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PLUMBING-INSPECTOR RECOHD
<br />APPROVALS DATE COMMENTS OWNI]R BTJII,DER DELC I ]ION
<br />I h.rcb rflnn undcr pc.rlry ol !.rjury rhdr I m cxcnu rio rhc coitacros Li.cnsc Lrw ror (hc rolkJwin8 Btr$.lss70:11.5
<br />Busin.s lBl Protu$n,n Codc): Any Ciry or Courry qhich icqtrncs r Fnnir h consrrucr. rllcr. inlllrovc. d.rmlish or rcnrn ony
<br />socrrrc. !.it b irs irsu!t.. rko rc+nds rtd appliclnr for such pcrni ro filca siBncd sr c'mnr rhar hco, shc i\ liccn{d pur\ui ,
<br />'o
<br />rhc nrcvisions olrfu Conrra.lois LilTnscd L!$ (Ch.trn 9. comEncnrS with Sccrion 7fix) o, oivision 3 oflhc Ausinc\r rnd
<br />Pdt\\nrn\ Codc) or rhar h. or rh. i\ dc U rh.rcliom d! rhc M\i\ Ior lha llhgcn d.nprn'n Any vi{nnn rofS.lrion?0.ll5 by rny
<br />Erpli.lnr Inr. pcnnit subjNls rM optlica ro i .ivil Fcn,x, ol mr nx,crhln ivc hutrdrcd doll.h ($5{n).
<br />l. .c owner of $c nbl*ny. or f,y ennloy&i wirh {ascs ds rhcn sk coh0tNrrion, will do rhc !trt ud *r stn.l@ ir not
<br />inra& orofi.rcd for $1. (Sa 7(}l4. Busi..s !.d RDfe.sio.s C6dc:Thc Co @rmsLic.nsLlwdxmrapl,lyloMowmrof
<br />rlt FoFny wha boitts or in{rcws lltmG !d wlD &Es sh wlt himslf or hcNll or lhmu8h his or ls own cdplort!.
<br />!.ovidcd ihor ru.h amt$wftnrs m @r hrcndcd or oficrcd for sle. ll how.!er. rhe t{iuins or n,tmEc h sld sirltu "nc )ur
<br />ofconpLrio.. rh. o,n( Butin will hM rh. hldcn of povins dd ho o, fic did mr t{iu or itr{lmrc rhc rmpsry for rlE plrrrs 6f
<br />-1.IowrcroflhcFopcny,ucr.lusircly.onhclirEwithlierladco,rclo6looElrucltl[Imi.{t(Sm.7044.BuiB$ard ProliBliDCodc: The Co etof s Licensc llw d@s rcl lpply ro owncrotlDp.ny who blildsor imptuE! U.rcoLrnd vho coihdsfor sucnrmj.ds wi'h rC.iue|o(r li.cNd l,UEu rorhcCo rrcr6r's Lienr Liu).
<br />-l
<br />an .rcn udcr Selion- B. & P.c- for lm Eamn
<br />llaxrE8lrrQMfE sarl(r!
<br />DECI,IBAIION
<br />I hcbhy afind undcr pcdl,y of rqj!ry om of rh. follo* in8 delsarn]flsl
<br />lhalcoldsillmlinrrinaCclrifEorcofConrnrroSclflnsurcn,qor*c^.onrncnllrion.!xrr.vnkdfornysdn,nlTtrootrhc
<br />trbor Oxle- for lh. pdnrmrcc ol rhc Bork rbr qhich rhc lsmn is is\ucd.
<br />_l nlw .rd sill dinr,in wo.ks .orp.@rion in.uraftc, a equiEd by S$tion lro0 ot rh. t$o, C.d.. for the ,,qaollr:ffi of
<br />rhis pcrnft i{ tq'd M""^"- irlufi \\)
<br />6
<br />_l.cnily rhar in rhc perfo,tuftc olrhc sork lor *nich rhis pcrmit is issued. I shall ror cdq,loy any pc6on in rny mMnct
<br />s as lo lrsm subF.' lo lhc vortm ompensa(ioo lass of Cllifomi!. lrd igc. lhd ir I sbuld bc.oN subjet lo ltE
<br />wortcN' comp.nsrion povisions of Serion 3700 of rh. Ldbr Cod., I rhall. fonhwi'h .oipry wnh rhos pmvishns..
<br />WAININGT Flile ro *c@ lorllm @qanidion @kEse is lnl!*tul lnd shall flbFct o cn{rloys ro €imiEl Fuxi.. ai<i
<br />civil fi@! uI to 6nc hund.cd ll|ouord doll&! ($100.000), i. addirion ro lhc colt of @r{Enslioi. d@ger a prcvidcd for thc
<br />Scclion 3076 of rlE Llbor 6q hrr$ and romr\ f6!.
<br />UCENIEILCONIf,ACrcB
<br />DECI.ABd.IIO!
<br />I hcEhy aiirm under p(nrllyofpcrjlrylhal I m liens]d ufr,cr nmvision olCh4ra 9 (onmncin8 *ilfi SNri'n 7000) orDilkt,n.l
<br />of thc BusiNss and Pnrlcssions Cod., &n nry li.cns is in tull fod ,Jrl .ffccr.
<br />CQINIA!STQNITNDIN J'NCI
<br />I hcrbt alfirn undcr If,ultrofpcrjuryrhrr rhcrc i\ a coi(rucri.n lcnding agcn(y itr rhc p(rforroncc ofrhc $ork lff *hi.hrlri\ Fmrir is
<br />isruc.l(Scc 3(197.Ci! C).
<br />AIfIICANIDECIA&$IA!
<br />I llEl,y atrnn udcr penolry orrurflry onc ofltc rbUosinP dccl,rarn,ns:
<br />t)tmlirion Pcrnih-Asbc(os Noiincalion F€dcBl RcSuln' ions (Tirlc &. Pan6)
<br />-Rcquird
<br />Lcrrcr o, NorifEorion
<br />I ccnifr rhd rhc f.drtulrltlak)n\ ftgudnrg hr{o\rcErhlrrc nor rpplic lcbrhnl,l.F.t
<br />_l cqli,, rhd I havc rcld rhn lr,plicr! ion ond srarc thlr thc 0hovc inlormrhfl t comd I !3E ro oryl, wirh lll C y ud Co!.ry
<br />onl'trrn..\ rnd Srxrc l.r*\ r.lxrill! r, huinli',9 .d hercbysuthorn! rcprcsnrolilcs oflhh Cn, ond Countyt. enlcr Won lrt
<br />obovc mnrioncd pmpcny lor insnccr
<br />Apdlca.l or Agcnl Sieelu *,alz-olznt*
<br />UNDER GFOUND
<br />Waste & Vent
<br />Water-Under lloor
<br />Buildino Sewer
<br />Area./Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Pi ptng
<br />Gas Pipinq
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P-trap/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 0!wt8 \rt ?llqul<
<br />Final Gas Test
<br />Meler Release
<br />FINAL Te/l,h 9t\ss
<br />Notes, Remarks, Etc.
<br />rD/stG.
<br />Gas-Underfloor
<br />L.ndci" Addr$:
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