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PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE COMMENTS
<br />UNDER GROUND
<br />Waste & Vent A/
<br />Water-Under Iloor rY
<br />Gas-Underfloor
<br />Buildinq Sewer
<br />Area/Storm Drain 1
<br />I nterceptor/ Clarif ier DA
<br />-)-I
<br />('7
<br />Waste & Vent
<br />Water Pipino \_AL,.r.-\k
<br />Gas Piping t<t4
<br />-1r/ nRoof Drain
<br />Tub/Shower Test e-€c )
<br />Rouqh Water Heater 7 Tz',i'",o\\t
<br />I
<br />POOL/SPA
<br />P-trap/Drain Line J
<br />Main Drain/Pool Pipino (
<br />Fill LineiBack Flow
<br />Pool Heater/Gas Line
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rouqh Plumbinq
<br />Meter Release
<br />FINAL l.0S lol
<br />Notes, Remarks, Etc.
<br />)
<br />OWN':R BUtt,D!]R DELC.TR,TIION
<br />I h.rc[y rrltr uo.ls l].nrliy.t pciury rh]r I r r cr.nu ftnn rh. Conlmcur Liccnsc Us lbr rhc fdlowinS rctqrn (S.t 7011 5
<br />Busin.\s trod Prncssn,n (ixlc) Atry cily or cotrnly shich tcquncs r pc.nrir ro con{ru.r. ilrd. i.U.vc. dc nlish ,{ tuNn .my
<br />{tu.rurc, p'x,k, ir\ i$urtrLT, rho rcquncslhe ipplicanr lor uct rEnnir t.,llc r si3n.d {,r.ntnr rhd fuor sh! is licctr\cd prn,rnr
<br />ro rhc ptr,vnnrns ol rhc Conrrncttr s Licci\cd bw (Chrfrf 9. CoNncncirA wirh Sc.rn,n 7(XXl of lrivi$on:l ofrhc llusirrcss i.
<br />Pofclstnrs Codc) or Ihrr hu or sh. iscxcmtlrhcrcllo andrh.l,!\isfrtrrh.slL!.dcx.Dflbn Anrviol0lionols<rirn70ll5 byrny
<br />rrplicrtrr f(r ! pln.ir \uhjfcts ric appli.lnr n, rrivill.nrhr.rnor nFrcih0n 6vc hund!.d dolhr (S5m)
<br />-1.
<br />ur owkr ol th. pmp.ny. q ny .mplolBs Pilh w&a.s ae th.ir slc onpcnsation. wiU do ,a sdt &xl t E cele ir ml
<br />inldi.d or of,cEi for sb (5€.?044. BusiEss od ltDfeisioN Codc Tt C.fllEtols Lkm Liw &*i er q,!ly lo a owmt of
<br />rhc tnnFn, slh t ildr or irprDw umn, $xl sln dG seh tr* himslf ot h.Mlf or rimus! tis 6 tE om.nployc.!.
<br />prcvid.d rh.r su.h Inptlrm s @ mt i.r.td.d s ofrcEd for sb. lf. ho{er. tlE hraldi!8 o idF.Ernl h $ld wlhin oft F&
<br />of 6nt Ltbn, tiE Owr Blitda eill lsr fic hlrhn of Fotiry 0Er lE d dE dil Dl h'i! or inprDE tlE Fqdry b. tu FrPs of
<br />l. ds owftr ofrh.Imldy, amcxclusiwlymnt scrins *irh lkcn{d .oonrron ro enrrud tlE pmFl (S8.7044, Burin6
<br />!"d Edarbn Codc: Thc C6nr&tur's Li.c.s tjw do.s nor lpplt lo an ownc. ofpolcdywho builds o. in'rorcs lhcrcon,
<br />,nd who conrBrs for such pmjcts qirh a C.nuu.ro(O lic.nscd l[uunl lo rhc C. m.loai Liccne lrw).
<br />-!
<br />mcxcnrfl lndcr Ssr
<br />lto86Ef,S:tOllfENtAIrO!
<br />IECIIBAIION
<br />I h.rcht !l6rm uMcr pctrllry of pcrjlry otu oflhc rulloBing d6l,mrions:
<br />l-rh., (idc tarrhcp-riannln.cofrhc $ork lbr trhi.hrhc lcrni n i\\ucd
<br />I hsvc ,ntl *ill mn rin *mlrcra comDcnsolion inruErc. $ requiEd by Seriofl 1700 of thc L$or Code, for lhc F.forlMa of
<br />0E work for whtn lnis lrcmir is iaoe4 My *o*ca Gnpcrurlion iEtrmEc cmicr !d policy nunb.r G:
<br />Gr,qlTjr,i& trqrarr^z Co
<br />-l
<br />edify rhor in lhc lotolmft. of rlE work for vnichlhis Frmir is hsu€d I shdl rct crploy eny P.Mn in dy Mdt
<br />s .s !o iErom subj.lt io rhc *mksf coqEnsadon L*s of Califomb. rd 0gN rhar if I should b.cor 3uhicr ro rh.
<br />m,tds compcnsorion pmvhionsofSNrion3700olrhc ljbd Code.I shall. aonlNhh odply wnh rbscprevhions.
<br />WARNINGI FdituE to sw ftrlcB' ompmsalion o68p ir u.lustul. snd eholl subif,l !n mploF lo dinimt Funis.d
<br />.ivil fincs ut b oG nundr.d lhtusand doll&s ($100.000). in addnion ro ihc .osr of comrcnsation. damg.. ar PDvid.d fo. lh.
<br />S<rion 1076 oI th. t$d C.de inlcrcst cnd romyt fes.
<br />Y*, topyn-
<br />LtrEII.lJ!_COrrXd(rQB
<br />ulir:Lr3.trlQN
<br />I hcrch, am!mrndd pc lxy orpcrjury rlr lamliccn*rdu.rprcvl\ionoiCh+rd9l.o.nMncirg*ilIScclhn7(xx))orDiv]rionl
<br />.f rhc llunnc$ud ltolisio.s Codc. aid nryli.cnsc is in lull fore drl cilccr
<br />ct,,, A rB, GLl, L-a-rll*z- r.i.,n\e Nrn,h.r ryjasl
<br />6tb
<br />,le
<br />coNsrBuln0Nrr Dllli-dliExlf.
<br />I hcrcby rit und.r Fn,hyofpcrluryrhd rhcrc t ! .on(rucri,! lcndinS agcry for th. !.rro.nuncc ofrhcqork ror *hi.n thn lEntn G
<br />hsucd (Scc 1l)97- Ci! C )
<br />AfELICANI-OEIIAXAUqN
<br />I hrrhyunimrunnrr pcnllryotp.rjury o.c olthc nnlrBin8 d..l[arinN
<br />Drmoliri,)n P.irnir+Ash.sos Noriiicarn'n l:cdcElRcEuhrioi! (Tirlt.l0, PM6)
<br />Rcquirc,l trn.r dl Norilicrtinr
<br />-l
<br />ccniry rhlr rhc fcdcrul ,.Br lnr ionc egirdrB lshc$os rcmralarc norlppli.abLtu rhis proFd
<br />!4ccni\ rhr I h!v. Ed rhis,ppli.arn,n MJ slolc rhor dE fi'vc inlornNnr h.onccl.I aSre tocomtly*irhall(lryanrl Counly
<br />odina.ccs onn Srarc Lass rclaiina n, bniLling..nnru.rt,r,rrl hcrcbylurhori.c rcl)rc*.rdivcs.rrhis Ciyund Counlylo cnrcr updn rlt
<br />ab.vc ftnrion.d pot'.ny hr insFcr
<br />)pr,-"..r0-,
<br />t€mxe
<br />Dm.redio V*a'
<br />IID/SIG.
<br />TOP OUT
<br />Miscellaneous
<br />Final Gas Test
<br />1/ie lo
<br />x^*,,WC-A2oZL{Ur- tl ,,l*.,€/2)rrl7
<br />.b,",61\/ tt
<br />F
<br />Fr
<br />I
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