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PLUMBING.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWNTR IUILDER DELCAXATION <br />t hcrcby iffirn undcr pcnaly of p.dry lhlt I m.x.nt tomthe Co mcroF'Liens tlw for llk follo*ing rcis. (S.c.7o315 <br />Busincas .rn Profcsio. Cndc): Any Cny or Colnry ptth r.quircs . Fhir lo onsrrud. .llE inpov., &mlkfi or EFn lny <br />slruclm, rior lo i$ k.u,Nc. rl$ Equics rlE aprlicant for srch <br />'tmi <br />ro fi|. ! sig*d sl,r.ft rhlr hc or rh. ir liencd llljer <br />lo th. lovhions of rli Contrerois Lien$d Lle (Cnaprcr 9. Comftkine wirh Ssrkrn 7000 of Division 3 of rlE Blsitus, {nd <br />PDfcssions Cod.) or lhal tE or si. is.rcnpl Ih.Efrom !d .hc brii.\ for lhc ,lh8pd crcnDiio.. Any violaiion ot S.rlir.70J 1.5 by aoy <br />appli.rl fo, . |Emn subjcri rlE apdi.. to a civil Fruhy of mr mrc rhe 6vc hlndrn do,les (S500). <br />-1. <br />!s owr ol lhc poFny. o. ny cDploy!$ snh wl8cr &i !h.t bb 6n!.niirion. wiu .lo tlE qdt dd r,r nn81e i! mt <br />inrdi&d or o,Imd for 5h (Se.t044. Busims md P,sL$ioB Codq Thc Coni@ro, s lie!* rlw d@s mr 4ply lo !n owmr of <br />lh.,,sFny st6 hilll3 or inifth rrab.. ,id wb d6 uh w* fiimFclr or hcr$lf or thmud nis q hs o*n cq'!6)rc$ <br />p.oided ln.r such itr{mv@nt' N el hlqd.d orotu for sh.Il lsM. rlE buildiq or nrFmEmnl h $ld {hhin otu Fa <br />ofcorrlelhn. ttE O*ffi BuitLr I haw th. hodcn olprovi.g lhat hc or slr dirl nor hild or irptoE lne I,Npsry h. de Fqn$ ol <br />-1. <br />es own( of rhc ,ropcny. rm cxcluiivcly .onracri4 wirh liccnsd conruron lo @ndrod rlE pmjsr (Scc. 7044. BBitu$ <br />atlj Phl6ri, Codc: Thc Conlmcrols Licensc l-8e docs nol splrly to M own.r oftmpdlywho huilds or imtmvcs lhcrcon. <br />and who conrra.c for !u.h pmjmts wirh a Conmcb(, liccn*d !!ru.r ro rh. Co ncrols Lk.ns Liw). <br />-l <br />sn cxcmpt undc. serio.- B & P C. lor rhh rcasn <br />IAAf,ESLCOMEEIAIION <br />DECI.AMIIAN <br />I lErcby amrm undd l,cmlly ol pfjury oN ofllt rollowing del@rio$l <br />-l <br />h.!c !d *ill minlsh ! C.nifEal. of C,ns.r b Sdf-l.sc f( sqlcE ooFnerioL a. p.ovided fo, by Setion 3700 of llr <br />Lllor C!dc. aor Ih. perf.rIl.@ of $e wort fo ahich thc Ddnir ii ireucd <br />_l haE and wilt mainlain sork R omp..srtion iBuiN.. $ rcquircd by S6tio. 1700 ot rhc kbor Cortc. ao. lhc D€,rollrec of <br />k nsucd. My workc* .onNnsdaon in{rtrtuc .aftidr {r1 lolicy numb.r dc: <br />t1s.t r-Zo r<a d+o.t.\.rau <br />_l c.difythal in rh. Frformne of rhc work ro, which rhh ncmrn h iasncd.l *hau oDt cmploy lny p.Bon in ony numrs $ lo b$om subFl lo lhc wor*m ompcnsalion hws of Californi4 and tr3N lhd if I shoukl tEcoE $bjd lo lhc <br />erkcrs'@n!.isrriontmlhionsofScrionl?00ofrhcLnbrCod..lshlll.lonh*ilhoq,lywirhrho$povhions.. <br />WARNINC: Ililurc lo RW wortes comrcnsarion .rvcmg. i{ unlawtul. md shtrll subirt d cErlorr m aiminal FMhts md <br />civil fircs un lo orc hundrcd lhousanl dolhB (llm.om), in addnbn <br />'o <br />rhc .o{ oi <br />Sdion 30?6 of thc L{tnr Code, brcrcst ed4. <br />I hchhtrflir uM.r lt.,lttorr.rjury rhi I rm licc!$d under rovisnr olChrnt.r 9 (.ommncin-q *ilh Scclion 7()o0) ollrj!ili{nr l <br />.r rhc Bu\i!.$lnd Polc\si{nnCode. ond nyliccne h ir tulln,.c md cflB:r <br />3 \o o1 I r,1 <br />g con .,o. V-4, <br />(gllilBlJ1:uall.lNDlNritclitrr <br />I hcrchy rllnn uMcr lxndkyoiFcquryrh0 hcrc is r c.n{ddtrn LidinE ugdn.y tur rh. l.dnrun . ofrhc sork id whrh rhis r.rnrir i\ <br />is\u.d(Sr. .1097.Ci! C ) <br />ATTIIIANLDEITABAIPN <br />I rlniby,itifrr u dcr pcnrhy 6t l,critrry oic ofrtc folloainA d$lmnion\: <br />Dcnnnirion tcrmirs Asbcnos Norifica'ion ltdcml R.tu l{r idtr ( tirlc J0. Pd6) <br />Rcquncd t,llcrol Nolili.rlbn <br />rc8uldiotrs rSaltlnr! ,\h.slo\ rcnDvrl arc nor +pli. lcrorhisI)n)jrrr. <br />srpnliclrionrd (orcrha[,r {h)vd inrorn iotr is.orccr lolrNtocomplywirh,llCiry,trdCotrnry.cdiiyrhar lhrvc rcnd rhi <br />oidinanccsrnd Srlrc h*s rchtin8 ro hlild ins consructiotr. !trd rcpEse otivs ofthh Cily 0nd Counlylo cnlcr uron <br />'rElhovc <br />'rcntnnrcd <br />pmp.ny lor inspccrion <br />AppliG orAa€nrsilmruEl <br />UNDER GROUND <br />Waste & Vent <br />Water-Under f loor <br />Gas-Underfloor <br />Burlding Sewer <br />Area/Storm Drain <br />I nterceptor/ Clarif ier <br />TOP OUT <br />Water Piping <br />lQqs Piping <br />Roof Drain <br />Tub/Shower Test <br />Rough Water Heater <br />POOL/SPA <br />P{rap/Drain Line <br />Jt/ain Drain/Pool Piping <br />Fill Line/Back Flow <br />Pool Heater/Gas Line <br />Miscellaneous <br />Gas Service <br />Lawn Sprinkler <br />Sanitary Sewer/Cap <br />Rough Plumbing 4/r9/r.t .D 6b <br />Final Gas Test <br />FINAL Iolq/rv -ac$ <br />Notes, Remarks , Etc. <br />Waste & Vent <br />Water Service <br />Back Flow Device <br />Meter Release <br />lr.lo- <br />kidci! Add6!: <br />- <br />- <br />D.Lr_4.. c .tc,