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PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under floor
<br />Buildino Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Piping
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />Main Drain/Pool Pipino
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbing 6h/t$,\^',
<br />Final Gas Test
<br />Meter Release
<br />FINAL t/t<tts 9\\<V
<br />Notes Remarks, Etc.
<br />OIlNER BUILDER DBLCAIIATION
<br />I hcrcty iifirm undc, p€noll, oi !.rjury rhd I rcxcnu tiom lhc ContrucloF l,iccosc liv irlhc folloNin8.ca$o (ftcl0ll5
<br />Aurin.ss LJld Pft,f.r\io6 Cuic): ny Ciry or Cou.ry $hich ,.qutcs ! pcmir ro d,n{ncr. ulrd. imptuvr. d.@lirh nr rr{i ny
<br />nructue. prior
<br />'o
<br />ns isuamc. also rcqutcs rhc appli.lnr for such qcnnn ro 6lc ! siEmd st.rcmnt lhll tr or shc n liccnsd tluNa
<br />ro thj provhi.ns of rh. C.ntn ror'r ,-i.cnscd Lis (Chqrrer 9. Gnnmlkin! snh Sc.rio. TUXI uf Diri\ion I oflhc Busincs nnd
<br />Profcsions Codc) or lh0r tr or shc ir crcnrl thcrclroma.d rh. basa ror rhc rlL8crl cxcmption AnyviolrlionoiSsrhn?031.5bylny
<br />lnpliclnl for!pemi subj(lsrnc opDli.all ro!.ivilpcnal'yofnol mrclhln nrc hundrcddoll!( (5500).
<br />l. N o\ ftr ut rhc ptupcny. .r trry cnrplqr\ *irh s rgc\ J\ rhct w,l. .o p.n\diotr. *iLlln rhc *ork d rsru1Nirfr
<br />inrc'x,lal orofi...d rd alc (Ss ?(}l4. ltusiNrs nDd h,r'c*i(,Ncr)de Thc attrh.ktr * Li.cn{ l-rwloc{ oripnl,nrrno$n..ol
<br />rhc$rf{ny vh. buildr or inpn,vc\ rlr()n. d wh) J(r\ {'cl, so'l hnn*ll.r hcrscll or rhnnrgh his dr hsr o* cnlplorccs.
<br />prcrid.{l rhrr such inrlRrt.xnh rrl Nr irru trd.d o. .llbrcd hr$k ll hourcr.lrr l)Uilding or inDounrnr i\ $ld *irhin ond }ttr
<br />.l dnnplcriotr. llE ONrcr Buildd willhilc rlt hurdctr olrovirig rh, hc or nr di rFI hoildor improvc lhc pmFny lbrrhc pu4r$of
<br />l.,soRturofrhc li.rdry. ancr.lurilclyco.r,acrins wirh licctrEd coniracroB b @.srud rhc r+d (scc. 7(x4. Buqift$
<br />rn hoB\i, Codc: Thc Cofllroclols l,iccnsc L!! docs nor aprly ro sno*ncr ofpnrcnysho blilds or ihproler fierco..
<br />and *ho .oobrts lor ruch pmirs wirh . Coohro(r) liccnrd purumr 6 rhr Contdcror's Lkcns tiw).
<br />-l
<br />m.rcnp undc. Sdrbn- B. & P C for $ir l!&n.
<br />D.L: Or.e
<br />_lhav.aldeill@i aao. Ccnifralc ofcons ro Scf-lnsc Ior erk6 @np.Balion. d provided for by S<tiotr 3700 of 0E
<br />L3bor Codc. for rlE pdf('rrlMr of the wrt for qhth rh. p.mit is ns!.d.
<br />lhrrcntul silln[inrrin workrN co rl.nlrrion i'rsrrrncc.3\ rcquncdbyS.crii,n.]7{X)ufrlrlntxnC.{lc,lnr$cpcrfornrn..of
<br />rhc sork lol wh{h rhisFirnir i\ issucd. Nryworkrrf dnnlci\dnnr nr{urnrcccrrrcr Md0.li.ynu rbcr !rc:
<br />(.,nr Slqk FunJ
<br />l
<br />_lc.dilrrhr! iothc p.rlormrc of rhc porl for shich rnh p.rdir i. ir$cd,I shlll mt.mDb, {., F^o6 i6 lny lMmr
<br />s os lo h.am sbj.rl lo lhc w*B'ompcn$lion loes ofcalifomia. and aBN lhll if I dDuld t$om sutirl lo ltE
<br />*0*6 sqrnslion lmvisions of Scclion l,00 of lhc tlhor C.dc, I shlll fonhwilh comply wilh lhos pmvisiotrs,.
<br />WABNINC: F.ilur ro sue wmtcrc on{Enidrhn sw6gc Lr untdwtul. o.d shlll $bjd u .npL}q ro diminol FMtics md
<br />cavil lin* rp t6 one hunde! th.u{nd dolls (5100.000). in addnion ro E c..r otc.mFn{lion, da@e.s rs pbvid.d for lhc
<br />Sc.riinr.rr,76ol rhcLfitrOxlc.inr(rc{airlrnonry \,cc\
<br />DECLIBA.IIIIN
<br />I hcrchy nilnm undcr rnlhyolpcrjuy lhrl I nfl lietr$d urdcr fmvkion oiChrrler 9 (connrrcncins {ilh Scdion 7000) olDivirt,n:1
<br />of rhc ausiroisnnd PruLssn r C.dc. MJ nry li..nsc is in full foft! ,nd cffc.r.
<br />o
<br />AIIIICANLDICI.ABA.IION
<br />I hott y !fim undd ncnulry oI pcrju,y onc of rhc ii,llowinsd(laations:
<br />Dc'mlilion Pcrflrits.Asbcsro\ Nolilicllion Fcncrol RcAul bns(Titlc 40. P.n6)
<br />-Rcquircd
<br />lrl!crof Nori6calion
<br />-lccnifr
<br />rhar rhe tcdcral rc8lhrn,ns rsudnrr axhcsros ,.m,vul arc nor lppltlblc ro rhi\ F,jc.r
<br />l2l .or'ry rhr I h$. rd,h,\ Jnll{rr'on rnl {6r.,tur rh. trtbr. inrfftunon i\ colmr.I rSra kr $n{'ly *ilh ull Cily and Counly
<br />ordin.n.cs ad sr,re ll{s nbrine
<br />'o
<br />builiinS .otrsrud bn. !n hcrbyaurhorizc rcprcs.rarives olthis CiryaRl Cou"ryro cnrcr upo" r$c
<br />atrvc nEnltun.d pbo.dy for insp.rrion pnrpo*s
<br />Arplicanl or ABenl Sisnat
<br />A1t,Ilr>
<br />A.Uaa,
<br />z
<br />ZS (,
<br />I
<br />Gas-Underfloor
<br />Gas Service
<br />}IIBtrEBS:I;OMTIUIAIITIN
<br />DEC1ARAfiON
<br />I hc.cby .mm undo Fnuhy ol p.rjury orc oa rrE rollowi'rB delmri.ns:
<br />7/2q/16
<br />CANiIXIJEIIQNIIiNDAC.dCINCI
<br />I tutuh] rfim undcr Fnrlrr u r ltlury rhr! rhc( i\ ! con(rurri,)n knding rlcn.y lnr rhc p. nmunN ol
<br />'hc
<br />work lor * hich rhis Fiinil k
<br />hsrElrs( 109, ci a t
<br />Ic c'-,NJ c
<br />Lcndcis A.ldGs:
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