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PLUMBING-INSPECTOR RECORD <br />APPROVALS DATE tD/stG.COMMENTS <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{rap/Drain Line <br />Main Drain/Pool Piping <br />Pool Heater/Gas Line <br />Misc <br />Gas Service <br />Water Service <br />Lawn Sprinkler <br />Sanitary Sewer/Cap <br />Back Flow Device <br />Ei(i )iIlED <br />Rough Plumbing <br />Final Gas Test FE - I ZUIU <br />Meter Release LOn 554 i67 <br />FINAL <br />Notes, Remarks, Etc. <br />Owna-Build.r Dlcl&lion <br />I h..cb, rlfilm urd6 p.n.lt, of pdjur, tur I m cxml fm tlr. ConuEtd!' Li@nr. L.w fo $. follovins Er5on (3.. 701 I J B$incr <br />&d PrclBioi C.&): Any Ciry 6 C@nty ,hid r.qut ! . Fmir ro coii-aucq all6 imFot' d.mli3h ofcpdr ay ff!.rurc, pn{ to iG <br />i$N*, rl$ r.qui6 thc igplicDl fdlu.Il F6n to nl.. liin d it .t6t lh.r h! o.3h. ii li@..! puEuul lo $. Fovi3io! olth. <br />C6r..tork Lic4c<l lre (Ct.ptd e. Comacirs wftn s@don ,000 of Dvbioi 3 of th. B6iia dd Pof6ri6r CodO or that hc d <br />sh. is qmpt tt@frlm ud in. bci, f6 tlt..ll.scd qgtrpri.i Ary eiohdo of S..ri6 ,03 | t by o, appli@r f6. p6n $bjat! $c <br />!ppli.$l ro ! ciril p.mlty of rot morc rn& firc hm&d dolls (I5cO). <br />_1. 3 ound of thc p.op.rry, d ny mployG wirh w.g6 s $.t rol. .@pcnrlrion, will do th€ wort dd dr. srucla. is nol intnd.d <br />or orldcd f6 !d. ( Sc 7043, Esii6! ad PrcfciN Cod.: Ti. Cdn&d'r Lic4. tle do6 no' .!'ply ro u ow..r of rhc propdy <br />,ho buil6 o imFoa6 $.,@, xd who d6 ruch worl hiN.ll d hn.lt G rlrd8h hn d hd own aploy6, Fovi.Ld lhd such <br />irprovoc.E s. noi int nd.d q offd.d aq $1.. Il hov.va, th. buildin8 or ihprovm.l i. sold wirhin onc y@ of compl.tion. rh. <br />owM-Buildcr will hev? $c burdli of prcviig fiat h. or 3ic iot blild d imFoE fq th. purpGc of r.lc) <br />_1, a oMr of lhc p.opcny, m cluiv.ly @tr..rii8 ei$ li@!.d 6L&to6 !o consrDct Oc pej.d ( 56. ?044, Bwi.ds Md <br />ProfBion codcr Th. cdr&1d,s Lienlc kw do6 nor alply ro e om6 of propsty Dho buil& d imFove $6c6 , ud who <br />conEa.B fd ru.h proj@B wid' . Cou&lo(!) licd..! pscumt to $. Cotrr.rtrk Li.o.. kq.). <br />_I M cxopr udcr s.ctio _,8 &PC.forlhklson <br />WORXERS COMPENSATION DECLAR TION <br />I hd.by alfin un.ld p.,5lty of p.rjury on. of $. following d.cl@lidt <br />_l n."c sd will m.i.uin . Cctiiic& of Cwar io Srll-lnlur. for wdlcn' cmp.G!ri6. a Fovid.d 16 by S.ctio l70o ofthc <br />Labor Codc, fdlh. pdfdlM@ of $. rdl fd ehich thc Fmn ir i$u.d. <br />_l h.vc dd vill mrjnoin w-t6 cohFns.lion insu@@. a r.quir.d by S6ion 3?00 oalh. LabG Codc, for lhc P(fominc. ollhc <br />wo.t for which $is p6mn ir isu.d. My wo*d Mp.nstion inru@@ emc od policy nlEbcr e.: <br />Policy Nunb.._ExpiB: <br />Onis scri@ ra! nor b. cmplctcd if thc Fnn is ld Or. hudrd dollE {l I00, d 165) <br />A*.,**6.-" *ir*'.ln. p€rfffiua of th. wdk lor which 6ii p.mit is i$u.d, <br />on l.ws of Calitdia, dd <br />\I ARNINC 3ubjan u dployd ro BimiMl Fnalti4 and civil <br />dollffi (l100,00o),in !ndi!io^ ro rh.de.as e prcvid.d aq th. Serion 1076 of <br />t hncby alfim odd pdalty of pdjury lh3r I m 9( <br />lh. Busin6s and Prof.$ions Cod.,hy li@,. i5 in full fdE &d.ff.ct. <br />iy ofFilry tha! ih6c is !cosmcion of th. wo* lor which this p.mi! ii <br />3097,) <br />AIII.ICANE!,.pICI.AEAIIAN <br />D.Dolitio ?mil!-A!bdto6 Noificld@ Icd.rd R.tul.rd3 (Tid. ao. lEl 6) <br />_ R.qdr.d lr(a ofNodfcrdoi <br />ro @m9ly wirh .ll City ud <br />ab.vc n.nrion.d prcp<ny fn iff c.rion <br />I <br />Fill Line/Back Flow <br />I <br />fT