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PLUMBING.INSPECTOR RECORD
<br />DATE COMMENTS
<br />UNDER GROUND
<br />Waste & Vent
<br />Buildino Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Pipinq
<br />Gas Pipino
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />Ir/ain Drain/Pool Pipinq
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rouqh Plumbinq zil+rtg blult9-4/4(?/
<br />Final Gas Test
<br />Meter Release
<br />FINAL Tla*rls 5f:s(
<br />Notes, Rem-aiks, Etc
<br />()wNER ttrlI,D!]Il Dlx,( aRA fl ()N
<br />I hcehy afun !od$ n mlly of lcrrury lhlr I m eienfl fen E Co.ltrcroB Liccns &s for lhc followi!8 E!$n (5*.?0!1.5
<br />Blsinss and Proac*shi Codc): Ary Cny or Cou y which equiEs e ltmn lo .oisrrod. als. ioprew. dcmtish n. EIEi .ny
<br />snrrurc, Fbr ro irs iseam, .h6 EquiB rhc rpplt&r for .Nn Fmil lo fih . sigmd sl"lc.Mr that h. or sh. is lkcn*d Puauatn
<br />ro 0r l,.virioN of ltE Contrrcld\ Lien*d kw {ChrF* 9, Conm.EinB wnh Sdion ?000 of Divisio! I of lfic Blsincss and
<br />Pmfcssions Codc) or rhur h. or shc h cx.opi rhcrclrcm a.d th. basis f.r llE allc8cd cxcn lion. A.y violelion ofselion T0ll 5 by any
<br />lrtlic..r for a pcmn subjers rh. appli.anl lo ! cilil p.Elly of nol mc lhe ti{c hundrcd dol,&s (3500).
<br />-1.
<br />&q own.r oarhe pmpcrty, or dy .nploltci *nh sagci &i rhcn sb coE .6!lion. qil do thc sdk .id rhc ,rutlE i\ ml
<br />inl.{dcd or o,f€r€d for sb (Sc.7044. BtrsiEs sd PrDfessioB Codq TIE Conlt&toar Lien$ tiw thcs nol lplD lo a. owNt ot
<br />rhc p'DF.ry wlbt ild, s iryrcEs lh.@'t a.d Pho dG seh trit hims.lfor lf,Rlf or llmugh hii or h6 o*r.nploy.c..
<br />pmvidcd rh seh iqrlMEnk @ mr hlsi.d oroficEd for slc. li tb9cE. rtE trildin8 ot inprcEtunl t $ld wirhin om lEr
<br />of.otr{,hriotr llE Oeicr Blildd win lurc rhe h!d.n of p,liie 0fl lE or dE dA ful huiE or irpnE lnc pqsry for llE ,,floe ot
<br />-1,
<br />as owrcr ofrlE I,op.ny. !o cr.lr.iwly c.ntndi.8 wnh [ccns.d ontra.loB lo.annmi rh. Imicd IS(. ?044. Blsims
<br />lrd Pn,rL*ion Codc: Thc Cont,clols Liccnsc Law docs noi lpplyro sn o*nct ofpmlE(y wto buildso, inpmv.s ihc.con.
<br />and who co mcrs ,r su.h ,,roj..k silh s Conhclo(s) li.cnscd ,us!u lo rhc C.nh.toas Lien* L3w).
<br />-l
<br />m.xcnpt !.d6 serion-- B. & P'c. for lhh rcMn
<br />l&oxl(, n-l' l:oMPrNsar()N
<br />DECIABAIIA
<br />I hceby smm lndf lcnnl'y of pdjury om ot lh. foUowinB dsl@lk)ns:
<br />-l
<br />halc und will nln linrccnittilcotco.scntroSclrlnsurcftnuorlc ..nP.ns0rion.as Prclided ad byssrn,n ]?00 oflho
<br />Latni Codc, rbr thc ncrlorote ofrhc wort ror qhich lhc Frmil Ls issucd
<br />-lhalcandrillf,aint,inworkcmconucasolioninsuEncc.arrcqoncdbysdrion3T(XroflncLlboiCodcforrrEFrformnccofp.irnir G issucd. My ,orks @m!.n*arioo iniurmc c!fticr a policy numbn el
<br />a h
<br />t
<br />-l
<br />ftniry lhal in rhc p.rformrcc ol the sorl for shich rhh Frnil is issucd. I sholl ml emPhy 6, p.Mn in .try mnmr
<br />$ &s lo l*od slbjccr ro rhc wo*dc onp.nslion hws of Caliaomi& and !!tc lhrl ,f I should bccom sbjcr lo ltE
<br />wo BC ompcnsarion f6visi... ol Selion 3?OO of lhc Llbor Codc. I nElL lonhwirh omply with lhos pmvision...
<br />WARNINC Failurc lo ww sortcn 6np..siion owmB. is unb*tuI. s.d shlll subi.tt s crpbytr lo oimi.al Fr.llas and
<br />dollds ($lur.fix). in oddirion lo lhc cosr of.oon .salion. dlegcs as pruvid.d ror rhc
<br />I h.eb, dlirm undcr i'.nrh, ol ncrjury rh{ I am liensl u.dcr n ofChspr( 9 (s6mn.itrB with SNliln 7m0) orD
<br />of rhc Busincs ad Pofcssiotrs Codc. ad m, li..n( is in tull forc dt elTcl.
<br />o
<br />!0!iIiII!JqIIONI!!DI!C.trOENIJ
<br />l heEny rrfin rndcr p.nalry or p.rjury lhnt rhuc n tr onn dd i,n tnJins ,!.ncy ror thc Pcrf$mncc oihc w.rk ftr shich lhh Pcmir h
<br />irsucd lSc..1097. Civ C.).
<br />8-StLlCrllIfDErL$AIION
<br />I h.nhy l\i,nu crtrnultyor F-'ju,yoncorrhc n'lhR rt dLrlmrn{\:
<br />I)rnn'l i,in Pc nns Arlr{os Norili.!rion lidc!rlRcEUlrrtr,n!(lir1d 40, PM6J
<br />Rcqui' crl hfidr ol Notifi.rrior
<br />l.ctrnvrhd rhclcdcrilrcsuLrioi\rclrRtir!n\b({osrc dtrlnrc norapPlcahl.k)rhilr*(r
<br />lm;iii I ho'" ,"*t,hi\ rf t,li.rrt,, ud {dc rhai rlr rtrivc ini{mrri{'n is comd I arl.\ ro.onrply { ilh rllcr! rtr,l cotrnrr_
<br />ordir.nccs ind Srnrc lissEulin! k,blilding .ffAYTY*:J,''T
<br />{hos mnrhnd pDlE ry tor inrp€dion
<br />Appli(onl or AI€nl SiANlum
<br />I
<br />IAPPROVALSID/SIG.
<br />e"ri"yr,"r,",, BUr.J r,J UcCol )'t 4r9 sri'*
<br />&dd r Add,EE
<br />-
<br />Pqror@'EBu,nn): Ftrfa:
<br />Water-Under Iloor
<br />Gas-Underlloor
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