|
PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OlVNER BU!I-Dl:R T'EI,CARATION
<br />I hcrchy llfim under pcntrh, nf pcrjury rhBr I .rc t, liom rhc CnnEcktrs l-i.cns Ijw r'or rhc iollowins rc.sn (Scc 7031.5
<br />Bu\ircs .d Profc\si.n Codc) Atry City or Cou ry which r.qutcs n !...rir io consrrucr, alrcr- iq,rort- d.mlirh .r rrdl nny
<br />sru.rurc. pri.r ro irs issuamc. aho rcquncs inc nmlic!fl l'or such lE.nrir n] nh 0 sismd srarcmnr rhd h.orshc n l.cnscd pxrs".nr
<br />k, rhc plolhion\ ot rhc Conklcroas l-iccnrcd uw (Ch3rr( 9, Amnn.n.inS qnh Sc.rion ?u)0 of Divisn,n 3 of lhc Busincss ud .
<br />Pii,L*iotrs Codc).r rhd lLorsht tcxcnu thcrcfro rndttuhNislorrhcollcScdcicr.prion. AnyviohrbnofSc.rion7011.5hy.ny
<br />smlicanl tur r pcrnrir n'hjech rhc lpplicrnr b s(ivilIentrhyol rxn,itrcrhan ncc hundr.ddollas(3500).
<br />L as owmr of$. pmFrry. or ny .qrloyes *irt w!8s &s rhcn st @mpcnsdion. sill .lo 0E wot 3!rt rh. crnElr is m'
<br />i crn d or oficr.n for sk lSc.?O!|. Blsin*s Md PtbfcsrioN Cod4 Thc Com.{dols Lien$ L& do.s nol q,pt, to an o*Nr of
<br />dr p6Fny ehot il& o. i"prDws Emn..d sho dc sh srt hinelfor hq$lfor ihtuudr his or h.r ow,.m,,k rts.
<br />pmva.d rhir sn.h tu{mwc.B m mr i.r.id.d .r otftEt fo. sh. Il lrN.B. rt ltrildiry tr irqmrm.l i! $ld sirhin om JEa
<br />of@trpLri,tr rtE Ower Auald.r eiu haE llr bu Ln olprovag ttE! lE 6r slE did ml tdld or iqmt t E !'qsty lor dE pqpo$ ol
<br />-1,
<br />.s owrr of rh. lhrsry, d erclolitly c.nheri.g wnh li.en*d .onr.dor ro on rucl llE Imj.rl (Scc.70ir4. Du\id$
<br />rnd Pmfcssbn Codc: Thc Conlretol s Liccn$ Law docs mr orply ro !n ow"cr of troFd, who builds or imro!.s rh.rmn,
<br />und eho onrrac$for$ch poixk *nh aCodBro(s) ltcn,cd putru.l rollECnntr.clols Liens ljq).
<br />I r6ck.rpr uod$ S(rhn , B. & P.C. aor rhn rc!$n
<br />Owrer
<br />UA8trDSICSMIENSAIOX
<br />DIC:L$AIIIIB
<br />I heeb, artun u.tcr p.n Iy 6f pojlry oE of llE loUowir8 dNlmtions:
<br />I hrvc d *ill ri,rirnnCcrllllc.tcolConscol k' Scli lnsurc lnrsl uF conlE Ndnn!ns pn,vidcd tur br Scdion .l7m ol thc
<br />Ljtxr Gxh, fu rhc Nrronn ncc o r rhc qork frtr qhi.h rhc llnnir is ilsucd
<br />-l
<br />nrvc ,nd will maitrlain wor*cB onDc.sation insulrrcc. !s rcqlncd brScdn,.:17fi)ollhc tjhorCadc. for rhc rcrforronce of
<br />for$hichIhhEm h Biu(t M\ { orkci! onEn{rion insurw ! m.r .tri potry numh.r uc.{l^k t",^.n Drs. F."d
<br />1l4bo 6l- >",1 I
<br />_l ccnify rh in rhc !.rfor@mc of rhe wort for which ihis permjl h isslcd. I sh8ll tol cnrlor dn, F,son in ,ny mnmr
<br />$ !s ro bcsm subjer ro ll* *oltsa ompcff.rion laes .l C.lifoni!- ed aCrc lhrl il t should b..om subiet lo ll*
<br />so cR oq).nslion tmvisionsofsccion lt00of$c L.hff Code l slEll. fonhwilh6lrlly wnh6oE pbvisionl..
<br />WARNING' Fnilurc to {.urc *olkr^ conrp.i\ari,,n cor.i8c i\ rtrlrwrul. rnd shnll suhtNr rn cnrrlo}rr ro riminal Ftulri.r ad
<br />.ivil lioc\ up t,.nc hlndrcd rhn!\rnd dollrs (SltD.ltxr). in dddnnrn b rl'(.rs olcnmpcn$lion. dnrBgc\ ai pR,viilcd td rhc
<br />Sc(rnr.:0'6olrh. LJhr CGh. in11cr Jnd Jtromt . i'T.
<br />ul 19 CPr,+ tG E . lM4-!
<br />^/
<br />Tr,s lf
<br />LICIiNSEIICAN1a^!tr)8
<br />DEIirXdlIaX
<br />I hcEly affEn urnn FMtry of pdjury thrr I m lkcns.d und.r FDvitk'n of Ch3pl6 9 (ollmtri.g eitn S..lion ?0@) of Division l
<br />of rlE Blrms.nd PotcsioB Co&. lrd ny liceN G in tull fo@ ird.fial.
<br />t-,**" "r*,
<br />b Liccn* Numtri
<br />'7oO,f'77
<br />Cvhc (x^r1- C,*i, . Duc,?>
<br />CQNSTtrjJ.(]IlQNTDXlllNA-dtirNtr
<br />I ncrcby ailirm nnder Fnallyof!.rjurr lhnl lhcrc is a coDslruciir bnninr rscn.! rd rhr ncdnnnuncc.lthc wotk iirr whi.h rhii Frfrir k
<br />i{ucd lsc..:1097, Civ C).
<br />Affura.NfD[ll,axauo!
<br />I hcftiry amm uod.r p.ndry.f p$jury on. ollhc ibllowing dcclarolions
<br />Demliliotr Pcrnrils'Asbcslos Norifi.ari.n Fcdcral Resuhrtun\ (TirL :10, PM6)
<br />-Rcquircn
<br />Lctts of NorifMrion
<br />I .diry rhar rhc rcddnl r.Bllalions ESonlinB $b$rx romvd 6. nor amlnabk ro rhh pmjcd.
<br />-l
<br />enify rhar I h.w Ead rhh applicdion ord sldc rh dE rh,vc infomttun is comcl. I aE@ ro .onpl, sirh all cny .M couniy
<br />odi' tr.c\ 3nd srrrcljs\ rchrii[ t, hu .:'nit;xr rcrrcsnrsriws orrhh Cn, and Cou.tylo.nrd uF.lrE
<br />!h.rc mnriotrcd rmpcny lor insFcr
<br />Appll.! or senlSismiurr[P*r f. W\e,T NTlsl+
<br />LL lv
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under f loor
<br />Gas-Underfloor
<br />Buildino Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarilier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Pipino
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P{rap/Drain Line
<br />Main Drain/Pool Pipinq
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary SeweriCap
<br />Back Flow Device
<br />Rough Plumbinq
<br />Meter Release
<br />FINAL ll24tlot -.{,{U 1(t4 )
<br />Notes, Remarks, Etc.
<br />Miscellaneous
<br />Final Gas Test
<br />I le
<br />trndd i Nrtu:
<br />I
<br />----+---
<br />=
<br />t-
|