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PLUMBING-INSPECTOR RECORD <br />APPROVALS DATE tD/stG.COMMENTS (,WNER AULDER Dt]I,CANATloN <br />I hcrrhy trrfinn un $ pctrrlry (,, Frjtrry rh0r I anr c{cnur iro lhc (rtrrr&br'l.iccn{ ljw r'or rhc t,ll{'wins rrnvnr lscc.7o.ll.s <br />Busnr$ .nd P(rfcsnn C c): Atry Ciry .r (butrry s hich rcquirG r Jf,nui! ro .\ srtu t. dro, i'nptu!., dcnDlilh or tupan r., <br />\rruduc. riorro irs hnmcc. a!\o.cqutcs rhc lptlicofl ror such rcnni ro nh. \i8ncd starcmnr rhar tEor shc i liccnscd 0uNrnr ' <br />to thc F)vi\tuns oi rhc co h .kn s Li.ctrsc ljs (Chnrrcr 9. Annn$cin-s siih Sccrion 7(x)t) ol Divi\i,,n :l .r rhc Busincs !trd I <br />P^,fcsrnnrs Codc) or inrr tu or shu iscrcnrU thcr.li. d drhrb$nrdrrhcullc!.d.rcmpri.n. Anyviddn'nolSc.rir7011.5bydny <br />rrplicrnr ruancrmn \ubjcchlhc arpliclnl h ucivilncnikyrrnot nnncrhln rivc hundeddollffi (3500). <br />-!, <br />m o*ncr .f thc lroFrly. or ny .nplolr.s *nh *og.s &r rheii slc ompeMrion. {i[ drc rlE *ork md lhc $odw is mr <br />id€rncd orofi.rcd fm sL (SG.?OU, Blsim3s.nd P,ofc$ions Cod.: Th. C.ntn loas Lic.no t w.locs.oI rrply lo m owmr ot <br />$. preFny who ldld.r or nqeE tt.6tr {t plE d6.i o.n tr* himlf or hcmlf or lhrclgh hh d lEr om.rpbr€i. <br />r,mviiled ihar.uch iml'bvft se bt inraicd orofi.,rd lor sk. If. ln*.a.lhc hrildi4 o inp|ftr hshwnnhmrdr <br />ot@n{,hion. lh. O*ftr Auil:ld MII hlw d. t rdcn of Fovitr8 thd tE or rh. dii mr boild or iryhr dr pEtEry aor dr pulos of <br />wotat(F rrs, coMfrNsaTloN <br />IIECI,AEAIIO! <br />I hcrcl,y afiim lnds pcmltyofpcrjuryoneoflhc followinS ddr6rio.s: <br />-lh!!condwillmnrl0inrCcnifi(IIcolConscntroSclalrturclirwrkcd(,np.nsdiotr.rspn,vircdforbyScctiotr]?mofthcLlbor Cdq rbr lhc ncrfo.nEmc ofrhc qolk ,or shi.h rhc pdmir is h\u.d <br />_l hak and will moinlain workcG compcnsatbn irsuEtrc.. as rcquiEd hy Sd ion l?00 of lhe Labor Codc. for lh. D.rfotmncc of <br />the qorL for ohich liil lcrmn is hscd My sorlc$ coni!.nsalion insurone caEicr ud lDlty tumb.r e: <br />lql nv----r--t- <br />-l <br />anify lhol in r p.rfoirmrc ol lh. *ork lor which rhk Frmir h h3uci. I shrll nor cmrhy 8ny FMn in rny nMBr <br />s ac ro h.coft $b,cd ro rhc *ollc6'conwnsart,n kws of allifornil. $d !3e rhor if I sholu ti{oe slbjEr ro tlr <br />ktkc* coffpcnFalionprclnionsofSstion l?0O of llrc L€bor C!dc.l shall. fonh*iit cotrplytrithllbrc tmvisions.. <br />WARNINOT I'lilurc to sN wortc6' ompcrslion ovmBc n u.h,aul nd shrll subi* an cn{,lorr. to aifiinal lrnhis lnd <br />civil fincs u,r lo orc filndEd th.lsnd doll{n ($loo.uJo), in &ddnion b lhc con otofi,cneuon. d!roxts N 0rovncd for ltc <br />sq h n .1076 nr rhr Lih4r codc. inkrc{ dnd arrormy', ltcs,//-'\ /l +- ' <br />*", 5l aL, /rtr ^",u^,,( )rrvt Ak@r [ *Itffiffi/ <br />I h.mby rflirn undcr,{halrr.rncrry rhr I .m lien({undd povirn,n of ChanrdI (oomncang }i$ Serbn 70m) of Divhion l <br />of lhe Blsimss ad Prcf.ssiotrs Codc, {n my ltcn$ n in 6ill fore un cffcl. <br />5 <br />I lEEhy .flifln und.r Funy of pcrjury rh{ dFr k o .onsh.rbo lcndoe recrcy for llE Fnolr:m. of lh. mrt for whkh lhls Frhh i <br />i\iu.d (ss, l{87. civ c,). <br />attuQtNfDgcl,lBd.roN <br />I rlrt$y a]]im und.r F.aky or p.rjury or or tnc lollo$inr d(llrar iotrs: <br />Dcmlili,,n Pcrmits'AstE(os Nolific ion ,tdcrul Rc8ul{' ionr (_rirlc (). Prn6) <br />-Rcq!ncd <br />lJllcr ol Mrincoli(tr1 <br />I .cnif, rh3r rhc lcdfol rclxlari,inr ag&di'rg asbrstx .c r al s. nor applklbL ro rhis f,hjdr. <br />-l <br />cslily lial I havc rcad thh applicrt ion irrd slllc thal thc d$vc nrformdiotr iscoriccr.l !3ra tocomllyunhsll Cilyafti Counly <br />ordiEnccs otrd Slate L!*s El,tinp ro huildins cotrnrucr rizc rcl)rcsnlllivcs .l rhn C ylndCounlrtocnrcrtrponrhc <br />uhole mnliorcd pmpcny ror in <br />,\ppliunr 0r is.nr Silrnnl 5ll<,1x-----T <br />UNDER GROUND <br />Waste & Vent <br />WalerUnder floor <br />Gas-Underfloor {l U-Fru=* <br />Buildinq Sewer <br />Area/Storm Drain <br />lnterce ptor/ Clarif ier <br />TOP OUT <br />Waste & Vent <br />Water Piping <br />Gas Pi ptng <br />Roof Drain <br />Tub/Shower Test <br />Rouqh Water Heater <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 />Rouqh Plumbinq <br />Meter Release <br />FINAL Hltl >D 8n <br />Notes, Bemarks, EtcI <br />70 a,/td.f(D <br />0I <br />ilq'SrE <br />POOL/SPA <br />Final Gas Test <br />lo( )e"l*, ra*oAo^ al <br />-1, <br />a osncrolrhe pmpeny. !flreclusivclycotuadins trnh ricc.kd ofltrtrdon to construd <br />'tt,,mjar <br />(Se 7tx4, Ausincsr <br />md PinLrsion Codc: Thc Co.kr.roCt Li..n\c La* docs nor aptly k, Mo*nrr orp!,pd, who tuilds 6r nnpn,fts rh.r.oo. <br />Md sho .onr8ctsinr such rrcjcch wirh r Conrmcronr) liccnscd pursu,nr k' rh. Conrdcktr\ Licctrsc L'p) <br />I oncicnrpt undcrSalion-. B &PC forrhirrcrstr. <br />t ndc\ Addrcs: <br />- <br />4 qf fi7'\,€ <br />I