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PLUMBING-INSPECTOR RECORD
<br />ID/SIG.COMMENTS
<br />UNDER GROUND
<br />Waste & Vent
<br />WaterUnder Iloor
<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 />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Gas Service
<br />Lawn Sprinkler
<br />Sanitary SeweriCap
<br />Back Flow Device
<br />Rough Plumbing
<br />Final Gas Test
<br />FINAL b-s--/8 JdeJo >fv9
<br />Notes, Remarks, Etc.
<br />OWNER IIUII,DER T't'T,CAIIA'I'ION
<br />I h.rcby rfltn undcr,.nrlrt or F.rjury rh,r I m cxc r rionr rhc cotundoN Lrc.$ ttrs ior Ihc bllowi.s rclsn (5$?0]15
<br />Bu{nr$ Ud Pnr[c$n Oic) Any Cty or Con , shich ,cqtrircs n ,i.nnir ro .on\rrucl. llrcl improk, d.d,lnh .r q,rn dy
<br />i!rucru!.. prir r. ils ncuarcc. !l\o ,cqutc\ rnc qrplicmi tu such pcm ro llh a sistud ddcmnr rhar h. or shc is liccnlal pulsuon'
<br />ro rhe F)visions ol lh. Conracrors Lietrscd Lnw (Chntrcr 9. Comnrncnrs $irh Scclion 7(x of l)i!nn,n.l orrhc Bu\nrc\s,nd
<br />Proltssions Codc)orrhcl hcorrhc i\crcnur rh.rclronr!trd lhc tush tu lh.0lkrcdcx. Drn,n Anyvn,h'iotroiSd6n?Ol,5brtrny
<br />llplicrd tu r pcrnir bjcch rhc antlican' roncivilnclahyrinor nmrhrn firc hutrdrcddollnn(S50o)
<br />l.osownd.frhcprcFdy.orEycnplolBswirhwag.sqsrlrislccomr.Mlhfl.*illdodr*utdn.nftr@iimr
<br />i cdcd or ofrercd for sl. (Se ?044. Blsifts lnd Pmfcssions Codc 'ttc Conr@roir Li.cns L{w &,er mr ll)ply lo an own.r of
<br />rhc F,p.rr, who liildr 6r ir{ms tlE@tr !]d eho &s *h s* himrlf o, h.rEltor thmuEh hir d h.r own.r{,loreca.
<br />proviH lhd tuch irymw'ns e mr hrqrd orof.rcd for eL. li tneE rlt hrildins or irqmeiE k sB *irhin m rEr
<br />oforgLrbn. llE Owmr Bui!.r will lsrc ln. l!d6 of pmvin8 dd lE or dE dil mr toild or iqmE lh. totEty fd rh. p{poi of
<br />-1.
<br />N owfld of rhc !'mF rr. ad crclusikl, .ontrsclins *irh licen*d conrac|os ro o.nod rlE po.ied (Sft. 7044, Busi*$
<br />$d PiDlcai{ Codcr Thc contrclol s Lic.ns. tjw dds er {aply 16 an ow,cr of lropcn, sno builds or inprcvcs rnscon.
<br />and qto onrr&ls for such proj$r, wiih a G,.ttulon, lic.isd ponu ro th. Conroc{or's Li*.* Lnw).
<br />-I7
<br />I h.rcby.fllr6 und.r Fnrlry of r.rjury om ol th. follof,ing d..lmli,ins
<br />-lhrvc
<br />rRl*illnuirrin J Ccnii.rr..tcotr\.nr t, S.llln{rc fitr sorkc^'ro rIf, \rrtrn!n\ |n.vrd.d rar hySL{ion.]7u)ol rh.
<br />Lnb.r cdlc. iorrhclcrrannan.c ol thcNoik l0 u[]chlhc Nnnii is isucd
<br />_l hlE .nd siu minhin sorleb co,Fnrsrb, itr\uEtuc. as rquiad by Sdrhn ]700 of
<br />'h.
<br />trhor Code, for lhc lcdom*c ol
<br />rlE wo,k for shth rhn ncm i. i.su.ri. My wo*6 @npcnsarion in.uec ffhl crn pot y numh.r m:
<br />_l ccniiyrhrr inrnc pcra.rmn.c .r rh. vork r{, qhkh rhh trrnir is hsucd.I shallnor onplot lny pcson in lny monncr
<br />s N to h.sm subF.r lo lhc *oltsl con cnslion hws of Cllifortri!. and u8R lhor if I sho.ld h.tom \!hrc.r ro ihc
<br />m c^ sr{xnsorio. pmvishtrs ot Sation 3?00 of llrc L$or Codc. I shall. ,orrt*ilh conirly *irh rho* tmviri,.s .
<br />WARNING: F3ilurc 16 surc w6rk B'.omp.n.otion covmgc i! unldelul. and thlll subicl on cmploFr lo ainiral l.DLici and
<br />cjvil fitui up ro oft hlndr.d lhousa.d dollrs ($iOO,0OO), dr.trron (o rBlost of comrrcn$lion. d!trDsls !i Ptovij.d Io! lhcYJibw*:x,wI I hcEby lrtrm ud.r Fnalry of Flury lhd I am li(nqn udcrymvkion of Chlpr6 9 (onmrilg rilh SNlio. 7000) ol Division 3
<br />oa rh. Busaoc* Md Prorcsio.s Codc. ana 6y ic.ne is in fu[ forcc 3rn cffcct
<br />L ..",,,","" l))? ,Jllc
<br />CANIXj]IUON.LI;IDIXGLGEIieI
<br />i\\uc,lls.c .l{}97. ( ir C J
<br />APILICANI.DECIdAAIIO!
<br />I nodry rtrm under pctrrlry of p.riury 6e or !h. touoqine ihcldari.nsl
<br />Dcmlnio. P.rmns-Ash.sos Norificarion Edcnl R.8llorions (Tirlc 40. P!n6)
<br />-Rcquncd
<br />bltcr of N<rifmtion
<br />-l
<br />enifyih{r Ihc tedcralrcEUl i,ns Esodin8 asbc(.\ rcnEvalarc nor xpplicnblc h rha rm,.(r.
<br />_l.cnifyrhd I tuvc r. l rhhrppli.drio
<br />ordina.ccs and Starc llws Elai.g l0
<br />xbvr nf,nri()Rilpft,n ny nn
<br />G,"
<br />h corcd I aBrc ro omplywirh allCiryand Cou.ry
<br />rcll$nrorivcs of rhh Ciry and Cou.ryro cnrtr ua)n rh.
<br />APPROVALS DATE
<br />Gas-Underfloor
<br />Water Service
<br />Meter Release
<br />bnd.as Addrs.
<br />-
<br />o44,a
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