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PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG,COMMENTS OWNI]R IIUII,DER DEI,C RA'I'ION
<br />I h.rchI rlltnr rnder l[ rlrt,)f n rtuiy rhdr I a , cr. fl from ih. Gnnra.rrs l-N { t-us lorrhc n)llowin8 rciwn (Sc.70.ll5
<br />Ilu\in.\! aid Pn'it\soi Codc): .t Ciry or Ci)utrry shi.h rcqtrirc\ . l[flnir I. consNcl. rlrc!. irnlrorr- &ff'li\h 'tr Rr,'n Jny
<br />srudurc, l]norro ns i$uarcc..ho rcquncslhc 0lplicor ror {rh lf.nf l. ilc ! sismd dtrrc.rnr rhrr h.or shd n li.cnsrl pur\uanr
<br />h rh. pR,vi\nn\ orrhL Co.kr.ktrt L,.cns.d tr* lchrprcr 9. Co nc .irg sih Scclim T(xI) ol Dlvi\i,,n:l of rh. auri',.\\ and
<br />ennis\nnr\ aodc)orrhirh..rshc is.xcnDlrhcr.ttDr.d rlr.tn\i! tu rhcnlc8c,iu.nrpri{nr Airr('rrri,,t.iSNi'rtr7031.5iy!ny
<br />rpflicrd lnr u pcnnir \uhjrr( rhc atpli.an! h rci!ilncn,hyolror 'n.tu rhri nvc hundrcdd llam(35(X)).
<br />-1.
<br />I o*rcr of th. pmFrry. or my enltrloles *nh *ags &s tl*n $L 6o!.tr{rion. will &r tnc wot ard 0E $nl.l@ n ml
<br />id.nd.d or oflcrc<l fn sb (Se.704.a. Bu.iB. ed Prot $io8 Codc: TIE Conr6doas Licns tw ltrs ml 3pply lo ,n owftr of
<br />lh. FoFny who boilds or inprDB llEEr lrd who dG sh *ort hiNlf or h.a.laor lhDugh his ot h.. ow. cmployss.
<br />lhvidcdIhd skh inp,lmdsa ml h.fld.d dotu lor sb.IL lnR6.llE tnildins or intetm Lr $ld wirhin oE r&
<br />ofonpLibl! dE O{M Builli wi[ h.E 0E hrno! of pDvb! rha lE o slE dt Nt hih d itrlrlE dt poFty tu dE lBpos or
<br />-1.
<br />.i owffi of rh. tmFny. u crclusiEly snrrdin8 eirh licrned .onrra.roB ro od3lnd rh. ,roixr (56. 7044, Busms
<br />!'n hoGs\i- Codc: The Conr@rol. Liensc L,w des @r lnDly i6 dn own* olFopcny who buil& or impmts lhdeon.
<br />8nd sh. orlrrd. fn su.t lmjds wirh . Conhcro(o li*n*d puBunr ro rhc ConErdolr Lt.M l.lq),
<br />-l
<br />do crcmfl undc, S6t B. & P.C r(r rhk rc{son.
<br />Ll.
<br />SQ8f,E8Ii:.COMIBIAIION
<br />DECIJf,AIITIN
<br />I hercby {lim uodc, Fnany of Fjury om of lh. followirg d<l,r lions:
<br />I l[krnd will'nrinrain,Cdnitialc.l(t,n*[ to Sdlt lisurc fitr *.'kcd c..rFn$rion, $ providcd lor hySccrion.]?C{lofrhc
<br />ktx)r A'dc. Ior Ihc p.rfonuncc o, lhc {ork fff 1vh i.n lhc pcnnil is nslcd
<br />-l
<br />h.rc and vill @inrain mrtcR comp.nsalion insuramc, as Equn d hy Sccrion 3700 oflh. Lihor Cnde. fo. $c p.rrotmre of
<br />thc work for which lhis pcmil is issucd. My sorlGs' omlcnsElion insoEN 6br od Plhy numbff m:
<br />*a*+ -.-ttn)
<br />s.?!11<
<br />-l
<br />ccniry rhur in rh. Frfo@ne of lhc work ao. whkh lhis F.nil is issucd. I shrll nor cmfloyrny pcMn in uy mdnB.
<br />$ s lo bc.om subic.l lo llE wo*m' cotrq*nslion laws of Califonit. and aEN lhll af I .hou6 b.<om sbjd lo tlE
<br />*orkEl mmFnsalion lmrisionsofSdion 3?0Ooflh. L{bor Codc.l shdll. fonhsnh oq,lywirhiho$ lmvkions..
<br />WARNINCT FailuE h scurc *o*.ri coor.nsi,n,. covccJsc ir unldwtuL d shdll {hj{l un cmtlo}rr lo oimi.rlFtulric\ and
<br />ciljl fioc\ u0 ro ore hunded rhou\d.d dolles (S100.ffr), jn rddirion b lh. cosr oi.ompcnsllion. doroAca as provid.d for thc
<br />Sktbn 3076 olrhc Litxr Codc. i"r&.s Md.uormy\ f*.
<br />o"r"' J'2!. lR - nrrr*,,-E-..--V
<br />l!!!LrtB,!ItaI
<br />I i.Ehy dlim u.dd Fmlty of Frlury thlt I m liorsn uid.r pmvision ol Ch.lld 9 (.omEftin8 wilh Setion ,0m) of Division l
<br />ot rhc Bnsincs rnd P,rfc$ions Codc. dt my lkcn* h in tull fom .,n .fic.1.
<br />oare: 5-
<br />B lbr1936
<br />2{.lf conr-"ro.-&
<br />CAILUf,!]gIIANIDNDIIC.AGENSI
<br />I h{shy !finm uodcr ricnllryorp.turyrhsr rhcrc n s.\rn{tu.ri,n kndnr8.8ctrcy for rh. fdlnrmnce ofrhc worr ror *hi.h rhis r.flnn i\
<br />nsucd (SL\ .1097.Civ. C ).
<br />ATPLICANLDECLAAAIION
<br />I h.rcIry lltimr u c, rnally ofpctury onc ofrhe follo*in8 dcclmrjons:
<br />D.,mlirion Pc.nire^sbc(os Nolificnlion r{dcral RcSulalions ITnh 4J, Pnn6r
<br />Rcquircd Latfi .f Noriic.lion
<br />-l.cni,
<br />t,n'r lh.fcdcr{l agularions rclliditrB a\bc{ro{ rcnovalrrc no' {dk,hlc ro rhis pmjNr.
<br />E{ .cniry rhd I IDv. rcd Ihis 3ppltll ion o d nnrc rhd dc olnvc nrioinul ii,n is coNr l rsre ro .onrdy with orl Cnr !trd Colnry
<br />odin0rccs rnd Sratc t *s rcblin8 lo building con(tucr herchylurhon& rcrtsn'nrivcs olrhh Ciryand Colnlyro rdt.r up.n lh.
<br />nbov. nrnrklncd pbp.d, for impe.lion
<br />Qa[D
<br />-,. Szg.t?
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor
<br />Buildinq Sewer
<br />Area,/Storm Drain
<br />lnterceptor/ Clarif ier
<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-trap/Drain Line
<br />Main Drain/Pool Pipinq
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Gas Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbing Llzpk, ,.{/qrD , /{* ntk uq* /t*snt
<br />Final Gas Test rez*)../,,-.L.'
<br />Meter Release
<br />FINAL tt/z("11 hts
<br />Notes, Remarks, Etc.
<br />Water Service
<br />Lcndn r
<br />^ddrns:
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