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PLUMBING.INSPECTOR RECORD
<br />DATE ID/SIG.COMMENTS
<br />UNDER GHOUND
<br />Waste & Vent
<br />Water-Under f loor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif ier
<br />Waste & Vent
<br />Water Pi ptng
<br />Gas Piping
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />M ain Drain/Pool Pipinq
<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 Plumbinq
<br />Meter Release
<br />FINAL il.t7 - lt)(Etrl I o)
<br />Notes, Flemarks, Etc
<br />()WNtlR B(rll-DER Dl.iI-CARAI I( rN
<br />I lrrchy rflnD uDncr trrilry ol p.rjuy lhil I nm cxctrrpr ri. rrhc (-ont$ron Li.en\c ltrrq,tr rhc ftll()wins.eis)n (Scc.7r)ll5
<br />Btr\in.\r rnl ltotts\ion (ixlc) Any(iltor Counry whi.h..quncs n p.rnril xi.on(n'cr. rlr.r. inrrov.. LLdnnh,tr rrt'rtr Jn)'
<br />dru.ru,r. [i,n n, (\ is\uatr.c, rko r.qund\rlr rlpliranr f{tr \u(h pemirkr filc r \igncd {d.nrnr rhri l!.r shc i\ li.ci\cd Nstrrtrr-
<br />ro rhc llnhi()ns ol Ihc (.onkcrors l-iccncd tiq' ((hqrrcr 'J. CoNncncins {ilh Sccri.n 7(x() oI l)ivi(i,,n I ol lhctlu\inc\\ rnd
<br />Pn)fc\lons C.dc).r rhrr fuor \hc i\.icrprrh.rclionrrnLl thchr\i\ lnr rhc lcgcl.xc priflr ntri,,hrbnofstciiinrT0:1l.5bydtry
<br />nffher0r d dpcr.tir !uDj..rs thc itplicani b tr.ivilpcnnkyofnor m,to rh l,rchundrcddolllrs(S50O).
<br />_1. $ owner of thc I,oFny. or my cryloyei *irn q.gcs.s rhcn sb omFnsrior *il! &' rlr wdl ad 0r ituim i\ mr
<br />intcnd.d or otrcrcd for slc (Sa.7Ol4. Busimss and Profe$ions Code: Thc Coir@ror'r Liccne Lrs docs mi rrply io m osncr ol
<br />lhc pmFny who ttrilds tr iEpmm d.mr ed Rho des sch s* himelr or thrFlfor lhmu8h hh or h., own.mployei
<br />polidcdthal $cn impoEEnri e mt i.lcndcd or oficrcd for sk, lt lDftw. rlE t{ilding or in{Ilxmnl is sh within oE ,@
<br />oaNtrrplct6n, rh. owBr Buildd wilt h,rc rtr hrdcn ofpoving rhd lE or {E dii @r hild o iqew U* pDpdt, 6. U. plrpos of
<br />-1.
<br />as owM of rhc fmpc.rr. am exclusilely co.rrocr in8 qirh liccn*d conrrstor to consrtucr rlf, Iojel (Se 1)44. aunrcss
<br />!tu B!fi*lbn Cod.: Th. Cont.cloas Lic.ns. Lrw dei nor npply ro rn ouncr or ropcrry who builds .r in:Fmvcs lt rcon.
<br />s.d who co 6.ls,o, such l,o,cc$ lnh r Co.hcro(s) lianscd,ur@nl ro rhc Co retols Li.ei* LiB),
<br />-l
<br />m cx.mpr ud.r Scrioo- B, & P,C. fo. lnh E sn.
<br />D .r oBnr
<br />lhrvurndLyilltruinrriraCcnilicrcol(o0\cnrr,,Scllltr\urclitrsork.nimncts3ri,)n.rsp(ni&JtrhySccri{ni:r7(l) lrhc
<br />lrlxtr Cdc. lbr,hc pcrli)maDcc ol rhc work lir $hich !hc J[rnr N r\ucd.
<br />-l hlw &d will minlain *o*m' .onqEEalioo itriurlk.. a rguicd by Setioi 3700 ol{r lrh.r tu . fo. tlE p.rfoM of
<br />Ihc adt fo. sni.h thii t)emn ir israd, My workfl' @npcnidhn iBul,m @if ,i Flty Nn$.. e:
<br />",*,, -4la-L Co ortr> E'ir..-\f <(t r l..Y
<br />-l
<br />c.niry lha' in rh. p.rlormncc oflhc wori lor which rhh prmir is L\rkd, I shull no' cnlploy lny pcEon in any mmrcr
<br />e sro tno& subjd to thc $rlos .\,mpcistn,n hqs ol&lifomic. nnd !8rcc rh,r i(l sh,uld tEcom slbjdt ro tlE
<br />w.rtlYa str{Enstiotr provisioni olSccrion 1700oflhe tator Codc,I slEll. fonhwnhomtly wilhrhos Poriri.ns..
<br />WARNINC: Failurc io scur. wo*cr' sqrcrsrion covcBec is unbwtul. lnd shall ub,c{l M cnlloycr to dini.ll txDltis md
<br />cilil 6ncs !t, ro om hundrcd lhous! dollau l(x).()oo). i. addnion r.
<br />'h.
<br />cosr ofcompcnslrion, d!roscs as nrolided for rhc
<br />Sccr ion ]016 of r hc litin Cftlc inr.rcsrand
<br />DESdAAIIO!
<br />I lErchy fi,nlndcr penllryofFrjo',
<br />'hut
<br />I !n liansd undcr po6!,n otCh,prort (Nn'tun.ing sirhs..rion 7000) olDivisn'n I
<br />ol rhc Ausinc$ ond Profcsst,ns cldc. lld nr, liccnsc h in full nxe n cftcr.
<br />\6?tz-65
<br />O"r., a
<br />I hcrchy o{firm undn pcnalty of Iciur} lho! I herc is o .onnrucrion knding oBcncy for rhc lcrfomncc of thc sort for which rlfi Frnit ir
<br />issucd (sN 1097, civ. c.).
<br />AITLIIANLDEIIABA.IIIIN
<br />I h.ntry,frnn undc. p.n,lry or p.rjury orc of$. rollowine dccldarion\:
<br />Dcmolirbn Permirs Asbcsros Norificr io. FcdcrllRcelhIions ( l nt ,&. Pafl6)
<br />Rcquircd lrncr o, Noriff,arbi
<br />I c.nify lld rh. f.dcral rcSulalions Eg,rrling rst$br ,.mval m fr, amlb,blc b lhis lrcj.rl
<br />-l
<br />cc'lilr rhur I lulc rcld rin o,'plic ionandsr0tcth.r thc trl[vc infornErion isconccr.I lgrc ro conlP], wirh all Ciiy rnd Cdunry
<br />ordinrnccs lnd Stblc ll*s rchtir8lo ildinscotrsrtucrion. n hcrcnyaurhorir rc0rcsnr0rircs o,this Ciryud Counry(o cnrd lF)orhc
<br />rlrtrc Df,trri(fud f'op.nyntr i
<br />!r,.r l lrelt't
<br />APPROVALS
<br />TOP OUT
<br />Fill Line/Back Flow
<br />Final Gas Test
<br />uoaf,ESs:coMEEltAIoN
<br />PECI,TBAIION
<br />I hcEby amrm udu pcnalry ot pcrrury onc olrhc following dftlararions:
<br />r-lt-t(g
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<br />I
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