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PLUMBING.INSPECTOR HECORD
<br />APPROVALS DATE COMMENTS OWNTJR BUII,DUII DELCARA'I'I('N
<br />I hrrchy rnim uodcryrn.lly af p.rjury thd I :m cxcnpr [io6 rh. C(,nrr(tu^ l-icrnsc l-rw r.r rhc roll{*iog rcav,i lscc ?011.5'
<br />Busincs\ arkl Ptur.$i, C{xlc): Any Cir, or Counry shi.h Equncs i Fanir ro .onnrucr, rlr$. i provc. dc Dlish or rcprr My
<br />$n'cnrc- lritrlo ns ksurtcc..l$ rcqunc\ rhc,mlicur lbr ruch lxnnr Ir) fL i sirncd nutcmcnl rhit h.o! shc is liccNcd pur{rN-
<br />ki rhc ptuvisn,.\ ofrhc Conrracrd\ l.i.cn{d Law (Chiflcr 9. Comrcmin! wirh S..rior ?UD of Dirhiotr ] olthc Bu\i cs\ and
<br />Ilolc*idrCodc)orrh h.mshciscxc rpr rhcrerromnnd rhch^1\is lor thc ullcscd cxcnrflion. nyriohrnrolScdion7tl:lI 5hy.n)
<br />xnrlicanllor0|Emilsunj.ckrh..!pli.,hrfur.iriip.hJlryofnorn-r.rhufivchundrcddolh^1tt0o)
<br />_1..( o{trcr ol rl[ I)mlkny, {tr ryc {loyc.s \iiri ug.sr\ rhctr ele conrFitr\ i,$. silld. rhc rork tnkl rhc nndurc i\ r
<br />inrc cd.roltrrcdir{hlsa7O{-l.BusircsrtrdProlcs s Cdlc lh. Co krrkr\ l-icci\c lls do.r nor lntly r. m o*ncr oi
<br />rlt pmpcny wh) larikls.r i'nnn^tr rhru,d. ndqhod(E\N,.h$orthiNcllorhcrrllorlhrcuShhisorhcro*trcrplo)ccs,
<br />fn)rn[d r,nr$,ch i'np'orcnrnr\ x'r rr, ir c.d.\].roflcrcd ftr \rlc ll h'scvcr, rhc btri nB or iml,Rrrnrnr i\ v'U wirhii on. J,.r
<br />l. nrowftrolrhc pDrcny. umcxclusivclyconrocrin8 wirh lic.n$d conr0do^ lo onimllh. Imicr (se.71144, ausmrs
<br />lnd h)f.\shn Codc ThcCont.c'or'sLi.c.sctlwdb.s.dropnlytoanoMcroll,r)nenyehoblildsorimrmvcsrhcrLlnr,
<br />Nnd who cbnt6crs for such proJ$Is sirh a ConlEcro(s) li.cnsd luBumr lorhcConlrodols Li.cnsc b{).
<br />_l ad cxcmnr onds Sccl
<br />'?hy/t0
<br />DEI]I.AM:IION
<br />I hccb, rlfirnundcr lcnally ofF luryonc oflhc folhwing delu.ra.$:
<br />L.rli, Cod(.,,tr rlr l{'lnnricc olrlI \o lnr\rhi.hrl[ D(nrd i\ i\n,c,l
<br />_l ha\c ,nd Nill minlain *ortcs conpcns,rion insurarcc. I requircd by sftri.n 3Il0 ol rlr Lrbor C6dc. fo. 0E pd(rucc of
<br />rh. erk for wha.h rhii !.mil is islcd My workEs amp.Mrion insu'a .aid [n Flhy nuntxr e.:
<br />P,,li.r NLmhfl _ L\ c\
<br />-l
<br />ccnify rha' in lh. Frrormm of rh. work for *hth lhis pcrmit is hs!.t. t shatl ,ot ctrploy any l,c6on in lny numr$ arlo b.otu $hjcct to lhc wo*m'onpctrs.li,n laws orColiromia, md '3E rh.r ilI shoold tE .m sublf,t io tlE
<br />wod<er conwns.riotr lovisiois ofScclioo 1700 of$c Lltsr Codc,I rh,ll, fonh*irhcoEply wth th)e pNvisiong.
<br />WARNING: Failur lo scurc sorkcs' .onlrc.ethn .owogc ir unliwrul. ed shall slbif,r rn .trployrr lo difrhal lcMhi6 and
<br />cinil fincs!I,loomhu rcd lhousnd doll.rs (Sl0o.00o). in addirkn rD rhc co ol codwtrqrion. danEgcs as providcd for rhc
<br />4 4
<br />PDIIdMITAN
<br />I hcrct y sfljrnundcr pcnrll! orpcrrury rlu l,m lic.trcd undcr nmvision ofChlplc! 9 (.ohmncins wirh SLttk n ?OO0) oltlirhion l
<br />oi ihc Bxsincs lnd Pmfciiofi Codc. und my liccnrc h itr n'll lor$ fin dlt r
<br />Liccnsc CIiss _t,ic.nsc Numhc!:
<br />lrlte: Conlhdor
<br />CONSARUCTI(Iii LENDIN(; AGENCY
<br />I hcrcby.r6rm und.r Fn.hrorprrjuryrhnr rhcrc is ! ansrdctir lcndir8 ascncy tu th. pcrfomne ofrhc *ort for *hkh thh Irlnn h
<br />i\\!cd 1SN. :1097- Civ. C ).
<br />ATILISAILDEII.ASAIION
<br />I hodry arm udcr Fnalty ot p€rrlry orc of rhc lbllo{i.g d(la.{rioos:
<br />D.nFlilion Pcrmik-Aslxsros No'iliorioo tucr{l Rcgolat io.r (Titlc rl{. Pan6)
<br />-RcqoiEd
<br />L.lrd ol Noifrdion
<br />-l
<br />cni,i thlt ttu rcd.El E8nlalions ES,rding dsb€slor rcnlrdl d nol applicublc to rhh l)oj*t
<br />I .ciify Oal I hrvc rcld rhi\ applicali.n lnd slarc lhll d. nhr. infomli.n h co,Br. I lgre ro smpl, wiih eI Cny and Cou.iy
<br />mdinr@s ,nd Srrrc L!*s rcLtin8 ro huildi4 constrElion. drd hcrcby aurh.ri4 rct'esnl'rires ol rhh Cny and cou.ry to cm6 lpon rlE
<br />rtx,F rmnrioncd Iropcny ior irsp.cr
<br />.{pplienl or Agctrl siamlu
<br />..4/L2./7
<br />UNDER GROUND
<br />Waste & Vent rp/d/ka t/6744d,
<br />Water-Under floor
<br />Gas-Underfloor
<br />Building Sewer to/(d/,? e/,4o./t+ld
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent thwill- t '/uDlt*/&-
<br />Water Pi ping D'fu+k ?aoo+/L
<br />Gas Piping iola,llv fure*/d7'
<br />Roof Drain t
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P-tr ap/Drain Line
<br />Main Drain/Pool Pipinq
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Gas Service tdlltht' c ?v|6dA-1o-'
<br />Water Service ( r,'
<br />Lawn Sprinkler
<br />Sanita ry Sewer/Cap
<br />Back Flow Device
<br />Rou gh Plumbing tDrrd/t (fu,ta7a-/A-
<br />tU,ililt- t Az-
<br />Meter Release A-tqqY )rt#00
<br />FINAL 17-l1"lY
<br />Notes Remarks, Etc
<br />ID/SIG.
<br />Area/Storm Drain
<br />4t Dr*Final Gas Test
<br />VJYdA/
<br />sdion 3076 otrh. L.lu c!dc, inrcEsr lnd !flomyt
<br />""" 1/t Yy'o
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