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PLUMBING-INSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS Waste & Vent Water-Underfloor Gas-Underfloor Building Sewer Area/Storm Drain lnterceptor/ Clarif ier TOP OUT Waste & Vent Water Piping Gas Piping Roof Drain Tub/Shower Test Rough Water Heater POOL/SPA Ptrap/Drain Line Main Drain/Pool Piping Fill Line/Back Flow Pool Heater/Gas Line M isc Gas Service Water Service Lawn Sprinkler Sanitary Sewer/Cap Back Flow Device Rough Plumbing Final Gas Test Meter Release FINAL G-S-/6 J).{at u€D Notes, Remarks, Etc. OsncFBuil.Lr Ddl.nrion V I h.reby!m. under pcMhy ofr"rruryrhd l.n,.remd fom rh. co.kldou LE nr.t.wlorrn.follosrnsr..sonG{ 70r1.5Busin.$ lnd frofc$ion Cod.): Any Cily or Couly uhich r.qun6 r p..mn lo coNlrucl..h.r. inprck. d.molish o. rcprt..y nruclu.- prio! to ng isunc., ilso ..qut6 lh. ipplicanl lor loch pmil lo ,il. ! lisn.d nlrdrcnt rhn' h.or!h. k lic.E.d FuRU.nrroth. pmlirioEof !h. Co.t.croas l-8.6.d L.w (Chiprd 9. Conm.nclns * hS.cton7000ofDivion3ofrlEB ind lnd Prol6lions Cod.) or rh{r l[ or sn. Ls.rcmpt lhcr.li.m.nd th. bssb forln rll.s.dcx.lnption.AnyliolslhnoaSftlion?0ll5b,dynpp,ic.nlaorapcnrilsubj.chltc a!!lic.m ro a.i!il D.nlnr ofnd morc rhnn n!. tMdr.d d.llaR (t500). _1. u o*n6 ofrn pmp.ny, or sy dplorc wiih w.86 a rh.t $1. comp. rion. sill do th. wort ed ih. rlru.t@ ir mr inl.nd.d or of.r.d for sl. ( Se.?O14. Butrnd .nd Pbf.ltioN Cod.: th. Contaclor'i Li..N. L.r do6 ml .pply ro .n o*ns of rh. pmp.ny who bdld. o. improvd rh.mn, &d *ho rio6 skh ,orl hi@lf or hcalf or lhrolih hii 6r hn osn dplorG, provid.d lh.r tucn imprcv.m.nr! u. nor i crd.d or olId.d for sl..lf. no*cva. rn! b{ildbr or inrroa.B.d n s6 wirhin oE yd olcomplaion, rnc Ovn6-Blildn vill hlvc rtc hr&r of previq llur h. or .lE @l brild or inDmv! t'r lh. purDok ofuk). rz1l.6 ow6 oflhc prcpmy, u Giclurvcly .onhduls *ilh li..scd @nl6.lou ro @Brtuc rhc proicd ( Sc. 7044. Bltii6 &d Pbf*io. Cod.r Th. Conttdor'r LEn* t * d@ mt .pDt !o .n ol@ ofproFry who hlild3 or improvo th..6n , .nd $tD @mndr lor ruch Droj6r. vnh . Conhclo(.) li..nr.d ruBrnt ro rh. C.dndoas Li4m. t w ) _l d .Mrr unda Seion _,8. & P.c. &r thir llen Drl.: o!rk: ltoa$8!ca!4rE!tAIa!.p&c!d8aE9! I hftby,mm ord6 p.@hy of lcrjury onc oarh. aollowinS d(ldrioG: Ihd\.a.drsillhainrdin,C.dili.ar.ofCo6.nrroS.lflnsur.lor*orkem compcns'r'on. rs provided fo.hr S(r'on l?00 olrn. l.a&trCodc, forrh. p.rfomrncc oflh. nort lor wnrh lh. p.mit is issu.d w(hr'.rnd*'lln'i'nrs'nsurl.rs'(omnensrr'on'nsumnc..as r.qtrrcrl by S.cr'on lTOOolrh.Labor Code, aor r!r.p. ohnnccofrhc dic'ceoricyNDh6 IO (Thb r.ction Nd nor bc comDl.l.d if th. p.mn is aor I ..niry rhd in rh. p.rfoImn.. ofth. w.rk f.r which rhb p.mn i.hrll .ol nploy t.y p.6on in any mDnd s as lo rI.B ' onp.nsxon LwsofC.ha6rntr,. ofs.clion 1700 otltu lrborCod.,l shall. wAiNlNC tailur.lo saur. wo,k6 @mDe.s!'ion ,loyd lo c.ininrlp.ulti6 ind civil a 9rcvid.d lo. rh. S.clion 3076 olnD.s up to oN tudr.d ltoustrd doll6($100,000).in ddnion th. hhor Cod., i ..6t and. o.n y! f6 ucEtiED-cauBA.qrQaioEcldtrauqN I hcEby lmm udcr p.nalry olprjury lhll I m lic..sd undr povirio, ofch,pld 9 Goft'n.f,cins wilh S..liof, 7000) oaDivision I of rll. Buin*.nd ProfdsioB Codc. ed 6y lic.tu. is in tult lor.. ed.rId.tDtnlB.," l--f'IF S CONSTRTICTION LENDINC ACENCY I ncrcby dfim md., p.tr.lry or pdjury lhrl rhdc is ! coNrtucrion kdins ls.fty for lh. pdromn.. of th. sort for shich lhi. p.irnil ie ir.u.d(S(.lm7,Ci! C.). a[E!.lcaxr.tDoct^tar]lltr Dcnolirion Pmil3-Alb.slo. Norificllio. F.d..!l R.gul.liod (Tir L 40, P.n 6) R<ui.d L.rrd olNodn..rioo I..niar rh.t th. fcd.ral rquhlions sb.nos ron \allrcaol dpplicabl.lo rht p,oj.cl ?'f c.nrry lhd I hrr. rad rhir rpphc.r 'l'I. ihlr rh. rbov. inlomrio i! corc( I !9r.. ro coEply wirh lll ciry .flI couty oidiunce rnd Slat. t $ rchrine ud hcrcb, .uthorn. r.P.G.nt.riv6 of lhis Cily .nd 6b.v. m..tion.d propcny for 0l<_I lnspoclion Forms\Plumbin9-lnspeclo. Rscod.doc 03.31 06 7 UNDER GROUND ^1" il [La ^*,"*,,\ t nd.ar Addr.$: L.LL-\ .l I