion, c Oqncr Blihcr will nat $c lrdcn of ImvinE thd h. or sh. dil mt iDih or inlmw thc poFity for lt* puIF* of
<br />-1.
<br />ar owncr of lhc l,ml,cny. !m cxcllsi@ly @nlracling ,nh lic.n$d cont8lo^ lo oflslruct lh. pmjd (Sec. ?O14, BlriEsr
<br />Ii ftolssbn codci Th. C.m@ror's Liccns. tj* des @r ![tl, ro e own6 olompcny *h6 buil& or inpows rhlrcon.,nd who oarEls ror slch prc!.ls wirh a Conolcro(, liccnEn r,lMnr ro rtc Conrftcror's Licne L.*).
<br />I m.r.mDr und.r Serin . A
<br />o"",aya//f<- "-""
<br />I h.irbyrrfinnr.dc.p.n lry.f p.rjuryohcorr&tulb*insdcchr n,ns
<br />-l
<br />hlvc arrl will tui.tli,, CcnifEarc otcioefl lo Scl 6orc fa works, conp.ndio.. .r prorij.{ for b, S6tion l70O of rh.
<br />Lrho. tuc, for lhc Ffotuc of thc qdl for whth lhc pqmil h issu.n.
<br />-I hrw !6d will roinrain worlcF conpcNarkrn insmn.c, as EqoiEd hy Sdrion 1700 ofrhe Llbor Codc.lor lhc rc.fmmrc of
<br />rhc wo ao. whici d'ic peml is irsu.d. My wortcB @npco$rion insunncc cdio dd polic, nuEbcr el
<br />CMiq:
<br />Policv Numtrr:JrDF\
<br />I e.ifr rhar in rh. FrIdrmN ofrht *ork lor *nkh iht Ftrrir ii hsu.d. I \htrll nor cmtlor rny p.ien in rny ntrrcr
<br />s N Io tErom subr.rt to llr wortcs' .on cnsr ion laB of Coliforni( aad ogrc lhai iI I sholld trsm slbi(l lo rhc
<br />wo cs onpcn\oriotr pmvisions of Sation 3?00 of ltc tahor Codc. I shlll. forlhvilh onply wilh rhos pmvisions,.
<br />€ivil fincs up lo onc hu.drcd rhous0nd doll&s l$loO.rXD), ir dddir
<br />S8lion 3016 of thc trbor @q i.l.Gt $d
<br />-,. o V/dgz/,/tr
<br />^
<br />DITLIBIIIQN
<br />o, rhr &\inrs rn,ll,olcsi{,N (inlc, rnd niylir.r\c ir i',li'llnnrc ul.llicr
<br />l)nlr (irlr rl.r
<br />tl)Ntjx!cllaNurNDllcitiDNrl
<br />isu.,lis.. :109? ( iv c r
<br />A}ILIqA I.TIECIrIAAIION
<br />lhol$ydtmlndcr pcnolry otFcrjury onc dfrh. f.Uo$in! dcchdbns:
<br />lxholirion PcrmilsAsbcslos Nolificoriotr ljcdcrnl Rcglloriotrs (Tnk 40. Pd6)
<br />-Rcquncd
<br />krrcr of Nolif'carion
<br />-l
<br />ccnify lhlt the fcdcal EBul,tions Eg0rdin8 .shcslos E mv0l @ nor ap!,icabL lo lhn troj.rr.
<br />_l ccrrily thir I h'vc Eld rhh optlinthtr ud stotc rhar th. drrc cotrsr I o&a Io.omply wiih sllCiry and County
<br />odinamcs and Storc tiws rcl,ri.e to builditrB rcpEscnldivcs.fthis Cily end Counlylo.nl.r upon d.
<br />at-vc trEnr hrcd l)n)pcdy ror
<br />Applionl orAA. l Sian u D.t,n7/af //?'
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under f loor
<br />Gas-Underfloor
<br />Buildi ng Sewer
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Pi ping
<br />Tub/Shower Test
<br />Bough Water Heater
<br />POOL/SPA
<br />Ptrap/Drain Line
<br />Main Drain/Pool Pipinq
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbinq
<br />Final Gas Test
<br />Meter Release I
<br />FINAL z,tt/14 zA 4-)
<br />Notes, Remarks, Etc. '/
<br />/ -f-
<br />WARNING: Fsiiurc lo surc wortc^ comp.n$rion mvcrugc h uolawtul. and
<br />Area/Storm Drain
<br />Roof Drain
<br />Miscellaneous
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