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PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor
<br />Buildinq Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Pipinq
<br />Gas Pipinq
<br />Rool Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />Main Drain/Pool Pipino
<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 />Final Gas Test
<br />tl
<br />FINAL -7ltglt9 1)
<br />Notes, Remarks, Etc.tl
<br />,
<br />OWNFJR I}UII,DER DEI-CANATll)N
<br />I h.r.hy imnn und$ ,Enrh, oi lcrjrrr rhd I m cx.nDr lnnn rh. ( rNmdon l-ic..sc l js li,r rhc rollt)winE rcuu lscc ?Or 5
<br />Busnr$ rftl Pofc$iu Aric). .^ny Cily or Counlt which rcquncs I Pcnnir t, .on{flcr. ,lrcr. inltrovc, dcmoli\h or qrn int
<br />(ru(rurc. priori{, irs irsuatuc. aln' rcqutcs lhc .l)plicanl for wch rcrmil nr lilc r \isnrd n,rcmnl lh.t h. or shc ir li.c \cd NBU!.|
<br />ro rhc pmrisions ol rh( Conrn.l{tr's Li..n\cil Ijw (Chaprcr 9. Conrnrn.in8 wnh Se.li,'n 70(n of Divi\k'n I ol rh. Rusincs lid
<br />Itotc$ioosCodc)orrhrrh. orshc iscxcml, IhcrcrioNrnd rlEbtrsis fnrhc allcscd c(cnnn,n Ant violoiionoiSecrbnT0:ll5 bya.y
<br />.ppli.id ror a l,-rni! suhjcck rhc rpplicanrb Bcivilr.tuhy.rn.r ntrhM livc hund,cd dollur (S5( ).
<br />-1.
<br />,r ownr ol rh. pmFny. or my chplortit wirh qaScs ur rheir solc .onFnsalion. uill do tr wok ad tlE {trtw n not
<br />inr.ftM or ofrcrcn for slc (SE.7iX4. Durinc$ od P,bfcsskrrs Cod.r Thc Conlrscloi\ Lk ie t P .rocs mr erPly lo u osncr oa
<br />rhc ForEdy who hr & 6r inpiD6 tlE@n. o,n who dG sh w* hid\clt or h.rklf or rhmu8h nG ot h.. oM cr'rloyccs,
<br />provid.d rllll such impmErnr: e mr 'ni.nd.d or orcdl fo, $lc. lt, lk,w.w. rh. l,uitin-q or ir{mwmm B $Id wnhm onc ,w
<br />or coqlclion, ltE Owrcr Builir will hsrc lhc bshn ofltrolins lhd lE ot shc dil ml build ot iryrcw the nopgly ftr rlt r tlDs of
<br />&s owm! ofthc pmpcny. Dcrcluri$ly.ont0crinB wnh li.cned conlsclrrsl{, coontucr rhc fmjc.r (se. 7044. Au\iE$
<br />Pnf.s\irn codc: ThcConticlor's Liccnsc Lis docs nor dpnly r. ,n osncr ofltopcny *ho h!ild\ or imporcs rhctsn.
<br />and who onrEcts lor $.n t,DjGk wirh r liccn*d puBu ro rhc C6ntel6, s L@N tjwl.
<br />9sl,?#.r,,---.,--
<br />DEITAEAIIJTN
<br />I ncrcby afrtrm undcr Dcnalry of psj!ry oic of rhc followiig d(hruiors:
<br />-lhr\clklNillnui
<br />triniCcniturrcof Cons n)srllldluicarr$o!kcr'conrFn\rri,)n. pn,vidcd l(n hrSNrion llTll()olrhc
<br />ljhor (itrlc.li)rrhcJxrLnr!$ccolihcw.rkf(trwhichrhclcnnir ni\{rd
<br />_I h6!. lnd qill mi.ldn wort6 mmpe Balior insuEmc. as rcaoir{ by Sel io. :1700 of lh. l,hor Codc. for tlE df(rur of
<br />rhc wo.k for qhict $n pcmir is bscd My wtrt6 comFnsalio, inslrane .ohr and rblty ,unh.r el
<br />-t
<br />anify rhll in rlrc ,.rfortuG ot rh. worl( tor which thh p.rmn is is$.d. I shlll not crllloy ey posn in any mnncr
<br />s ai h heom *lhjccr ro rhc worlrcs compcNrliotr hvs of Crlifornis. &d ase lhd if I should b.com subjd lo llE
<br />w*ol codpcnsrion Imvlrions of SRtion 3100 of lhc bn,r Cod., I rlell. tonhwilh .omply wilh lts$ ,mliiiotr ..
<br />WARNING I',ilurc ro {curc workcn cor,tti\dnnr co lawtul. and shau suhirr d cmplorlr ro ai'ninal lEmhis and
<br />ion. d.@gcs .s providcd tor lhccavil lir.i up to oE hundrcd thols.nd doll.6 (t100
<br />I)t:( 1. \R,\ rll,1
<br />I h@by arud !ndc! Fnllr, of Frrury lhd I m liensd hdcr Folirion of Cn piq 9 (onftminS Filh Selb. 7@0) of Division 3
<br />of rhc B$ircss and Pmfcssions Codc, ad my liccne h in tult fom &n eff61,
<br />CONIIAICII!]NIENDINGJGIICT
<br />I ncEby aff"m udcr pcelry of lcrjury ih,t rh6. is o sinrudbn lcnding es.rcy tor lh. pc.foru. of llE uort fo, whhh rhk Fmn is
<br />i{sucd (Scc.l0i)7, Civ C.).
<br />AITUCANfDECITIXAII9N
<br />It Nhyamnnxndcr |fnllrt ol pcrjry om oflhc folloNins dcchfurnrn\
<br />t).trx,lirt'n Pcrmir\ A\b.{.s Nolifi.ntion lcdcr!l Rcs!lalioN (lirl.l0, Pd6)
<br />Rcquird h ft ulN.rificdi'n
<br />hflr",,*,,*'"
<br />fcdcral r.Culari,,ns mg,.di.E nstEslos rcrmval orc nor lppli.abl. 6 rhir Pru,..l.
<br />B[l srarc rhlr thc,hov. i.romdion iscorccr.I lsd rocrntlywirh {ll Ciry.nd Counry
<br />onlinrtrcs md Sr.rc kws rcUl aurho.rc rcrcsnhrirc\ ofrhis CnFnd Counlyro cnrcr !F. rhc
<br />trtx,rc 'ft.ri.rd prcncny fo.
<br />trppnsr .. Asor sk'ru
<br />. ltemit& Nme (Drinl)A^,,r{
<br />slel, ?
<br />,tagfi
<br />UNDER GROUND
<br />Meter Release
<br />Polic, Nlnbcr-Exllncs:
<br />-
<br />Cotlrrclor
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