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PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.GOMMENTS OW]\ER BUILDER DELCAX TION
<br />I h.Eby .rm u.dd ,,@lry of ndiury Oar I o dcnpt foo tlE Conlrac1o6 Li.64 Llq for lh. folLwii€ E in (34.70! 1.5
<br />BsiMs .id Pbl*io. Cod.)i Ary Cny or coufliy *,tich rqund ! ,cnl lo 6i{rud, tn6, inpmk d.mliih or ,!!.ar ey
<br />sirucrr. Fior t ir! i!tum.,d$ rqui6$. aprlicad for sch F.nll !. tL.3i8r.d rltul thal h.or CE i lic.nqd puE il
<br />!o th. porilioN of th. Codrcld r LicnEd t w (chlplr 9, conftfting whh sstion ,oo0 of Diriion I of lh. auein.B .nd
<br />Pmf.*iio6Cod.)ortrl tE q !h. ir d.tr{,t llEE on lnd ltE h$h for th. alL8.d.x.mPlhn. Any viohtion ofsdion 7011.5 hy tny
<br />aptlicrnl for r FoiI $birr3 rlr olrli.lnt lo a cival lc@lry ol ml mE thm fiv. hudt{ d,oll6 (St00)
<br />-t,
<br />a! olM olu. Dm|Enn or my .mplorr.u eith waad a lh.ir $L om,.Mioi. will dt llE m .!d ltt !ml6e . n{
<br />i .d.d o. oildd for sL {5(.7044, BuiiEs snd PbadioN Codc r,* Co'n6crd t Licd. Llq (t,s ml .rrly lo u o*E of
<br />dE lep.ny *,1b build! or i,lImB tll@tr od slF &B och ert hin*lf or b.Rlf or thmush hh or hd om mploy6,
<br />pmvid..l rhar sch inpol*it. c mr iddrLd nolH 6r sL.lt ho,.E, El ildinS or inlllmvci* l i! sld rirhin nG td
<br />ofompklbq d. OwM BuiE rwillhaE0El d.nofFoving rhd trordEdij mt loildoriqhv. t p.tffy 6rlh. purFsor
<br />I. as owmr ofli. nmD6ry. am dclusicly conradins wnh li.@d conlmctod to 6isoc1 thc rojdl (Se. 7M4, BuiR$
<br />and Pmlts{im Cod.: 'l'h. Conlraclolr Licms. Low .lo* ml .pply to s oend ot pmp.n, who buil& .r imlmkr rh€.mn.
<br />and who conrEctd for such Inoj(r, wirh a Coln6cro(d lac.Md puBunl lo thc Co rrcrolr Lic.nt. Ldw).
<br />lnmex.m unde! Secr
<br />t!!!ar!8$taMfE!taua!
<br />DEC'ASADAN
<br />I hd.ny .mrE u.d.r D.Mhy ofrdiury or of$c fouowi.s dcl,ntioN:
<br />ll$vc..dsillminrain,c.fl,lic.r.olc.nknrbs.lf.l.sur.forsqkc*'conD.nslion,.srrorid?daorbysali,'n3700.1rh.
<br />L.hor Code, lor tfu l,Blormrcc otrh. *br* fo, wh(h rh. ro,nir is ssu.d
<br />)O harr rd will ma'd.rn pork.r! cnnlFensl ion rtrsunm.. ns Eqnr.d hy set ion 1700 of rhc ljhor C..1.. lor tu I'6lormm. ol
<br />lh. mrl( n)r wncn lhii p.mrir is im.d My wotkdt n'mp.nernrn i6uram.6rid.nd policr.oo$.r r.:
<br />/r
<br />3-)ot7 - l/-il- 2ot(
<br />-l
<br />cenrryrh, inrh. p.dommc of th. *ork for which thh l.mir i. iru.d. I sh.ll ml.mploy lny p@n in nny n0nn.r
<br />s s to b.omc Fubjc.r ro rh. work.s' com,'.n.arion Lws oacalilomia, r.d asBc lhal if I itnuld bc.om flhJ.cl to lh.
<br />\ortm' @np.mar ion Dovniom ofsftrion 3700 of lh. t trr codc, I stEll, li,nhwnb on y with llos ,mtkioN .
<br />wARNlNc l..ilur. h wu( workcis'cotrrp.nslrion lxlmac is unh$lul, nnd ,hill subJsl onpl.r.r b.nminrl Fmkis ind
<br />civ'l lincs un r(J onc hundRl rhnuqnd d.ll'ns (S101r,000), in rddiuon k' rhe co{ of conrPctrqrion. danrrca m tmvd.d for lh.
<br />Ssrion.10?6 olrhchl codc, nncrcs ond ono'.ry's fc.s
<br />,*", '//-1-2d/7 ^,0,-
<br />//2.-
<br />ucElsrucoNr8acrol
<br />IES.dAAIION
<br />I h€rcby a,nih und.r p.mlry o f p..Jury rhd I am lift.ed n.d.r povishn of Charrcr 9 (d,m.rcr68 wnh SEtion 7000) of Oiairion l
<br />of rh. BunB..nd Pmfdnn3 Co&, ltxl my licdE h r fnll fore aid.llel
<br />7z;t97.-(7
<br />- f-zrtti c.",."",..:(7\z-ru-
<br />cqNsrBucr,olLt.INDllc-dcl:l.c.I
<br />I h.Eby !fliir. undcr Nn y ol r.rjury thd Ihce is r mnnrudion lending ,s.o.y for rnc pdr'onuNe o f the w.rk nr *hrch Ihh P€rmit is
<br />ks.d (Scc 30q7, Civ C ).
<br />AIII.ICAtrLIIiCLABAIIO!
<br />I hftt y.0im undcr ,p.nn, or,'erury o.e ofllt follo$in3 drl..ari.ns
<br />D.nFhron P€dnir$A3b€stos Noriljc,rtr,n lcdcmt R.tularonsll i1.40, Pan6)
<br />-R.qurcd
<br />Lsx.r.f N.tfi c.rhn
<br />I c.nify d rh. a.d.ral rcgnlurioN EBt di.3 mb.{os r.nDul dre ml applrcrhle ro I h'r lmFr
<br />,f cediB rhir I 19r Gad rh'r ,ltl'canon . sdc rtnt lh. .hoE inlomrtrn r codd I r!rc ro smpry *ilh all c t .nd count!
<br />ordinrNs and Sr0rc li*s,.larint t' huilding c.Nrtudior\ ond h€rc6y ourlFri4 tpr.enr.rivs ofrh6 Cnyoxl Co!.ryr..nrd u,'.n rhe
<br />abore trmioftd rmpcny fo. insrNtion p!4n*r
<br />Appllcrnr or Ag.nr SI*ialurc:fx>-A c -,.,"
<br />' 1/''-2O//
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarifier
<br />TOP OUT
<br />Waste & Vent r llt ltX 6rnct*It .)
<br />Water Piping )il-ArY hlnoil-la
<br />Gas Piping .,t
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOUSPA
<br />P{rap/Drain Line
<br />lr4ain Drain/Pool Pipino
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />I
<br />Rough Plumbing rl\x//A +/nl l'e/ll-t@-)
<br />Meter Release
<br />FINAL tz-/tr4t J/.)^"{vyNotes, Remarks, Elc
<br />-)
<br />Miscellaneous
<br />Final Gas Test
<br />I
<br />F-
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