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PLUMBING-INSPECTOR RECORD <br />OmcGBoild.r Dccl{.ti@ <br />I hd.by afllm udn Fnalty orpdjury lhd I n.xdpt fffi tc Cont-&!oE' Li..is. tie aot th. follNiig tao. (scc 7031 J Ecins <br />ed Prcf!33ior cod.): Any Cny d CMty which ..quiG . p@it ro @n*rucr dtd. ihprovc, dmolbh o. rcp.ir ey strucru'., p.id !o itt <br />isB@, .le rcquiG rh! dpplicer fr !!cL pahn lo fit . tien.d !l.to@l $51 h. .r shc is lidscd p6@t ro lhc prcviiiont 016. <br />Con .rdt Lic@.d l-!w (Ct.$E 9, Ctuacins vilh serion 7000 of Divilim r ol $. BEin6 ed Prcf*id. Cod!) d thr h. or <br />shc b ampr th@ftom d lh. b$is fa dlc dl.scd c:dpnon Any violsrion of Sc.tio 7031 J by uy lprlic&t fd a p.mn.!bjc.ri thc <br />lppli*r ro ! ciril pcD.lty of not nm the fiv. hudr.d dolls (1500). <br />_1,6 oM6 of$. Fop.rty, q ny odoy.6 vilh wssd a 6cir 3ol..mF .ri@, will d. $. work dlh. sn'uctur. i! nol inladel <br />d o6.Ed fq srlc ( S& 70a4. BuiD.ss 6d kof*ioG Cod.: Thc C@rardt Uc4c Ls dG nol .pply lo d oM6 of lh. propdty <br />pho buil& d imFovd $.@n, od eho do6 suqh wMt hi@lf or h6.lf a ntDuti hi! d hn os 6ploy6. Fovid.d $.l 5!.h <br />isrrrcvclmt' e .. inrad.d d or6!d fq i.1.. lq tuwlvtr. Ul. blildins d inprotmat i! lold si$in 6c yd of cmplcli@, lh. <br />OMd'Buildd wall hsvc $. blrdo or Fovins thar hq G sh. not build or ihprcv. for dt putpodc of !.1.) <br />_1, B Ma ollhc prop6ty, o cxclBiv.ly @F&ting wilh licft.d cot@6lo coaulct th. prcj@r ( Scc 70{a, Bui.a ad <br />Prof6i@ codq Tnc Co.r&1d! Licd. L.v &6 nor .pply to 3 oqd of FDpcrty sho build! tr improvB td@. . 4d sho <br />qorsa tq och Fojer, 'ith ! cdF!.rd(, lihlcd Pls@t to $c Cdleto.'r Lic.n!. rrw ). <br />_l h.xmp( urdcr S.clid <br />v9BtsEESlqr4ErSAlSr-UEg!4&rAd <br />I hdcby affim uda podiy ofpcrury m. oathc aollowing d.chdions <br />_l h.v. md wiu m.i.rdn r Csdid. of CNqt !o Sclf-lnsr. lor wot6 .mpc.r.rion, s provi.Ld fs by Sddon l?00 ofthc <br />Labor cod., fn$c pdfclMe of $. wdt rn which {t. p@it ir ireu.d. <br />_l hav. sd sill h.int jf, sqtd' @np6$de i utucis cqlnldby Se.io.3700 ofln. Labor Codc, for$. p.rfffiee oflh. <br />wo* for *hich this p6nn b is!.rl My w6td' comp.Nnion iNlec. .ai6 &d policy numbq a. <br />An-n^"&rc n6:ao t. <br />b. @mplct d ii rh. pemn ir ro. Oo. huo&.d doll4 {llo0ld <br />pdfomd.. oalh. work for which rhis p.mn n;sucd.l <br />laws ofCalifomia d a€I@ <br />cmp43ti6 prcviti@t <br />dolls (l100,00o),in ldditio., d.m.86 a providcd ld thc <br />I hmby llfim ud.r podty oi ldjury thlr I 6 licds.d undcr prcvisio. of Cha9r6 9 <br />rh. Suin6 ud Prol6ioN Cod., ud my I n ii 6rll fft. ad .fr@t <br />Lic.@ NuDbc <br />p<j!ry l}trl th@ is . con.rrucdon pc.{om&cc ol lh. *ort for uhich lht p.mn i! <br />, Civ C) <br />ABI.ICAN$.DIC!4!4!9! <br />Danohio. PmiB'Albdrd Nodfic.d@ Icd.r.l R.sddi@ (Tid. 40. lat 6) <br />_ R.qunld r4ttE of Nodfadon <br />-'y^Zatd;tt lhat <br />rh. fcd.Bl ESulaions rc8&dins ab6t6 <br />I hav. Ead this arplidioo &d ir3r. <br />ordi.e6 Dd Sr.rc l,lsr allrinA lo b!ildi.8 <br />3!o( md6.d FoFy fd ii3pcrioi <br />APPROVALS DATE tD/stG.GOMMENTS <br />UNDER GROUND <br />Waste & Vent <br />Water-Underfloor <br />Gas-Underfloor <br />Building Sewer <br />Area/Storm Drain <br />lnterceptor/ Clarifier <br />TOP OUT <br />Waste & Vent <br />Water Piping <br />Gas Pipeing <br />Roof Drain <br />Tub/Shower Test <br />Rough Water Heater <br />POOUSPA <br />P-trap/Drain Line <br />Main Drain/Pool Piping <br />Fill Line/Back FIow <br />Pool Heater/Gas Line <br />Misc <br />Gas Service <br />Lawn Sprinkler <br />Sanitary Sewer/Cap <br />Back Flow Device <br />E 1.tr'IE!ET <br />Rough Plumbing <br />Final Gas Test FI :B-120 I <br />Meter Release <br />Notes, Remarks, Etc. <br />Policy Numb.r:_Erpncs _ <br />L.nd.r'r Ad&6s. _ <br />Water Service <br />FINAL