|
PLUMBING.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS 01VNDR BUII,DER Di:LCARA'TION
<br />I hercby !fifl. utrdcr pcn0llyollrcrjury rhd I m crcnrrr lnnn lhc (in rndor\' l-icc sc uw lhr rhc iollowin8 rc!s. (Scc 7(J.ll5
<br />B!\incs ad Prolcs\i.n Codc): Any Cir) or Counly {hich rcquics r p.nnir kr con{rull. 3lrel inprolc- dc@lhh itr rutln rnr
<br />{d.trrc, I,rinro ir\ nsran.c. al\o rcqxnc\ rhc{pli.r inr suchrcnirn) lllc r sighcd iat. rd rhxt h.or\h. is li.cnsd pu^unr
<br />n, rh. pmvi\n,n\ olllE Co ricnr\ l,iccnscd ltrw (Chrplcr e. (innmcncins wiih Sc.li,)n 7tl()O ol Divi\ion I ol rhc Eusincs anrl
<br />Proli:sion\Qrd.)orrhxrhcurshci\rxdnuihrtulioNrdrhcha\i\lbrrhc{lc!.dcbrtrim Anyrioldion.lScdionT0lll5hyr y
<br />rrplicaortorrrrmitsuhjc.r\rhcrpplicrnrrorcivilpcnrlryoftror'n.r h livchund!.ddoll (!5rx))
<br />-1,
<br />a oprcr oallE pmFdy, or my cmplolu3 eirn sa8.r s thcn sk ohpensdion. eil {t tlr ect ad tlE smrtm b ml
<br />inroi.d oro,I€En for slc (S(,7O14. Busircsed PDGsions Code T[c Co r&lor'. Lite kwd..s mr,pplyro@owErol
<br />thc Follny who boiE! or inpos llEmn. !d wh. &E trh s* hims.f or h.Blf m lnreu8n hi tr lEr ow cnll,loy.6,
<br />lrovidcd rht Mh impeEmiB @ mt hl.fld.d o, oftErl f6r BL.li thl!6. tlE ttrildi.g d i,prcm.r is $ld wnhi. orc r{.l6r9bri.,t 0r Otur AuiEer will luE rlf, hldo of thing tld lr d dE dil tEr trild d irlcE thc rDldiy lor ilE purpos of
<br />_1. r. owrcr of rhc Irolxny. lm.x.luritcly confiacring wnh li.cnscd.onrrucro lo.dnntur rtE lmis (s(.7044. BusiBi
<br />ond ftolersim Codci Thc C.olmlols Liccns. tjw dms ml rpply ro an own$ of protEny vho buiks or iqrrows lhson,
<br />d who ontm.rs fo. slch !rcjsG wirh o ConrEcro(s) licnEn nlnu ro rlE Conrturois Ltc.s Lis).
<br />-l
<br />dcxcnfl uder SErhn-. A. &P.C. aor rhh B&io..
<br />}ABf,EEII.COMIENIA.IIQN
<br />DEIIASAII(A
<br />I h.r.by r$irm uodc. pcnall, of p.rjury oE of th. following dGlr.alionsl
<br />I rh.r Co'lc.lar rhr F-nnnnrn.! rl rh. \.'k li *hi.[ rlt Nnrir i\ i*xcn
<br />-l h,!c and will @intlin wort.d .onFn*alion insur.ncc. r{ rcquiEd by s..lion 1700 of lhc tlbor Codc, tbr lnc Dcrforture of
<br />thc work lbr which lhic p.mit is nsucd. My worlcn' mmrc.sarion insuromc ffhr ud rolicy nlmbcr m:
<br />-l
<br />criili lhar in $e p.rlormm oalh. work for which lhis Fnrh is issu.d.l shtrll not cmploy!n, pcMn in rny mntur
<br />sNroh(amsubirrrotlEeitc.onFnsdionlawsofcalifonir,aduserhutifIsh.uldh.smrnb.,ell.rtf,
<br />sorke* @mpcnsarion pmlisions of S<rion lTO0 ol rhc lihor Codc. l slEll. tonh{nh conply wirh rlD$ l,mvisioos..
<br />WAkNINC: FailuE lo wurc utrteB' compcn$tion $vcmg. is unhwf!1. and shlll \lbjet an dplorcr lo diftiEl pcMhicr d
<br />civil fircs up to orc hundEd rfiolsond dollas (SIO0.O00), h sddniotr ro rh. cosl of cohpcNrion. dlmsca !s trcvid.d for rlr
<br />Sdion 1076 of lhc t bor Codc. inlcrc( lnd allormy's fes.
<br />%
<br />I lEEby ,rIrm udd Fnalry ol p.rjury in i I an liccnsn und.r povLion of clE ird 9 (onmrcirg wnn Seio. 7000) oa Division 3
<br />ol llE Bsircss Md Prcfcssions Codc, dd my ltcn* is h tull loEc oid ctrrtl,
<br />')-_fr
<br />IONSItrUCITONIINDING.trAIICI
<br />isncd lScc. :109?. Civ C ).
<br />lllLl! Nfl)liEl2I-B IA!
<br />I hcrcbya nm utrdcr ncnrlry otlcriury onu oirhc,nlhwnr! n.chturhn.:
<br />D.mlirld. Fcnnnr sbcnos Norili.dirr l,cJ(rrlRcgullrii \ ('lirlc,r0.ld16)
<br />Rcqutcd Lcn$uf NorfMiifl
<br />I cenifyrhar rhc lidrn rcBll bns ft.lrdin! aslf,(.s r.nx)ul arc norrppli. lct, rh(Ioj.ci
<br />-l
<br />ccnily rhar I harc Ed lnis appli.atnrn dd srorc rhd fic rtrvc inbrmrion is conc.]l , aEe ro comlly wirh all Cir, lnd Couoty
<br />ordinamcs and S'dc tiws nbtine to building constrcriorl dnd h.r.by rurbrizc rcprcscnrorircs of tnh Cny ud Co!.ty ro enl. lFn dc
<br />rh'rc tunrioned pmncny lo, iispecrionp!! xc\
<br />',,/',?P\Z{
<br />UNDER GROUND
<br />Waste & Vent i -1r- \s ))" Srt 2('fi)
<br />Water-Under floor
<br />Gas-Underfloor
<br />Buildinq Sewer
<br />Area,/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent \$,r.(rh
<br />Water Piping /5.?l l()- @Y
<br />Gas Pipinq
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />Main Drain/Pool Pi ptng
<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
<br />Final Gas Test
<br />Meter Release
<br />FINAL /-r-/8.,
<br />Notes, Remarks, Etc
<br />Water Service
<br />t/,Lr4o
|