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PLUMBING-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS <br />UNDER GROUND <br />Waste & Vent <br />Water-Under Iloor <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 Piping <br />Roof Drain <br />Tub/Shower Test <br />Rough Water Heater <br />POOL/SPA <br />P-trap/Drain Line <br />Main Drain/Pool Pipino <br />Pool Heater/Gas Line <br />Gas Service <br />Water Service <br />Lawn Sprinkler <br />Sanitary Sewer/Cap <br />Back Flow Device <br />Houqh Plumbinq <br />Final Gas Test <br />Meter Release <br />FINAL t0-il-lt <br />Notes, Remarks, Etc.V <br />OWNEf, BUILDER DELCARATION <br />I hcEby slfim ud* rEn.hy of p.dry rhar I m .x€mpt tDm th. C.niracro6 Liros Lrw for th. tollovil8 EaFi (Se..m31.5 <br />Bosinc$ and Profission C!dc): Any Cny or Couty vhkh r.quifi ! Ign! ro oinrucr. .llq. iqrcE &mlhh or Elst sy <br />$rucrE pri,r lo nr i.strc. rls E4uics rlE.I,tlisr to. iuch Fmir lo lih. siSn d st.Lmnl tlEl ltd 3lE h lidBd Pullar <br />ro rhc provhions of $e Conr.cro r Li.enrcd Llw (Ch.prcr 9. Comtrrcin8 wi$ Scclior ?0m of Division I of thc ausi..rr and <br />Prcf.sio6 C.dc) o. rh.l & o, dE k .rcrtrpr rh.Elion.nd $. b8is for rh. dLrln crcmFrioi. An, vi,bdon ofSp.lbn 7011.5 hy..y <br />appli.s for ! !.mir slbjcls rlE lp?ticlnr to ! civil Ftulry of tul mE thd fo. hundrd .lolldi (1500). <br />_1. a ow, olrhc pDp.ny, or ny coploFq with wt8s a rlEt ek onFetio.. wiu &' rlt d* ad tlt nf,mrc n @i <br />inldd or offcEd fo. sk (Sc.?O4a. Busircss ud Prcfsions Cod€: The Conlrelor's Lems Lrw da ml.pply lo m owr of <br />rh.porEny *ho buildr 6r iqmB tlE6n. lid vho dB Mh mrk hims.ll or Lr$lt or ttEust his or ltr 6M.n4loy..s. <br />providd rh.r such irymwirs e IDl i .txlcr! orofiotd for $L. la.lrsE tE birildine d inproEm.l ie $ld wnhin nt )st <br />of corphrion. tE Owrcr Buildcr will trw dE t'lll&r of ptuvin8 rtd & or sh. dil hr build or irpr.w tlE Fotsty tor tu ,upoE of <br />-1. <br />asown*ofrh. pmp.ny. !mcrclusivclyconlr.clinS wilh lia.sd conlracro^ ro conndcr lhc Pn,icl lse.7t}:l4. Bu$nc$ <br />and t'lntr\sion Codc: The C.ntra.roas Li.cnac Law d@i nor apply ro a owmr of proF.ly who builds ot iry,rots licren. <br />and wh. 6n'tu1s ror such nmils wnh a C.nrE to(s) liccns.dl,usu]Ir ro rlE Co 6.toar Lieos rrw) <br />I mcx.hDl undcr Sdlion , a. & PC. forlhntMn <br />Orner:-- <br />UAf,TEf,UI]OMPJNSAIIAN <br />DECIAX4IIOtr <br />I hcEhy alftarundcr pcnaltyofpcrjuryorc orrhc lnll{,qins d(hBlions <br />Ihrrdr lwillnuintrirrCcni6carcofCo.\cnrloSclfl.surclbr*ortcrs.omp.n\di.n.a\ pmciddrllorbySlrlion:1?(lOolrhc <br />t]hirc{xlc. turhcp.rror. r.olth. work tur which'hc pcrml n hsucd. <br />_l hlv€ and will roinroin *orkc^ .or{En\!r ion in.urakc. ar rcqun d by sccrion 1700 of thc Llbor Code, for rhc Frfo@n.. or <br />lhc work ld {hkh rhis F.mir iq i!su.d. My worknc @rp.nsrlion insur0ncc clEicr o rricy nomhcr de: <br />Policy Nudber: FxpiEs: <br />-l <br />enify lhat i. rhc perlorNfte ot fi. w6rk to. which lhia p.ron t hsucd. I shall mt nploy any ,cr$. i. &y mtnmr <br />$ $ ro b.om subiEt to rh. mrks'or{rc,stion laws of Califomis. ard aglc rh{ if I should b.{or s!bJ..l to lL <br />uortss' conp.nsrion povisions of SNtion 1700 of lhc Lator Codc. I rhrll, tonhwnh .omtly wirh lhoe tmvisions.. <br />WARNINC: Faal!rc ro s.re workcR' ompesrtion cov68c i! u.hwnil and snsl subid m dPlor!, lo dhin&l FMlrias lnd <br />civi! 0es up ro oe hundrcd thousand dollG {5100.000), in addirion r. lnc .ost of cotrrpcretion, drmgcs o! previd.d aot lt. <br />Sdiotr l{)76 oflh ljborCndc i cen ahd,nomy 3 tcci <br />t <br />I hcEby .lIm qd.. FDIy 6f pniury ln.l I m liensd u.der Flvi,ion of Chetld 9 (omEmi.g sith S4tbo ?Cr00) of Divirio. ] <br />of rhc B$ift3. ed Profc$ions Cod.. nt my liccn* is i. tull for .d .6e1. <br />o*", S/t 9/ t?t ,*,*,* <br />APILICANLDECIAf,AIIIIN <br />I h.nby ollmr u.d.r t nally ol ticrju, one of lhc folbeing dcclealio.r: <br />D.nsliridn Pcrdn$Asbcsos N.lificllion Fcdcnl Rcaularions (Tnlc 10, Pon6) <br />-Rcqut.n <br />Lct'cr of Norificalion <br />-l <br />ccnify rhar rhc lcdcnl (s]lhrio.s Esoding asbcsros rchovd @ n t {plicnblc ro <br />'his <br />poi{. <br />-l.cniryrhur <br />I hnv. rcod tht trt'pli.nlion and slalc th0l lhc etrvc itriorrorion h corer. I tsre rocon0ly wirh t[ Cnyand Counl] <br />.dinrn..\ rnd Sr3re u*lrclnrint bu i ld i.8 .oh{rucr ioo. .*1 h.rcby aul hortc rcprcsfltltivcs oflhis Ciy lnd Connryl..n!cr upntr th. <br />lbow mtrtion.n Dmpcrly for <br />Appli(rnl or AEonl Si[mlo <br />L<,1it) <br />(-3t )(, <br />liEgzil <br />IOISI3ICU!,INIENDINS.AOEN.CI <br />I hcEl,y aflinn undcr lEnalty of Frjury rhd rhor ir . onsrud ion hndang !g.n.y for $. pcrlormre of thc work fo. which rnis lrrmil t <br />issu.d (S.c.3097. Civ. C.). <br />lldca\ Nom'- <br />Fill Line/Back Flow <br />Miscellaneous