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PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.OWNER AU|LDER DELCAAANON
<br />I hcrcby a,lird und6 ,..ilry ol nerjury rhar I m d.oDt fism rtE Cofrclm' Lians kq for th. followi.g !!e. (SN.?031.5
<br />Bosinc$ ltd PNf6lion Cod.): Ary Cily or Counly whth Equircs ! Fhit lo e.smcl .16. iiqnovc, .Lruh'h u tP.n 4y
<br />.locrw. prbr to ils L<uare. !t!o rcqutd thc lppli.anl for st pcmi lo fib . si8ftd .r.lcmnl rhat lE or sh. b lien*d Pum.
<br />ro rtF l,revisions of df, Conr&rd s Lic.nsd k* (Chafld 9, Comrc.cilg *iln S..don ?0m of Diekion I of ihc Busincss a.d
<br />Profc*hn. Codc) ol rhll h. or .he Lr *rpr ttm&Dm srd rlE hss& lor dE alk8.n cxcnpdon. Any vioblion ofse.rhn 701,.5 b, rny
<br />rpplica.r fo. rlcmir subjcl3tnc lptli.anr ro a.ivil pcnaltyofnot mrcrh.o livc hundrct do,la.s (S500).
<br />l. .s osnn otrhc trotlcn!. or Dry cnrpnDrcs u'irh lrscr as rh.n w,t.onD.i\dnrn. *ill do rh. wolk dt rlr slmruru i\ nn
<br />id.trd.d orofl.rcd lbl sllc (Scc 71144- Br\incs nid Pnrc*ion\ Cod.: Th. C.ntrrktr r Licc.\c Law docs.or!ppl, h !i oar$or
<br />rh.rDFny whot ilds or nrttutrs rlBN'n. url sho d{rs $.h q,A hinr\c ll.r hcrrll or rhx'r8h hi\ .r hcr own .nlloycec.
<br />p0vi'lcd rhnt such irnpn,v.nrn( arc ft i, cfrlcd or oltir.d lbr *'k ll. h)scvdr, rh. huilding.. imtn)EnrN i\ slld wiihin onc F,
<br />ol..rll)Lriofl,thcOwncrBuiBc.willluvcrhcnur.lcnollDvingrhlrhcor\hc il norbuildor nnlfi)t Efmtdyinrlh.puqr*ol
<br />-l-
<br />&\owrcrofrhc DmtEny. ancxclosirclyconra.ring sirh li.ensd conmlos ro omrrucl llr,,ojcr (Sc..7044. Busmi\
<br />,ni PlrL$im Codc: Th.Conlm.lols Liccns Llw des not enplyln anosi.r ofDrop.ny who builds or inDrovcs rhcrcon.
<br />und who Nnrturs aor s!.h tojccls wirh a contmro(, lhcnsd tlunuont ro rhc conlmcrols Ltcn\c Ljw).
<br />-l
<br />ancrcmfl lndcr S6rio
<br />{OTf,EBIi:CIOMIENIAI.T}!
<br />DEII,IIBAIIAN
<br />I hcrcby af,irn undcr p.Mlly ol Fjury ok of lnc rolbeing dcclordioN:
<br />-l
<br />hrve old wall @inlain r C.niiE.t of Conrc loS.l 6ur for*0116 otpcr$rion. $ Fovid.d for by Sclion 37m oflnc
<br />Lib.r Code. for ihc pe,fo,lr@( ol tlE k,rk for ehich llf lEnil is k!.d.
<br />-l havc and will mintlin qo*cts .ropcos.(ion a. nec. os rcqukd by Scl ion 1700 ot llt Libo, Codc. tor (he pdformmc of
<br />lhc work for vlich rhis Ic mir is icsucrl, My work6 comFnsrion insumtrc .6icr un pohy rumbq mi
<br />linc.l a al
<br />a 7 / t,r /iq
<br />-l
<br />ccdity rhar in rhc IqlonMne oi lnc work for which lhis pcrmn n i$ucd. I shnllnol.Eplo, n.y P.son in any mutrrcr
<br />h
<br />"s
<br />lo h.sm subF! h lhc ,od(sl .ompcnrorion lo,s of Califomia. ,rd e8m lh, il I should bcarm $bJccl ro ih.
<br />worl@6 compcnseiionpmvnhnsofSccrion l7moflhc L,tnr Code.I shill lonhwilh.onPl, wiln lh,s ,mvilions ,
<br />WARNING: Faille r. {.ur. *orkcrs .onpcnsltion t unhwtul, lid shJl iubjd o cnploFr lo aininll teEhi\ od
<br />civil fincr !p ro.rc hudftd rhouend dollan ISI ). in lddnion ro rhc con of.onFtr.tion. dmScs .s ,,rovid.d fo.lhc
<br />Sdn,n.1076 oflhc lihor C{td.. n ctcN and
<br />I]ECIAtsAIII}N
<br />I hcrby rflirn undn p.nnlry of rcrjlry rh{r I am liccnrd undct F,visioo oachtrprs 9 (.umm,Ei,8 wilh Strlion 7(xro) orDivhion l
<br />.r rh. Brsincss rnd Pi.r.sions Codc. rtrd myliccnr h in iullft,m and cffc.r
<br />D
<br />o",", df lq I ix ,.",
<br />tj)NsrauquoN.LfNDllliic.EM;l
<br />I hcft'hy nrltm uMcr Nriliyor ncrjuryrhar rhcrc h ! condru.rion lcnding agcn.t li)r rhc pc,tonrucc olrhc $orl rd *hi.h rhi{ lcanir is
<br />i\ud (Scc .1097.Cir C )
<br />AITLICAN:LDECLASAIION
<br />I lmhy afiim undcr p.trtrhyofpcrjury ok ofrhc ldlowins d..ludion*
<br />D.@lnion P.rmir{.Ash.qos Noritic.rion Ftdcrol Rc8uhlions frilb t{r P,n6)
<br />R.qxi(d ktrcr ol Nolilslior
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under Iloor
<br />Gas-Underfloor
<br />Building Sewer
<br />Area/Storm Drain
<br />I nterceplor/ Clarif ier
<br />Waste & Vent
<br />Water Pipinq ql?olt! rt,UNta,r+X ;t)
<br />Gas Pipino ul
<br />Rool Drain a_
<br />Tub/Shower Test 4l7AN,fitIypt
<br />Rough Water Heater I u I
<br />POOL/SPA
<br />P{rap/Drain Line
<br />Main Drain/Pool Pipino
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rouqh Plumbinq U\
<br />Meter Release
<br />FINAL tpl>t )n'T@t-ea "-444 ^,(tvtl_yNotes, Bemarks, Etc.t
<br />COMMENTS
<br />G/+44 r
<br />-lccnifyrhtrlthcfcdcralrcsxrllrionsrcg{dingdsb.sto*romovrl{r.nolo,licahlcrolhislDFcL
<br />-l
<br />eniay rh I hrv. E rhh applialion dd (!lclhal lh. atDvs infomrion t.or.cr. I tE cro mq,ly wnh aI Cny tnd Counry
<br />ordirdftcs uod Sl!r. t ws rl,linE ro buildinB Nnsrdction. !d hcrcby !!fiorir rcpr$n,0livcs ollhis Cilydd Countylo emq upon rrt
<br />arnvc mnrioRd pnl{n) ln, in.l.dirn purpg5.r ------ .2
<br />noo,*no,nu,r,u^un1..1;a{j- ' ^,, ?//*//[
<br />p,-r,n- .,pa"u y' t\Rl cr ah€(Loi
<br />-
<br />TOP OUT
<br />Miscellaneous
<br />lzhl(Rn ,v)
<br />Final Gas Test
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