|
PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWN!]R Bt'IT-DER D!.]T-CARATIoN
<br />I lrrchy 3ffirn ! dcr pcnrlry (,f prrury rh l, crcmprfrunrhContu.ror\'Lic.nscLrsforlhelhll'{in8r.avnr(Scc70.115
<br />llu\irlcs\ rkl I'r.fcrsi C(xlc)r Any(il,or Counry shich r{uirr r Fn.ir ro.o!(ocr. alrcr. impolc. dctri,lnh or rlrn dny
<br />{rucrurc, prirnr, ir\ i\surn.c, al*) rcqurcs rhcimliuir fitr su.h Jririirn) flcr \i3rcd *itcncnr rh hcor sirc is liccn\cd puru!trr
<br />k) rhc tnrviri,,n\ ol rhc O,nlrrctr's Liccn\cd hw (Chlpr.. 9. Co'ntuncing rnh Sc.ri( 7UD of Division I oi lh. Ausircs( rod
<br />Pnr,i*ion\Cod.)or rhrr lf,or rh. iscrcnq, ihcrclrondrd t,r hrris r(r rlf, dllcg.dcrcmprion Anyvblali{tofSc i,n7l)-ll.5hy3iy
<br />rpflicunlr'orr,rcmilsubjcchrhca,'pliunrh!(irilpcnuhyolmlnrrclhrnfiv.hodnddolh^l$5u)).
<br />l. n\ owncroftf,tn)ltny. ornrycNdoycci $irh srgcs$rhcn {nc.onrr $ri{nr. {illdo lhc rort lnd Oc nturm n frn
<br />int.idd oroficrcn ror Rrlc (Se7(${. Businrs and honssiotrsCode lhc (inrrctr's Lic.n\c L wdo.snor{tlyro.no*nctol
<br />rhc |t)tr.y sh. hulldror nnprcvcs rh.tr{.. !,xl who d,{\ qrh $uA hnnscll.r h!r{llnrrhmughhi\ or lNr own cn,Il,,ycc\,
<br />ln,vnh(l rhir s'ch i'npnNr'tuih trto nor inrc el or .ltcrul lbr * .. ll hooclrr, rhc hiklnu .i nnptuv.nr.r $ s,kl wthi'r om ,a tr
<br />of conllllcrbn. rhc O*tur BriLld $ ill hrlt rhc hrrdcn oI prcling rhnr hc or \h. .lil fr{ build .r im$r. rhc ln)ndy ro! rhc ouqbr or
<br />La\.wncrorrhclmn dy.i cr.lu\iltly.o r ri,r!wirhli..nsc.otrhncknhcon(flr.1lltDfl,jcd(Scc?0,1.i1.Bu\i"r$
<br />nnd rhrarsirn codcr Thc Conficktr s Li.ctrse Lrw docs nor lnnly r, o owncr ofpon(ny *ho huild\ or imp(nB Ihcrcon.
<br />rJ sho rcnrrurh l',)r such pn*cts *irh r Coika(,n, lic.n\cd pursurtrr t) rhr G rrtx s Liccn\c L,s)
<br />-l
<br />!mercnrpr undcr Sccl
<br />D!(. O,ne
<br />uoarEas:.coMtfatarloNI'ECLAIl AION
<br />I lErcb, amrn !nd.r pcMlry of pcrjury orc oftlE louowile d6Lr.ri.,ni:
<br />-l
<br />hlvc ml *ill luinraio o Ccnificarc.r Conic rosclfln\rrclortrorl.r{.snDcns nnr. $ Fovacd lor h! Sarion :17{)0 Da rhc
<br />Lab.r Codc. i$ thc rcdorruncc ofrhc wo,t lor which rhc 0cmir h isucd
<br />I h,vc rnd{ill rinr,in workc rr' c. mrns0r n,. nrsurrmc.0s lcquircd $yScclion.lT(N).irhc Llhor Gdq ft, th prrronBn.c ol
<br />I enili rh'l in ihc p..Ior@N of llE Nork for which rhis Frmir is issucd. I shall nol cq,loy any pc^on in aoy ntnmr
<br />s s to h.om subJcct ro lic wrlm' omncnsarion lsws of Cdifomi.. !.d aeft rhll if I should bcsm subj.El b llE
<br />workdl omp.n$lion Foyisio$ of SNtion 37m of fie t bor Codc. I slEll. {onhwnh 6n{,ly wlh rhoe ,evirions
<br />Scdi,)n.1076,'frhr l- hn CoJe. dcrcn od rrkrncy\ l.cs
<br />ttcENs[DliQNlxagl0a
<br />D&IIASAIION
<br />I hcEbyrlltrmnndcr p.trllry of p.rjury lhat I0n liensn undcr ,,o visio n o r Chruicr 9 (snrmking wirh Sccrion 7uD)ofDivnion 3
<br />or rh. Busitusr rnd ftotasrions Codc. {ld my liccnsc k in tull foro .rd cffccl
<br />clluslaul:uoNrliNDMilli[Ntr
<br />I h.rht dfir un,l.r Fnrlry or pctur! thd dnc is , $,nrudi'n Lndirg r8.my for lhc rcr{o.nErcc oi rhc nrrk ior *ni.h thn Pcnnil is
<br />i$ucd (Scc .1097.Civ. C ).
<br />AIILIIANLITES,AAAIJI,IN
<br />! ho$, altim undcr l'cnllty of pc+ry orc of rhc followi.E dcclanrions:
<br />Dcibhion P.rmik.Asb.eos Norific.lioo Fcdcnl Rc8ular ions Ont 40. Pan6l
<br />R.quir.d Ln.r of Notiarcnrirn
<br />_l .cnify r har rhc fcdcEl rcsular ions rcB ding asb.srosrcnDvnlae no',pt'lklblc h rhh poJccl.
<br />I ccd ify rhd I lrvc rcid $is opplicarioo ond slatc th|l thc otrvc intunEr ion is corer I agN b cooply wirh trll Cny und Counly
<br />o,nin.ftcs and Sr.rc llws e&linB ro hlildinS ion- ux, hcrcby aur tFri,e ,t r,. *nrd iv.\ otrhir chyand Counry lo ctrrcr uIDn lhc
<br />rlbvc mnrn,ftd lmp.ny tu iNpccr
<br />Appli.unt orAlenl Sian u ix
<br />Waste & Vent
<br />WaterUnder floor
<br />Gas-Underfloor
<br />Buildinq Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Pipino
<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 />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbing 4l?-/x Sben
<br />Final Gas Test
<br />Meter Release
<br />FINAL 1/tt ls ,D tri
<br />Notes, Remarks, E1c.
<br />UNDER GROUND
<br />Water Service
<br />I
<br />It--
|