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PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE rD/srG.COMMENTS OIVN I]R BT]II.DI:R DEI-CARATloN
<br />I herchy aflirm undcr nen,lry ol Btury rhat I .m.x.mnr lmn rhc Conlracrors l,tcn.e Iaw li, rh. i{nh$in8 reasn (S(.'i0Jl.5
<br />aBinrsc ilt Porssion Code): ,^ny Cny or C.unly whch r.qun.s t nLrdm lo snnrucr, .lter, imDrovq &frnch or RIrr iny
<br />rrruciun.pnorro r f$rft., ako r.qums rh. .rplr.nr aor such pcm t. fil.^silncd n.remcnr rh,r h.o. rh. h lic.nsql nurnrmt,
<br />ro ih. rmyision\ olth€ Conlrt.ror's Li..n3d L.w {chrnr* 9. C.nm.ncins wilh Sstion 7000 ol Divit,n I ofrlf, Busincss ind
<br />rmf.s$.ns Code) orrh.r h. or sh.6 exrmtt rh.r.frch and rh. b,cis lo. the 0llc-{c<l excmrnon. Any vdnon oasdi.n 70ll 5 hy rny
<br />applicanr li,r ar.mir slljecrs rh. oprli.rnr {. n ciril pc hyolDor mrc lh.n five hhdBt doll.n (5500)
<br />f 4. * "**,.,,* ^r.").
<br />$ m) e,nrlL',K( $ l'kucsarrh.tr$ccon,Fnsrion.s'ill.brh.sl,niand16.nMWsDn
<br />rnr.dcn "r.,lieRn [r s].(sn 70,14, Buqn.r(nn,lP6i.ision,(od. lhecontacldisl,'..nsL,*dodsfrrla,rplylos!o*ncror
<br />rhc pmFny who ltrildq.r qrnB rlE@q ri tr'h.tBe.h rbft hiDsclf.r h.isclfo' rhmrgh hr o, hcr own.mDloy.es.
<br />Irro!'d€d rhrr such iftpnnrftn* arc dn imended or o0iFl hr sL lr, h)scrd, E hoiklrry ot inDmrHEnl is $ld qrhin .n. ,ed
<br />ol'conDl.1ion, tne O*mr Burld( wllh,re rh. bdrd.n olrnJvrnS rld hcordEdid mt huild., i,q'nrE rhe pNptny fo! lh€,!u4s*ol
<br />-t,
<br />,r.{n.r of rh. l'()p.dy, ,m.xctuiv.ly contEctins vnh licssd snl@io6 r. odruc' ltqmjet (56 7M4. BLi'n.s
<br />and PmE$im (hd.: I h. Conklcbl3 Lic.nsc L6w do6 mr arply lo .n ownd oflmFrly eho hu'l,kur "nnncs rh.re?n.
<br />I
<br />*)
<br />snd *ho onlracr. lo, sch pmj.d. wnh a contdo(o lic.tr cd plNlool lo rh. Conk.clor's
<br />a"
<br />DICIJSAIIO!
<br />I hlEby.mr6unddFodiyoapajuryonofth.L.U.vin8ddlomlio :
<br />-lhf,r.aod*i11tu'm,in.c.nific.rcofCnnscdbS.ll-lnsurefo,\o,[c6'conrPe,s
<br />io,.!s nmY ed lorhys.crn'.]7rx)olrh.
<br />L.hor C.de. hrrhe ll.rfo@m. dfih. wo* lor which rlr pdmir is hs.d
<br />I hsvc Md will nainhin *ork(r' .ooF....thn iNu.rm.. au r.qun d by Str io. 1700 .flh. L.bor Cod., Ior rh. pflomm. 6f
<br />th. wort for *l ch rhis pmn t ii{..l My workdr omFnetion insffic @nif &d Flicy .umb.r se:
<br />in rhc p€rtormafte of lh. work for which Uis !.mn ir ns.d. I shall ml !q)l6y nny l.m. in .ny lmEr
<br />$bjd ro th. w.lin' @mpcnsrion bvs of cllilomia, lnd asc that il I should h.com sbr.t lo lh.
<br />wo*.rl mmFnstionthvhionr ofsdon 1700ofih. tatsr Cod.,lshlll, fonhwilh @nrly wilh'h'* nmlisiotrr.
<br />WARNINC: ,:oiluE ro sw wort 6' emp.tr 0tion ov@sc i$ lnldwtul, .ffI 3h{tl suhj..l an mPlortr ro fininol ,cmlli.s and
<br />civ nn . np l. oB hundEd rhowd dolls ($100.000). 'n.ddlion io ltE cosl colllEnglion, d$Ea.s N previdcd for lhc
<br />s(rion 1076ofrlE Lah.r codq im.rcst.nd dtorncy, ies/y' z't' 17
<br />D}jCI.^SAIION
<br />I h.rby.dnm und.r D.nahy o t pcrjurr rh'r l,6licenkd on{t! tm$io. of( lspl6 9(@nwnc'ns wirh scclio, ?000) olDilhion 3
<br />.r rh. ausi4s and Pmlcsmns Codc, and oy ncms. is in lull loE! ml .lT.cr
<br />Contnrtor:
<br />CONSI'RI]C'fION I }'NDING AGENCY
<br />I lReby auinn u.dcr p.Mlty oI Fdur, riar rhec " a con{rucro. kndmS !s.my for rhe !dli@nc. of rh. wort 6r $Eh rhN lEfrfl rs
<br />ss.d (Sec 1097. Ci!. c.)
<br />AELICAtrI.D&CI48AUq!
<br />I h<dry.trm und.r p.Mhy ofpdjury onc of lh. lollowins del@lioNl
<br />Dcmolirio. Pdhil3-.drhqtor Norificarion l:.d.El R.xulalioDr (f ill.,l0, Pd6)
<br />I Rd n d ldr.r of t{d,adh.
<br />, l,pr'f\rh
<br />'
<br />l'. leJerJl re|[lrr nnc rped,ry ".hcn$ en..{il,'rt arr rnl'.,rhlci,rhr|n,Rr
<br />214
<br />"a,r't tt r r *'",,"a
<br />'r.r
<br />innl'$,n n rnd nrrc,lmrrhc rbv. mroiindion F cored l ss(i t, con0lywnh.ll(\ryaod counr,
<br />onliMmes 0tu1 Std. tiws Ehtins ro building cotr{ crion, and aurh.nc .qtr.*nraliv.r of rhas cny ,rd Counly to .nl.r !Ilo. rh.
<br />dbov.mcnrion d lmr.dy f.r itrrFlio.az4 //-27/Y,rppIcrtrr or,\qrnr Slgndorr:ZaLz
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor I
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarifier
<br />TOP OUT
<br />Waste & Vent [.,hIr14 LMq()
<br />Water Piping I
<br />tl
<br />Gas Piping rq d^44c )
<br />Roof Drain \;z
<br />Tub/Shower Test 1q iliqfi t)
<br />Rouqh Water Heater I \J
<br />POOUSPA
<br />P{raplDrain Line
<br />Main Drain/Pool Piping
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbing t9 l')l/,/,1/1
<br />Final Gas Test
<br />Meter Release I I ,, rl
<br />FINAL t43 lq t/\Ud/rl/e 15 d"
<br />Notes, Remarks, Etc.
<br />/.
<br />6 '1
<br />6
<br />Gas Service
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