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PLUMBING-INSPECTOR HECORD
<br />APPROVALS DATE ID/SIG.COMMENTS olvNI]R B(JII-DER D}I-CARA]'IoN
<br />I hdch:_ rfiird uidrr rMlrt (,f Frjury ihrr I i r cx..rr, rio r ihr Q ncrtrr Li.en\c lnw ri)r rhc foll{,$ing rcr{tr! rsr.7r)}l5
<br />llu\ircss r Pdtrsi()n Codc): AnyCiryor Cotrdy qhic[ rcquirc\ r Fnnir n) connd.r. ali.r, nlllrn'vc. &Nrnh ot rct'rn rtri
<br />im.rurc. nri')rn, irs i$unnrc. rln) r.qundsrhcdmlicrnr n, uh pcn irro lilc, \igftd ucnrtrr ihrr hcor shc h liccn\.d puruanr
<br />h rhc lmrisnnrs oi rh. ConrrJcrr's Liccn\cd lnw (Chrprcr 9. Cflurcming $irh Sc.ri(D 7fiX) of Oivi\idr I ol'rhc ausinc\r rnd
<br />Pn,f.\si{n,\Cod.)orrhnrl[or\hcncrcnrprrhcr.k..tdrhchrsi\larrhcnlLlcdcx.trlxi,nr An}viohli.nnfS.crhil0.ll5byriy
<br />anrlic{nr n)r r |tanir \rhi..rr ttf, nnnli.!trllo r.nilncnrkvolmr nu.rhln n\r hunJrcddolhr\ (t5( )
<br />-1.
<br />as owmr of rlE pmFny, o! my cryloyccs *nfi qaScs as thct Fk mdncn*tion, {ill do rhe wort ed hc sl.r1@ h ml
<br />intcflLn d offcred for elc (Sa.IX4. Bu{ress ed &$fessions Code Thc Co ...rols Lie.sc t v docs nol lpply lo d owtur of
<br />th.f,DFdy wlbt ililc or in{mG $mn. rn wlx, d(B srh w* hinrEltor hq*ltor rhDugh hh ot h.r own €m0hr.1
<br />tmvjdcd rh,( skh iiportrk m mi ht lld.n oroffcrn for Fh. tl rswr6.llE t iBins or innftcnr i{ sld si(hin m Fr
<br />olcoq)Lthn rhc Orncr Blildo *ill haw 0E hlrlcn ot nto{.9 tlur he o. inc did mt hrild or LlproE thc popqly for lL purPo$ of
<br />-1.
<br />os owr ot rhc lhncny. !6 crcl!.ilcly contrdcring wnh li(.nrcd .onlrachn ro onidd lh. !rcjsl (Sc. 70,44. Buiitsr
<br />and B!ftsibn Cod.: Th. Cont!.roas Lic.ns. tiw d@s mt lpply lo.nowncr ofprcrcny who buil& or inpmws lhctcon.
<br />.nd who @nlEls ftr !!ch I'oirh {iih . Conorcto(9 liccnrd nlBMr ro iht Conhdols LtcnE L!*).
<br />-l
<br />!n cxcmpt under Serion- B. & P.C tu rhh rNon
<br />Own..:
<br />laBrE8s:.CAMfENiAIrQtr
<br />DECI./I8A1IQ!
<br />I h.rcby s,firm un&r nctutt, of pdiBy orc ol th. following &.Lntionrl
<br />lhrlcafrlwill' inrri',3Ccnifi.rrcorCoscirr,Sclr.ln{rrntrv.rkcrsconrNn\xri,!,.!ratr,vnlcdlnrhyStcri{t:1700ofrhc
<br />htxr ('odc- lilr rhc p.rfonmn . o( rht rorl lnr *hich rhc F.flnir i\ issucd
<br />_l hlvc and sill minllin sorkcrs comNnrdrhn inslrdn.c, !r cqrir.d hy sccr ion 3?00 of lhc L.hor Codc. fo. rhc Frrr,mne or
<br />My workea .oqxnqri6n i.rnmc.dir ud lElicy numbcr ac
<br />I ccnify lhnt in thc pdformmc of thc wort lor which lhii pcrmil is issled. I shaU tur cnploy in, Fson in ony mnm,
<br />s a{ ro bcsm subjNr ro rh. *oftc6 ompcnrarioi hv. oaclliaoni!. {od +m rh ifI should bc.om subjd roth.
<br />eo.[cF' corycnsarion povnions ot Sccrion ]700 ol thc L$or Codc. I shull, ronh*ith .omply with lhos pmlhions..
<br />WAINING: Frilur b scurc wor*cN smpcnerion corcn8c h lnhsiul and \hall slbJd e c
<br />civil fitr.s uD Io onc hnndrcd lhousnd dolltrs ($l(x),iJoo). in addilon lo I dnmscs as proridcd f0 rhc
<br />S.cri.n 3076 ol rh. tjt r Codc, inlncn and onomy\ f6,1.2-,10"
<br />I
<br />I h.'.hy xlfi'f, un{lcr t^-"nxlry ol !!rNry rlrr I rnt x6do F)vision olChlpls 9 (sm"rcncins sirtSccrion 7000) olDivkion 3
<br />ol lhc Busirc$and Poitssio and mt liccnsc i\ in tull tor.l uld cffNt
<br />lootqWt
<br />It
<br />caNgISricIlllNIlxDlNli-fG[NlI
<br />Ihcrhy,Ikrundcrp.nrllyofpcrjrylhdthcrcisaconsncrirtrlcndinslsc,r{trrbcFrfom.c.rrhcsorkforshichrhi\lsnrii
<br />i\sx.d (Scc .lll)7, Civ C.).
<br />APIUCANI.DEEI.ASAIIgN
<br />I hor$y.frtrn und$ pctr0hy of lcrjury onc oathc tollowin8 dccleralion\
<br />DrnDlirion P.nnirl^sh.{os Norificalion ftdcEl Rcsulilions (1 irlc 40. Paa6)
<br />-R.quncd
<br />trttcr of Norifi c.rn n
<br />I ccdify rh,r rhc f.dcral r.ellrr i(nrs aBUninB.slE{os Eni)lrl!rc nol applicllhlc Io lhi{ l]roFcr
<br />g/"nlty ,r',, t t'o," ,",a rrr nuli. ion u! srarc rhnr rhc dnvc intonurinn t coErcr , IgrN tu .onply wirh lll cir y nnd colnty
<br />oftiimn.cs Md sr,r. bws Nlaring b buildinS cotrslflctiotr, ad hcrcby au horizc r.prcscorari!* orrh( Ciry and Cou tylo cnrd !t'.n Ih.
<br />tuvc Donri,Nd porcn, n, insrccri.n
<br />UNDER GROUND
<br />WaterUnder lloor
<br />Gas-Underfloor
<br />Buildinq Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Water Piping
<br />Gas Pipino
<br />Roof Drain
<br />Tub/Shower Test
<br />Bough Water Heater
<br />Ptrap/Drain Line
<br />Main Drain/Pool Pipinq
<br />Fill Line/Back Flow
<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 7/tl k 5N8t
<br />Final Gas Test
<br />Meter Release
<br />FINAL _q. tu rgi /Llz4fn
<br />Notes, Remarks, Etc.7
<br />Waste & Vent
<br />Waste & Vent
<br />POOL/SPA
<br />9l4lrr A
<br />t.trJ.1'. 4.t't'..\
<br />lppli.nnl or ig.nl SiEnniu E:-*1 .4.1%._
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