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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE tD/stG.COMMENTS (,WNER AULDER Dt]I,CANATloN
<br />I hcrrhy trrfinn un $ pctrrlry (,, Frjtrry rh0r I anr c{cnur iro lhc (rtrrr&br'l.iccn{ ljw r'or rhc t,ll{'wins rrnvnr lscc.7o.ll.s
<br />Busnr$ .nd P(rfcsnn C c): Atry Ciry .r (butrry s hich rcquirG r Jf,nui! ro .\ srtu t. dro, i'nptu!., dcnDlilh or tupan r.,
<br />\rruduc. riorro irs hnmcc. a!\o.cqutcs rhc lptlicofl ror such rcnni ro nh. \i8ncd starcmnr rhar tEor shc i liccnscd 0uNrnr '
<br />to thc F)vi\tuns oi rhc co h .kn s Li.ctrsc ljs (Chnrrcr 9. Annn$cin-s siih Sccrion 7(x)t) ol Divi\i,,n :l .r rhc Busincs !trd I
<br />P^,fcsrnnrs Codc) or inrr tu or shu iscrcnrU thcr.li. d drhrb$nrdrrhcullc!.d.rcmpri.n. Anyviddn'nolSc.rir7011.5bydny
<br />rrplicrnr ruancrmn \ubjcchlhc arpliclnl h ucivilncnikyrrnot nnncrhln rivc hundeddollffi (3500).
<br />-!,
<br />m o*ncr .f thc lroFrly. or ny .nplolr.s *nh *og.s &r rheii slc ompeMrion. {i[ drc rlE *ork md lhc $odw is mr
<br />id€rncd orofi.rcd fm sL (SG.?OU, Blsim3s.nd P,ofc$ions Cod.: Th. C.ntn loas Lic.no t w.locs.oI rrply lo m owmr ot
<br />$. preFny who ldld.r or nqeE tt.6tr {t plE d6.i o.n tr* himlf or hcmlf or lhrclgh hh d lEr om.rpbr€i.
<br />r,mviiled ihar.uch iml'bvft se bt inraicd orofi.,rd lor sk. If. ln*.a.lhc hrildi4 o inp|ftr hshwnnhmrdr
<br />ot@n{,hion. lh. O*ftr Auil:ld MII hlw d. t rdcn of Fovitr8 thd tE or rh. dii mr boild or iryhr dr pEtEry aor dr pulos of
<br />wotat(F rrs, coMfrNsaTloN
<br />IIECI,AEAIIO!
<br />I hcrcl,y afiim lnds pcmltyofpcrjuryoneoflhc followinS ddr6rio.s:
<br />-lh!!condwillmnrl0inrCcnifi(IIcolConscntroSclalrturclirwrkcd(,np.nsdiotr.rspn,vircdforbyScctiotr]?mofthcLlbor Cdq rbr lhc ncrfo.nEmc ofrhc qolk ,or shi.h rhc pdmir is h\u.d
<br />_l hak and will moinlain workcG compcnsatbn irsuEtrc.. as rcquiEd hy Sd ion l?00 of lhe Labor Codc. for lh. D.rfotmncc of
<br />the qorL for ohich liil lcrmn is hscd My sorlc$ coni!.nsalion insurone caEicr ud lDlty tumb.r e:
<br />lql nv----r--t-
<br />-l
<br />anify lhol in r p.rfoirmrc ol lh. *ork lor which rhk Frmir h h3uci. I shrll nor cmrhy 8ny FMn in rny nMBr
<br />s ac ro h.coft $b,cd ro rhc *ollc6'conwnsart,n kws of allifornil. $d !3e rhor if I sholu ti{oe slbjEr ro tlr
<br />ktkc* coffpcnFalionprclnionsofSstion l?0O of llrc L€bor C!dc.l shall. fonh*iit cotrplytrithllbrc tmvisions..
<br />WARNINOT I'lilurc to sN wortc6' ompcrslion ovmBc n u.h,aul nd shrll subi* an cn{,lorr. to aifiinal lrnhis lnd
<br />civil fincs u,r lo orc filndEd th.lsnd doll{n ($loo.uJo), in &ddnion b lhc con otofi,cneuon. d!roxts N 0rovncd for ltc
<br />sq h n .1076 nr rhr Lih4r codc. inkrc{ dnd arrormy', ltcs,//-'\ /l +- '
<br />*", 5l aL, /rtr ^",u^,,( )rrvt Ak@r [ *Itffiffi/
<br />I h.mby rflirn undcr,{halrr.rncrry rhr I .m lien({undd povirn,n of ChanrdI (oomncang }i$ Serbn 70m) of Divhion l
<br />of lhe Blsimss ad Prcf.ssiotrs Codc, {n my ltcn$ n in 6ill fore un cffcl.
<br />5
<br />I lEEhy .flifln und.r Funy of pcrjury rh{ dFr k o .onsh.rbo lcndoe recrcy for llE Fnolr:m. of lh. mrt for whkh lhls Frhh i
<br />i\iu.d (ss, l{87. civ c,).
<br />attuQtNfDgcl,lBd.roN
<br />I rlrt$y a]]im und.r F.aky or p.rjury or or tnc lollo$inr d(llrar iotrs:
<br />Dcmlili,,n Pcrmits'AstE(os Nolific ion ,tdcrul Rc8ul{' ionr (_rirlc (). Prn6)
<br />-Rcq!ncd
<br />lJllcr ol Mrincoli(tr1
<br />I .cnif, rh3r rhc lcdfol rclxlari,inr ag&di'rg asbrstx .c r al s. nor applklbL ro rhis f,hjdr.
<br />-l
<br />cslily lial I havc rcad thh applicrt ion irrd slllc thal thc d$vc nrformdiotr iscoriccr.l !3ra tocomllyunhsll Cilyafti Counly
<br />ordiEnccs otrd Slate L!*s El,tinp ro huildins cotrnrucr rizc rcl)rcsnlllivcs .l rhn C ylndCounlrtocnrcrtrponrhc
<br />uhole mnliorcd pmpcny ror in
<br />,\ppliunr 0r is.nr Silrnnl 5ll<,1x-----T
<br />UNDER GROUND
<br />Waste & Vent
<br />WalerUnder floor
<br />Gas-Underfloor {l U-Fru=*
<br />Buildinq Sewer
<br />Area/Storm Drain
<br />lnterce ptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Pi ptng
<br />Roof Drain
<br />Tub/Shower Test
<br />Rouqh Water Heater
<br />P-trap/Drain Line
<br />Main Drain/Pool Pipinq
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rouqh Plumbinq
<br />Meter Release
<br />FINAL Hltl >D 8n
<br />Notes, Bemarks, EtcI
<br />70 a,/td.f(D
<br />0I
<br />ilq'SrE
<br />POOL/SPA
<br />Final Gas Test
<br />lo( )e"l*, ra*oAo^ al
<br />-1,
<br />a osncrolrhe pmpeny. !flreclusivclycotuadins trnh ricc.kd ofltrtrdon to construd
<br />'tt,,mjar
<br />(Se 7tx4, Ausincsr
<br />md PinLrsion Codc: Thc Co.kr.roCt Li..n\c La* docs nor aptly k, Mo*nrr orp!,pd, who tuilds 6r nnpn,fts rh.r.oo.
<br />Md sho .onr8ctsinr such rrcjcch wirh r Conrmcronr) liccnscd pursu,nr k' rh. Conrdcktr\ Licctrsc L'p)
<br />I oncicnrpt undcrSalion-. B &PC forrhirrcrstr.
<br />t ndc\ Addrcs:
<br />-
<br />4 qf fi7'\,€
<br />I
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