PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE tD/srG.COMMENTS OWNER BUILDER DDLCARAIION
<br />I h.Fby .rrm undd p.elry of ,.riury rn r I m .r.ofl tbh rn co' rrcr6 Lic.n* kq for $. followi.S E sn {se.?011.5
<br />Buii.6s .nd Pm&sion Cod.): Any ciry o, courry which rcquiR . !.mn to comrucr dlr. inlr.E. &mlisn N EI'!n sy
<br />3mdurc. p.br m iri mac,.,s r.quiB lh..tplicrnl tor tuct pldn lo fl.. iiCftd d.1Mt rhrl lE or !h. it lic.r€d plmdn
<br />ro rh. I'ovtiom of rlE Connadd ! Li*lrld Law (Chrnr.r 9. Com.rci.8 with Setion ?000 of Divhion I of th. BNims 8nd
<br />Pmf.ssioB Cod.) or ltst lE or ilE h .xdtil $cEfon ..d tlt b{ii! for th. rlhS.d .x.nptirn. Any liolalion ofs.cl.n 701 L5 lry my
<br />q,llicrnr tor ! D.mir $bFt! th. a0plica.r ro ! civil p.Blry of.or mE than fiv. tudtd &lloB (ltoo).
<br />-1,.s
<br />owi.rolrhc tRrn dx or my emDlqres wili u'r86 as thetr sl. conrpq\an n, wll do rtr work lnd rlE {Mru€ F mr
<br />r e d oroller.illorsl.(sr704t.lld$nc*dndtortssnnrCod.r'lhcConlracroisLic.ns.l.:*do$n.r.nl'lyt'rnoqkrol
<br />rh.ln)p.ny w, hu rlds or inrmrE tlEmn. xltrh.do6n'c[trn&hinr.lforh.rclforrhnrS[hnorh.ro*n.m!'l,t]".cs,
<br />nn!'dcd rhar such ihptuvemnN d. ,Dr i.rd d .r ollcfti I'or a,lc ll h)*ss. rh€ huild'n! or innovetrrnr s arld *(hrn oD. ,sr
<br />oflunrlclion, rlrowner BuLlc!* *'llh.k rlE hlrdcn olphvinr rld h.or rh. did mr hrild or ihnhv. rh. nmndy lor rh. ruqrsc.l
<br />_1. I os*r olrh. I'hpdry. m .xcluriv.ly conlmcring with lic.ni.d mol.acrofi ro o$mct rh. pmj.ct (S.c. 7044. Buin.s
<br />ond Pmf*in Cod.: Thc Co r&rofi Lic.nic Law d..i mr rmly to .n own.r ofDmrErly vho hlild! or imrrovcr rh.hn
<br />and qho e Edr for sch pmjccts wnh a Conhcto(s) lic.nrd pllMnt ro lh. ConlEdorrs Lic.n* r,w).
<br />-l
<br />m cxcrp undd s6rio
<br />w$Eas:cq!4EEdsarp!
<br />DECr
<br />^IUTIONI hdby !fli,h lndd D@ltyof FjuryoE of ln.6lhwin8 &.lmtirN:
<br />-l
<br />t6w dd will tuintlin a Catificarc of CoBot to S.ltlNE for w*Ea dD.@tio,r e prcvid.d fot by Setiof, 1700 ofth.
<br />Lrbor Codc for th. p..roM oirh. m* ft'r *,hich tu tmn ir as.d
<br />Inavcad*illmai sin mlk.G coop.rs.rio. inluEft.. $ r?qun d by S€lion 1700 .l rh. bhor C.d.. for lh. ,.rfomncc of
<br />rhe (o finwhicn rhis!.mit is sscd M] worlm o{nn.nrqri, ltbi'" *l n in$rume cadcr a.d policy numbff d.:
<br />6vet </, /r1b.o7 &r u----7---T
<br />-l
<br />u.n it thrt in th. p.rfo.mncc of th. *ork for ehi.h rhii p.rmir i. kru.d, I sn ll ml .mploy Dny li.en in any nm*r
<br />$ N ro b.comc sbid h 0E wo*ft' 6mp.6ialiod lows oacalifomi!, lnd asE $at ill rtbuld tE o@ fltj..l to llt
<br />h*.ft' @nri.Nr ion lovisiom of sethn .1700 of lh. btnr codc, I rlall, fodhvnh 6nply wnh rhos pmvisioN.
<br />WARNING: Iiilurc ro *@ md(6'@mt!.Mrion 6vcE8. i3 unl.wtul, and sh.tl objd to .mPloF ro aihiEl IEBhis a.d
<br />civil fin.! un to o* hlndr.d rhole.d &lls 15100.000). in .ddniof, lo llE cosl ofconD.trsrioo. d.m8.. !t providcd tor lh.
<br />Codc, mtc..$ and oey'
<br />rt rv
<br />rrcirriu irrx inrEF
<br />rrt('r AR rt(rN\-J
<br />I t Eby afnrm ond.r pdahy of Fdory thrt I am lieEd uidr povision ofchapls 9 (6omtin8 wiih Sdl hn 7000) otDivisiln l
<br />of rn BBiB$ .nd Pmr.ssiodi cod., aid my lic.nrc it in nrl toE &{ .trer
<br />7a?otr
<br />6
<br />CONS'I-RUC'NON LIItDING AGl. NCY
<br />I h.i.hy .mrm un&. n rolly of r'6jury rnnl rhac h a qnntudhtr Lnding 3e.ky for th. Perfomrrc. of rh. trbrt tu whch rhm ,Emril is
<br />t$.n (s6 :1097,C'v c )
<br />AfTLI(ANLDTCIASAII(}N
<br />lh.,thy.mnnund$ nenalry of peljury onc ollhc folk,{ int dclanloN
<br />DemoIrhn I'ermilr Arh.nos Norificari.n I'.d.r.l Rerul nns (r'irl.4(]. Ian6)
<br />-llcqurEd
<br />l,.rr€r of Norili6rion
<br />-l
<br />c.n ify rhar rh. f.d.hl re8ualions csarnins oshsros EnDral ar. a{ lmlicabl. h this ,,o.r..1
<br />-l
<br />cdify rhar I hs!. rdd rhh amliorion 6rd ar. rhrt rh.0hvr i.fonnalnrn is cotur I lec r. 6m0ly wiln.ll Cir, and Cotnly
<br />L!* cbri.g r. huildinS .onlrucrior\ .rd hs.by autthri2. r.fi*.ralives o f
<br />ev/'
<br />tl'n v. {t(){d\ h dul,mrrr
<br />,,,,,|t f z@/ttr
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />I nterceptor/ 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 />POOUSPA
<br />Ptrap/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 rl/%/lo i6)6'[
<br />Final Gas Test
<br />Meter Release
<br />FINAL z\-i\r1 l,t14l,
<br />Notes, Remarks, Etc
<br />o,r.ll L
<br />Lcndfi Addcs:
<br />-
<br />f------T------
<br />I
<br />=
|