|
PLUMBING.INSPECTOR RECORD
<br />APPROVALS,/,,ID/SIG.COMMENTS OWNf R AI]ILDEN DI:I,CARATION
<br />l h.tuhy amrm lnder pcn.lry oa pcrjury lh lnm.xenDl fnn. rhc Conr,crois l-ic.ns. Larv lorlhe finb*n8 E e,n (s*.?0115
<br />Eusncss .nd PioLssion Code) Any C y or C.unry wh'.h rcqurcs i n mil lo con{tucr, !hs. imptuk, &mlFh or EI'.tr .try
<br />issuaoc., al$ rcqur.s lhc annlc.fl fo. such p€iinn h lile a sismd rrar.Gor rha' h.or sh€ 6 ncensd rutsmnl
<br />ro rhc pnlN'nr .lth. c.nraclois t,ic.nsed t $ (Ch.rlcr 0, CoflrnEncin! s b s.crion 7ml) of Divhion I olrh. Burin*s dnd
<br />Pnrissn)nrcod.)o,th,r h.orshe i( .xenrlr t here lrom and rh.lxsr\ lar rh. allcrcd crem ion Anyviolilonofs.cts.?0:ll5iynny
<br />mplicnnrfo!!pemisutjcckrheapflL..mb.civilr.Mhyolm(nnnlh.nnv€huDdr.ddoll.rs(s500).
<br />.[,r.*""'o,.trr'.p.p.rrurnrycmnlt,y.6crrhrrlrsdcrh.rsn.comp.nslion.\'ill&lhc{o d trht<odueicmr
<br />{nrdld or ncred for elc(s( 7r),.,4, tsu{k$rnd Pml.{srotrs(odc l lE Coitacd s l-'ccn< L.u' do.s mt 0Pply l,, an o{.cr of
<br />rhc pmndv wb hoildsor i,l!'mv6rhnoc ind s'n d.s tuch Ml: hrms.llor heuclf or rlmush his or h.r 6$n .mIlorts,
<br />p,ovitlo! rhai slch imrmr€mnrs .re , 'ntctok of.rtn nr sE Il, lrrq€.. th. ttuililin! .r 'n!m\$E r is $ld $ihi', ok )m
<br />.I cotrDl€notr rh. Owncr truius F ll tutr rhe In&n oatmvhs llw lf, or sh. did ml huild or imF,v. rh. pmFny r'or ItE puq$c .f
<br />-1,6sornerofrhc
<br />pmFny, 60 .xcluiivcly contdin8 wnh [en..d ontndoF ro coNlruct rh. pmJ.cl (S(. ?044, Aurin.s
<br />rnd Ptr*si1nCod.:Ih.Co.lractor'!Lic.nrcL.wdo6tol6prlyro0nown.!ofproP.nywhohuildrotimrtovcsthson.
<br />aid eho mnl@rr f.r sch pbj4t. wiln o ro rhe conrractols Liccn* La$)
<br />I m.xc r undcr Sccl
<br />-5- Zcrl ,""..
<br />Dl!L!]!!! r!r\
<br />I hcr€by amrm und( !.@lty ot t'dJury onc of
<br />-lhivc.ftlwillminrainaC.nincdeofaonsenrroS.lflnsur.16r\er*cBconrpcnsolbn,ispn,vidcdfrtrtyS.c'ionl?(x,oilh.Lrbor Codc. tor rhe ,.rlbmrc. o I rhr vod( lor rhich rhe nennr G hs!.d
<br />_l hrv. ond will nirnrarn *o.k.rs comp.ns.ri.n Nr.tu., ns Equn.d 6y SErion l?m otl hl l.ahor cod., lor rh. nqfotnmft. o I
<br />rh. *ork tu which this pcn t ri isssl My @116 6!,l).her
<br />'on
<br />n$h'f,. clFi.r nd polrcy DU hb.r e.
<br />-l
<br />..n i& thnt in lh. p.raom!rc. ofrhc wo ( lor which fiii p.mit is irsu.d, I shou nol cmploy lny r.rsn in ant manftr
<br />$ a! h b<sm flbjd to rh. m.t.F omp.nslion laws olcrlifomia, and alc rhd il I !tuuld t .om sbjftt to th.
<br />w6lt6 66r.os.ti.n pmvi,ions of S..lion 1700 oflhc Lltnr Cod., l .lEll, aonhwnh 6mnry wnh lhot pmvbioN..
<br />WARNINC: Iarllr. ro su. *0*.6'on .trslion I shjet .n snphylr ro.tuidl p(Blrir and
<br />cnd nfl.s rp kr oE hondr.d rln'usrnd dollam (51 omD.trsliol\ d.de* a pbvir.d for th.
<br />Sdnotr 1076 orlhe tabor Code. in'.Err aDd onE
<br />","./t-f - zol f
<br />I h.re6y rmrm uMl.r r.nrhyol'pcrjury lhtrt I Ch.pts 9 (mmftacins w h S(rion ?000) ofDilhionl
<br />.f rh. EusiHrsd P6ae*'. Cod..myliccnE is in tull force ad.Ikr
<br />Li..trt.NumtEr:-
<br />cllNslSJlcr&x"LlNDrlGIGENCX
<br />I heEhy riilnn under FMlrrorp.rlury$,r lh.rc is. constdctlon l.ndins asency r.. I h. |)cr ionrmncc olllE $ork litr r'hlch r[n ]rrnril h
<br />issu.d (s.c. los7, Civ. C ).
<br />AIILIC NIDICI,AEAIIO!
<br />I hetry aflim uder p€E[ y olt.tj$y on. ofrh.l'o]lowiry d.chdions:
<br />DoDFl mo P.rmih-Astcsros Nonficarnn l;ederal R.Sulahons( lill.40. ron6)
<br />Requncd Ldt.r olNorifralion
<br />-l
<br />c.niry rhar th. fcdcdl qrihrh^r c{ad,n8 dhdlos ..mrrl .rc ml at pliotL io rhi. Poj.d
<br />-l
<br />cenity ihal I hart t .d rhir n pl
<br />ordiEtucs .nd Siare bws Elati.A k,
<br />infomrion iico,Rr I.sR to emtly *irh all Cny t l Counry
<br />aurt6rz. rclr.rnlaliEi of this Cny and cou.'y b .nlq unon th.
<br />atnrc m.nrioncd pmp.ny f.i
<br /> DDllc.nl or Arerl Slsn.tu
<br />LP.rnlte n.n'e(rd ):_
<br />U N DER GROUND //./,tbbfU D
<br />Waste&Vent ' /0il6il0 .a4pru Thnd ,/
<br />Water-Under floor .JV \:/
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarifier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Piping
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />P{rap/Drain Line
<br />Main Drain/Pool Pipino
<br />Fill Line/Back Flow
<br />Miscellaneous
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbing z/t"/q 4 742
<br />Final Gas Test
<br />Meter Release
<br />FINAL eltalb 6n/va-/t)_.,
<br />Notes, Remarks, Etc.
<br />DATE
<br />POOL/SPA
<br />Pool Heater/Gas Line
<br />Lcnd.as N!m.
<br />-
<br />knd6'. A.ld6:
<br />-
<br />)?^,
<br />*" ?l:l-3:12
<br />trz.h.-
|