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PLUMBING.INSPECTOR RECORD
<br />tD/stG.COMMENTSAPPROVALSDATE
<br />UNDEH GROUND
<br />Waste & Vent
<br />Water-Under Iloor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif ier
<br />Waste & Vent
<br />Water Pipino
<br />Gas Pipino
<br />Roof Drain
<br />TubiShower Test
<br />Rough Water Heater
<br />P-trapi Drain Line
<br />Main Drain/Pool Pipinq
<br />Fill Line/Back Flow
<br />Miscellaneous
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Bough Plumbing
<br />Final Gas Test
<br />Meter Release -.'t^'4c aFINAL\.Lt,181
<br />Notes, Remarks, Etc.
<br />'t-llJ\
<br />I h.rchy dlllrm undcr Ff.lry {,1pcrNry rha, I nit.tr 't, no r rhc Gr tu.ror' I ic.nsc I r\Y f(tr rh. f()ll,*in8 t$!)n lsuc 7)ll 5
<br />8us[c\s rnl lt.lcr\i,,n Cod.) Aiy ('[y or Coutrty *[].h rcquir.\ r rnnir k, coNrucr' rlt.r. i Prrt. d.irli\h .r (_|[n rny
<br />{n'ciurr. frirrn) i( n$rnc.. rl$ rcquirc\ rhr rpllicri tur su.h !.nDir ro lllci signcd {lrtnrnr rhtrrltor dt i\ li(c scd lur{anl
<br />rffli.trtrr fttr 0pcirnn srhjccl\ rhc !|]i,li.r kJrciril|[ tlrvofror mrcrh llvc hundrcd dolh\ l$5(X,
<br />-1,
<br />dr owm. of rh. prcFny. tr tuy.mploFs *nh wa8!s !s lh.n eb con{ENiion, lil &, thc ert lrd rE 3ilfu i! ml
<br />iolc .d d ofcrcd lor slc (Sd.?044. Bu.ircs ed Prolssions Codc: Tnc Co.lrlcro s Li..n* Lrs dfts ml .nply io a oan.r of
<br />rh. poFnr eh. boildr d inpros llfDn. snd srb &B uh wri himsclaor ltr.lf or
<br />'hrcugh
<br />his or hcr own ci0loy.cs
<br />orevidcd rhur r&h inplwrnls @ ml id.nd.n qofErcd for sle. lt howE, E buildir8 or irprewm i.sldwnhhomFs
<br />of.orphthn, ltrc Ovrcr Builrd qill haw &. hdc, of povug 0rrI lE or she dil ml hoiu or in{noB lhc PDPsty for lh plqe of
<br />L es owncr of rlE !ml,.ny, .m qcurively co.rr&ritrg wilh lic.n*n .oift.rou ro @.srdd lt! Foicd (se. 7044. Busirc$
<br />sd Eoi:sionCodc: Thc Co.t@loas Liconsc t qdo€snolalllytooowncrofProP.nyqhobuildorimprovcrlnr.on.
<br />lnd sto @druls for iEh Fojdlr with ! Conhcro(s) lk n*d puF@nl lo th€ Coonlcro s Li.cns Lrw).
<br />I onrcrcmfl undcr Sccln'B. & P.C. forlhn,c!\on.
<br />JIABrcf,S:IjQMTENIAIIAN
<br />D&CITAMIrcN
<br />I hcrcby r0irmund$ r..,lryolpdjuryonc of thc follovin8 d.cl,4ti,nsl
<br />I hrvc ud sillnui rhaCcnilrtrr.ol C. * h SclllNurc lot sorkcr' conPc.sxrn .as Imvid.tl lir hySrrn'n 17(x)o, rhc
<br />htx, cdr. f.r rhc lErfon k-.c .I rhc $ork fitr shi.h rhc n rn'ir is nsuc
<br />I hiv. anJ ! ill mrinroin *orkca .o'!p.n\.ron rnsulrtrcc. trr rcquircd b, Scci bn l7m ta lhc khor (bdc, lu ih. l.rronmftc of
<br />lh. $ork lorshichlhn pcnnir i\ isodl. My wor*.r' .omPrnsatn,n insurarcc.uki rl}d Flicynumhcroc:
<br />Policy Nunbcr:-ExP
<br />-l
<br />ccnily rhat in $c lrrfor.Emr ofrnc work lor *tichlhii pomir ir i.s!cd. I shall nol cmnk,y uy p.tron in any truncr
<br />$ ar t txcom subjccl to lhc ertcn'ompcn\arion laws ol Cdlifomia. lnd lBE rh irl should i*conE subrc.l rorh.
<br />*odrds coml).nslhn pmvisions of Sc.rn n l7O0 6f lhc ribr Codc, I slull. fonhwnh coopry si$ lhorc pmlisiotr1..
<br />WARNINC: Frillrc ro suc volk.n ompc rlion .olcsse is lohwful, nd shall rubjccl 4 enllorE lo 6i'riml FtuLtr o.d
<br />civil nncs up ro onc hunded rhous!trd dollm SI00.O0O). in rddnion io lh. cosl io.. d!m8.s rs proridcn for rhc
<br />Sccrion .1076.frh. Lah.r Codc. inrcrcst
<br />,*", Otr,{ zry,l u
<br />I hcEby !flirn undo Fnalr, .f prju.y lh.l I um
<br />DECIdBAIII)N
<br />n*d undcr pmvnio..fChucr 9(commeins vnh Se'i ?0m)ofDivhiot:l
<br />ot lh. Busimss snd Prcfesions Codc, dd my liccnc is in tull toN &d cll6r
<br />Z-
<br />I hcEb, a,nm undcr Fnrlly of pcrjury lhal
<br />krucd (Sc.. 3097. Ci!. C.).
<br />co.srrodb. LndinS ag.flcy fot lhc Flrfomrc oflh. s for {hkh thrc Fnnn b
<br />tJ'dc'-.\'i{-_
<br />t nddi AddrEcq
<br />-
<br />AIILICANIDI,CI,IIaAIII,N
<br />Itrnhylltimundcrrcnrhyof pc.juryoncoith.folloqirgdLrl !ln,n\:
<br />Dcmlnion Pcrn rs.Ashcnos Norificarhn F.dcrrlRc3uhriotrs (lirlc40, Pdr,
<br />R.qnncd Lcuer o{ No'incri,,'
<br />Pninc( e\ius
<br />TOP OUT
<br />POOL/SPA
<br />Pool Heater/Gas Line
<br />,*", d.lza'l
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