|
PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS
<br />UNDER GROUND
<br />Waste & Vent iL/rc /n
<br />^ffi
<br />,il21., 1Ml 72rt^t=
<br />Water-Under floor t{/u'tlr >\E{Tp6, pdll6tl
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterce ptor/ Clarifier
<br />TOP OUT
<br />Water Piping
<br />Gas Piping
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOUSPA
<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 />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbing I nlaohq AflA,n ,&
<br />Final Gas Test
<br />Meter Release
<br />FINAL ( ( 11l lol u.e|@)
<br />Notes, Remarks, Etc.
<br />OWNER AUILDER DEI'ARATION
<br />I hRby.frm und6 p.Mhy of Fjury thrr I m.x.md noD lh. Conmdon Li..!s Llw lor thc follovin8 E$n (Sd.?011,6
<br />Blrin*s and Prof*ion Codc): Any Cty or Counry nhi:h r.qui.6 a ll.mir ro 6n{ .1, 116, impmv., &mlish.r q'ar my
<br />,ruchr., prior r. il. i*{rftc. .b. r.quirc. rh. applicanl for sch n mir lo 61. o cirD.d slatocnr rhll hc or lhc ie liced FUmd
<br />lo rh. Dhvilios of rlE Colnr.clq r Li.a!.d Llv (Chatr., g. C.m.rchg wilh S.clion ?000 of Dirsion 3 .f $. Buin r. a.d
<br />i.rsio.t Cod.) or rlEr ,E or BIE is q.npt thftnlm .rd rh. beris for rh. all.s.d .rcFplior any viohr ion ofsdlion ?0, L5 by lny
<br />snpl'., nrtrI)trm tubccrsrh. rpphc.nrr.,crr'lF.ahyoino' nmr.rhan nve hund..d doll.rs(5501))
<br />_1, 68 oM.r of rh. proFny, or dy.nplorr., enh w!s.B as th.t slc mhlcdillio., eill do l1l. wrt !d lh. tMG i, ml
<br />i .i<Ld or of.r.d for sl. (56.7044, BNiBs sd Phfsiotu Cod.r Thc Conhclol! Liffi Llw d.$ ml tr,ply 16 u owr of
<br />fi. popdy wh.t ildr or inp,lE lh.6l\.d *'ho dG sh w& tim.lf or h.ellor ilmuph hh or h.r om.mploFe.
<br />povidcd rrr tuch ir'roG@n. c mr o!c.d.d orotu for $L. l[ tnw.G.ltE blildiis or ir{ovff.I ii sld sithin om )&
<br />ofmnpErh..dEO"mBuildE willh6w rlEt dcn ofpmvins ttd lE orrlE dil ml hliH or irFsr 0'. ptoFny tu tll puF* of
<br />_1, .i om.r ofrlE pmp.ny, om .xclu,iv.ly cor.lEcr ins wirh lic.nrcd &ntEcros ro @nsldct ihc pmjel (S(. ?044, Ausins
<br />and PoEsin Cod.: Th. Corlr clol. Li..G. Law des mr apply to
<br />"n
<br />owne. of pmr.rly str hlilds o, innovB rherol\
<br />a.d who 6dtrt9 for sch pmj.{t3 enh . C.ddcto(s) Iicnrd t!M.t ro rh. Conh.lols ticmk ljw).
<br />{(t
<br />!lE!!.!!l:!1].ql
<br />I h.rchy amrm uM.r p.Mlty of pcjury ok oflhc fo
<br />-l
<br />lsv. ad eill @inrah ! C.flifraE of Corst lo SclI-t,le for wlca @mpadrion. s Fo"ird for by s.nion l?o0 of rlE
<br />Libor Codc,,t rrlt Ddt,trffi of E m* for *,hhh fi. lmir i! iscd.
<br />_l h.v. a.d will Minl.in worl.G omp.ns.tion insnE., .B r.quiEd by Sel ion 3?00 oflh. L.l,.r Cod., fot rh. ,,.rfolmmr of
<br />rlE m.k for whicn rhi. Foil ii is.d. Myturtd onP.Mlion iNBrc. cdEid,nd Fla.y Nnb.r a.
<br />I ccnify thal in Ihc p.rfomnccoflft. eo.L lor whicfi lhi$ D.mi ie n.u.d. I .ht Il .or .mploy any ,.r5o n in any oann.,
<br />$ .s ro h.$tu !ubj..r to fic vorts'onpmldion laws ofc.lif.mia ..d .sr thot if I shdlld lt .o. tultjet b th.
<br />mrts' 6np.rerio. lmvkiom of Sdion l70o of l& L.L'. Codq I slhll, lonheith ohpD snh it s porisiom .
<br />WAn]!INCT l,ailurc to KuE woltss @m,ensrion covcBse t !nln{tu|. ,id shrll snbFd an .molo'tr ro aimiMl Fmhie and
<br />c l fines up ro.m hlndred tn usad doltaF (Sl .000). in ftldnn,. b rhe cosr ofcohrcniarbn, dnm-res n! po{ided for rhe
<br />Sdion 1076 of rh. t hor Cod.. inlserl arxl
<br />,*", ll .t ,r
<br />D!.LL!B,tll(]l
<br />I hrrcbvrnnruD Crlcnrlrtolncttrrtrhr p6vision of Cho!l.r 9 (commcrcins wilh S€clion 7000, of Diviikr. l
<br />of lhe 0usine$ ond Pmf.ssions Cod.. and my lrccns i m tull fo... ad .fld
<br />colirtr[cllorlJixDltclQlltc.r
<br />I hcrehy antn xndq pemlly o l rrjury rh rher.isnconslrucrionkndinprrenc!brrh.l,.r,nnrrNcoir[ctrorki.rrvhichrhispcmrilk
<br />NUcd (s.c 101)7, ( iv C.)
<br />AEITAdLDECLAAAUO!
<br />I lErby lfm und.r n6!hy of nsilry om of th. followins d..hnl iorsl
<br />D.mliriro P.rmit-Ash.cos Notificrlion i.dtrol Rquhtions 0 nl. 40, P.ni)
<br />Rcqxrcd l-.trE. orNorncrtun
<br />qrrlMbl. ro rhis omjad.
<br />on is cold l olrLt lo onrrly wrlh aU C yaod(i,unry
<br />n2. rcnrcFd0lvcs ofthis City.nd Counryi..nr.r upon rh.
<br />lrt [m
<br />Jo*r Qcuee (t9
<br />Waste & Vent
<br />L?ndd'r Adrlrar
<br />-
<br />_l
|