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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER AUILDTJR Df, LCARATIoN
<br />! h.r!'by.mi,n undd p.Blty ot psjur.v lhnl I m cxe.nrl fo$ rhr Conracro('Liccnsc Lrw litr rht nnbwm3 r.iern (S.c7o:ll5
<br />Blnnes{ 0' PrrGsnn C{de) Any Ciry or C.unry shrch r.qr'Br d rimr b conrrrucl, alr6, inDro\r. d.molirh or Ep.n any
<br />rtucfuE,rrrt rrs (s,tuc. al$ rqtrr.s rh. .llrl'cad nr fuh l,cmn r. li l. n si8rcd $dcmd r hit h. or she n lic.nr.d pu&,nr
<br />ro rhc pmviiions ol th. Conhcroas Lic.nsed lnw (Chafler I, Commcncins s'rh se.iion 7000 of Diviron I ollh. tlusincss and
<br />Phfcrsions codc) .r rlur hc orsh. n.rth rh.r.ltrm 'rt rhcLrris lor rtu all.g.d .rehrron Anyvn,l ionolscclhn7l,.ll5$y.ny
<br />rnpllc. lornp{r.rrflbJ.dsrhc.mlMdroa.ivilr.nihyolnormrerl[DIivehu r.ndollm(S50(r)
<br />4(.1.***,",,**'*..n,mvcn'rr'{rccurhu'n/Br{rh.tr$r.(.,nn.ov,h,n.ni,d.rrno,(u,hcsMmnn{rcd.n,trollcrdlhrsr.(S(Toaa.lrunncsindInt6cioNCod.:-lh.cont.cr,'sLic.nx.Liwrl('.snorapplyhanowrcro,
<br />rh. t'tunedy stb bril& or nlomvd rh.mtr a lvh,d(a{.h"r)* hi',r.ll or hcrslfo. rlmu8h hF or h€. .wn cmtlort..,
<br />!rcvidcd rhil eucn innn,vdEnll aE rn idql.d or oiirn ir sl. I I l[s.tr. rh. buil{lir8 or mnmve,E is n,ld wih'n one ]sr
<br />ofconDl.lior rh. owftf Builds will tnvc rh. huRlcn of povllu rrDr h. or sh. dd d hliH or ltr]Imt! lhc pmpdy lor rh. purlns or
<br />_r. a! owft. ofin. pmlcny, ah dclBiv.ly conhclinE wirn ticmsd conrEcro* ro 6.(tu 1 rh. poj..l {Sc. 70a.4, BuliEs
<br />drd Pmhqion cod.: Thc conr..crof3 Lic.n!< l-iw dcs mr alrly 16 a ownr of pmp.ny who buil& or impmtr ln.e..
<br />rnd who 6nt6cir for scn poj.{3 vith ! Conrrlcro(s) licdrd pnMd ro rh. Cont6crd r Lk G Lrw).
<br />ldhex.rnp' undcr S.cri,,n . A & P C. liyrh^ r(1str,X,*. ll- M- lg ,y.. a< r../tr.Jfiffi"rr
<br />I h$cby amrmund& rcnrlty ofn.lury onc ofrh. aollowhg d.clamrions
<br />-l
<br />hrE a.d qiu @inbin a C.nilicd. of Cocnl to Sdt-l@E t r wrkdJ @np.ndioq a ptuvid.d for by S..1i.n l?00 of llE
<br />Lrbo, Cod., for rlr p6fomm. of lnc ei. fo. which lhc Fnn ie ie.d.
<br />-l hlvc d vill mainrain $ork.B comFBalion itrsdnc.. &c Equn.d by sdrion 1700 ofrh. kbor Cod., for ttu t.rlomrce or
<br />rt work lor whth thii Ddir Li istu d My worlsi 6n[Fe'io. i uram. cari.. ui rblicy nuohcr e]
<br />Policy Numb.,:-Er,,'&c.niry rhdl ii rh. p*for@icc of rh. work for sn'ch tht pmn ii issued, I sh.ll ml cmplo, &ylcmn inlny @nftr
<br />ro n<omc sbj{rt ro rlE eltm' mnn nslion laqs ofcalilomia and asB. rhar it I d$ dt str.ubj€l hltE
<br />worlc6' omp.Nal ur nmrFions ot Sccr
<br />'on
<br />37(,0 o f rhr Ltxtr ( nlq I rlhll, Lnh$nh onply snh rho€ ,miibtrr
<br />WARNING: frilur. ro *u. work m' omp..sarion oy.ma. b unlawtul, and shrll shjd nn mpl6Fr ro dimiml n mtiB and
<br />.ivn,in.rtrrtoomhu.dndrhousnddollm{$t0o,00o),in.ddniontorh.cdrofconpc.s.ti.n,da@E.raipovid.dforth.
<br />Ssrion 1076 oftheLlborCodc, nrcr.s,nd.turEy ! lc.r
<br />\I tg h
<br />r rirlr$'ir co,r rn wrrx
<br />DI](IIIIAIIAT
<br />I h.Eny.mrnuhd.r pdallyo,rcrjuryth.t I ar liccnsd undd pmviibnotCharls 9(mnoErcihs {nh s.ct.n 7000) ofoivision l
<br />of $. BnFrKs and PD[e$ionr cod.. aal ny I'c.n* h h tull a.m ,nd cfler
<br />Lic.N. Clr{*-Li..M Nrmb.r
<br />coliraxEuoll.lNDlls-Acllcr
<br />I hcehy qnirm undcr r.Nlry ofp€rjury rhar rh.re ir a con\ocrion Lndmt a8.ncy lor rhc,tcrfonnaace oflhc work lor $hi.h rhr Fnrir rs
<br />hrued (S€ ll)9?,Civ C |.
<br />atfucalruiclaaaua!
<br />I tRhy ailnn under ll.nolty ol!.rjury one ofrh. folhr*ins d(lnrarionr
<br />D.mhtion P..nits.Ash.stN Norific0liotr lcd.ml Rcrularions ('l irl. {0, Pan6)
<br />_R.qatd l-.nerdtNorilldi'.
<br />, I ..nily lhd rhc fedcol rqllii ioN ro$drry asbeslos rcnn,vtrl tr.( frr npd r$1. tr rhk pn+d
<br />-:!k.n,ly rh l rmre re0drhFinlhcd'onind {rr.'h rhe atnle rnlo@rioh f coft.cr I rrre h conrply { iih all Cil, and Cnrory
<br />ordimnces and srste Laws rchtiry b h!ildrna con3tucrF4 arl hcr.by.trhrn,. r9r.s. arNsofrhhCity0.d('.untyro.nr.tufo.rh.
<br />.ho\r mcnriorcd pop.ny for iNr€tion 'V t)<ADDn.rnt or As.nt slsn.lur€:/)K,", I
<br />_ltcrh,l.R nsD. (prn )e AAzi SftSA
<br />t-lq-tg
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor x
<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 />POOL/SPA
<br />P{rap/Drain Line
<br />Main Drain/Pool Piping
<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 />Rough Plumbing
<br />Final Gas Test
<br />FINAL ll*tE-rv A M'N)
<br />Notes, Remarks, Etc.
<br />Back Flow Device
<br />Meter Release
<br />v-/vv
<br />Conlhrtor:
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