|
PLUMBING.INSPECTOR RECORD
<br />DATE ID/SIG.COMMENTS oWN0R Bt'll-D[R I]llLCARAl lON
<br />I h.rhy trfln'n xnd$ ,. rhy of Nrjury that I nn cxcnrlr lr.m rhc C nlrirkna l-ic.n\c I:w for rhc follorir8 tcasn (Scc 7'r.ll 5
<br />Busircss nrd Pri,l.\si Codc) Any Cily or Connry *|ich r.quircs r lrrmi n, .o {nkr. rlrcr, nntmtc dcNlth ,tr rFn ,ny
<br />nrucru4,,'itrt, ih n\ur cc. ak. r.qnnclrhc+fli. Dr for nrh Fnnir ro ilc! \is.cd srarcnEnr rharhcor\ho L\ li..n\cd Iu ud r r
<br />rorh.rovi\ion!oflhcConi.lcktr'\Liccn*dhtr(Chr/cr9.Co'nrn.in8$rhSc.riorTrnO.lUi\isi,rlorrh.lrrrri'rc{srnd
<br />Pn,rc$nff Codc)orrhar h.orshc iscrcn!, thcrcfnnnrnd th. hn\is lorrh. nlles.dcxcnrpri{,n ny lidrrionoiScdion 70.11.5 hynny
<br />{tpli.rnr rur atlcnnit suhj(ls lhc amlicanl l{, ucivilpcn!lly.lnor mor.rhri ivc hundrcd dolli6(3500)
<br />_l- r\ owtur or
<br />'hc
<br />pfl,|[nt, or y cryloyccs wirh w.8cs n1 ihcn sob $"rpcnsrr ion. trill do rrE *ork dd rhc {flcrm is nol
<br />trrc.d&, or otl!rud ld elc ( SN 7(x1. lrusinc\s lnd t'(,icssions C{xlc Th. G,nkritr s Licctrq trw docs trot 8t'!ly lo !n owncr ol
<br />rhctopcny $hr nuills or inyrort\ rtrmn. rtol sh d'B \uch trr* hin\clfDr hcrrll or lhmugt tis or ncro$n cq)loycc(,
<br />t)tuvidcdrhrr su.h nnpn)rcnrnNR nor i edcd or ofctr\l li,r ML.Ii hi)ecv.r, rh. htiillng or nltn*Mrnr is st wirhinonc yu
<br />olcon{,Lri'n rhc O{no Brildcr willh!\t rh. hunlctr orB)vnr8 thir h or \hc did tr.r buiuo. impo\t rhc,mFry rd rlr luqx,rc ol
<br />I, ar osner of rhc l,.Fny. !n cxclusiwly conln rins wnh ficcnEn co mcl6 ro.onrrud
<br />'h.
<br />pojccl {S(. ?044. Blsims
<br />lnd Aldrsbo Codc: Th. Conm.ldrt LiccB. Llw d@s .or lpply ro a. owncr of propeny who builds or inprovB rheron,
<br />ud *h6 omra.ll lm luch pmircts N n a ConrEcro(, lic.nEd plFurr ro rhc C.nu&roa. tr..* b*).
<br />I nncrcnrrr unlcr S(t
<br />Dotc: O*nE
<br />UOaf,EXI:COMIEIAIIAN
<br />oEcLASa:no!
<br />I h.rcby aflim lndcr ncn.[y otFrjury 6E ol lhe fouowi.S dclfaiiom:
<br />I hrk lrl$ill Hnn3i'r rCcnrfir rcofConscir r, ScllnNtrrc f(n \.rli.r' comp!nsrrnn,. a\ In,!klcd fd hyS$ri(nr:l7l)Ool rh.
<br />l.itin Onlc.lbrlhc p.ri.rnDrc.trhc qo nn whichrlr If,n ir '\ tr\ucd.
<br />-l haE and *ill minrain so.k n .onFDsriio! irsunmc. I mquircd by Sal iot 1700 of rhc fdo. C..h. lot lh. Frfollrw. of
<br />qhi.h rhis n mn is is$cn. My wo,k6' con{EMion imumr trir ud poli.y numh.r e:
<br />.J +o
<br />-l
<br />ccnili lh.l in lhc pcrfo.mme of llrc *ork tor *hkh rhis lcrdil t a.sucd. I shall not cnploy !fly Pcmn in any @ncr
<br />$ 4s ro bccom suh.id to rh. wo*.* .on{Ensdion lnws of Cdifomia. snd !s@ thal ia l should hdjom subitl lo llE
<br />*orksa .dnqxrsiion nrevhioos ol S.a]lion l-r0o of ln Ubor Codc. I shrll. fonhwilh .onqiy wiih ihos tmvhions..
<br />WARNINC: Flihrc ro e.urc qo d omp.ns.tion covcmSc is unh*tu|. and shnll subi*r s cnPloy.t
<br />'o
<br />aiminll [EnallicF md
<br />cnil fincr un ln n( hundcd rthuEnd dolln tlloo.ooor,
<br />Sdrion 1076 of rhc Lit .Codi im.rcs ond diomy r fms
<br />io!. drMB$ os prolikn tu lhc
<br />G-'+-t*
<br />I hcrchy !firn undcr E.ahr.aneriury rhar I am li$n{d 9 (commmnrs wilh S*ri,.70m) oiDivhion l
<br />of llr susims and Pofcssions Codc. nd my lic.tr$ is in full lorc ad c,tNi.
<br />r-i""*" cr,*,----€-:u**" r".t,,lCr>11
<br />AfILICANLIIEII,ASAIION
<br />I hc(6y !,linn u.dq pcnilty orllcrJlry orc oflhc lolloeinB dftlffdn'n\:
<br />Dcmolirt. P$.rirs AstE{o( Nolilicalion Itdcrrl Rcsul ions(Inlc,r0. Pfi6)
<br />Rcquncd kncr of Noriicoliotr
<br />ictuvBlrE Rn rprlkoblc lo thi{ poj6r.
<br />rrl,ly eith lll Cit, &d Colnr,
<br />Cny ann Cornry to cntd up6n rhe
<br />above nf,flioncd Pmpcny for insrEcrion
<br />ADplimnl or Agenl Signal L t.p-
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underlloor
<br />Building Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Pipinq
<br />Gas Piping
<br />Roof Drain
<br />Tub/Shower Test
<br />Rouoh Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />l\4ain Drain/Pool Pipinq
<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 />Rough Plumbinq {o/il16 <a€Y
<br />Meter Release
<br />FINAL V/r"ils sbs"6
<br />Notes, Remarks, Etc.
<br />APPHOVALS
<br />Miscellaneous
<br />Final Gas Test
<br />o.", b4,11 conro"ro,' 14.1<-enn
<br />C( TNSTRTJCTION I FNDINC AGENL-Y
<br />I heEl'y lrm hdcr penalry of l)crjxry th.l th.n is s onirudion knding aScmy for llE pctloMc ol thc wor* lor wl ch lhis p.rmil n
<br />issucn Ise.109?, civ. c.)
<br />L.nLr'\ NLm
<br />-
<br />r-Pcmile mmelprinl)C)a--/)
<br />I
|