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PLUMBING.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DET,CAR TION <br />I lEeby lmm lodf n nalry ol pdjury $nl I d crcnpt fbo rh. CorlDclc Li..trE tiu for lhe following of,sn (S*.7C41.5 <br />BusircB rJn Profcsraon Cd.)r Any Ciry or County *hich rcqlits a ltmir ro ennrud. alr.i iDl,mrc. &tulish o' Epa, oy <br />shcrw. pdor b ns h$re. also ftqrids thc rpdhd for skh P.mir lo 6h. siSn d slalrmnl lhlr lt or shc i! li..n*d tlmut <br />ro llE Fovilionr of dE ConlBclols Liccnsd Llw (Chrllcr 9. ComnEtuinB *Ih Se.li.n 7000 ol Division I of lhc Ausincss {rd <br />Pof.ssions Codc) or rhlr hc or ih. h ex.nfl lhcrcfhn snd E lErir lo! rh. rlhgcd.rcnlption. An! lioklion ofsetion ?03 L by.ny <br />aprliclnt for ! pemir subj*rs thc appli.@r to a civil p.oally of oor mrc thd fivc hurdEn do[a (1500). <br />-1. <br />s o*ncr of rhc pmFrry. or hy.ndoyM wnh waB.r ,s rhci $lc ompcn{ion. will .b lh. ect od tE sur.l@ i! @r <br />illledcd qoflcrcd ftr slc (Ss 7Oa4. Busimss sd PreLssions Cndc T,t Conmdd i Lkcn* hw docs mr.Pplyl. o*erof <br />rfi. Fsp.ny who huildr or inproB tlrtun, od -tn d6 Mh e* hiNlf o. h.rkllor thnud his or hcr own.nt,l6ycca. <br />lmlidcn rhd such imp,lEmnts e ht in.nded or olErd for $L.lt loE6.0E tlihing or irptutftd h $ld *Ini! oB ttr <br />ofonpldhr!. Eo!,@r BuiLls wil h.rc E borncnofpovin8 dd trordr did mt h)id d irqhE lhclmFny fordEp,po$of <br />-1. <br />!r.*ffi of rhc Fqdry, am cx.lBivcly co.rtrrin! willl li..nsd contncloF lo on$rucl rlE omjcd (SF. 7044, Butircn <br />0nd Ploa6six Cod.: Th. Conrrudol s Lic.ns Liw dGs mr E rly ro d o*n6 of prcp.n y vho builds or improtr lhcmn. <br />,nd *ho onrtur. tor such noirrs wirh a CoitEcio(O licss.n puBMl b lhc ConF&rols Lilns t w). <br />_l !n c&nF uldo sEaon----, B. & P.C. ror rhis lwn <br />D.rc O*nei <br />TOTf,E8I:COMPJNSAIIA! <br />DECI.AEAIION <br />I hcrciy .mrn uder pcmlly of psiu, onc of lhe follooi.C dccleliom: <br />l hnvc$dwill ntrn ir0Ccnific colConscnrr,'Sclaln\urcntr$orlcifco{.nJdiotr,rslmvidcdlbrtySccrn,n:l7U)ofrlti <br />hlxr ( od.. tur rhe p.rrontun.c ofrhc qork hr *hich <br />'hc <br />pcnnn n issucd. <br />-l <br />hrvc und *ill Mirtlin sork.s codleosation inslrlke. as eqlittl by selioo lrmof lh. Llbor Codc. t{r lhc perrormncc ol <br />rhn llcrnrir t n\uct My trn,k6 c.'nncn+<V €,'"',"--^ <br />srn,n nFurmcc crricr d polty numbe. uc: <br />',S <br />C,bYb b .'z-h'L^ <br />l..diiy rh,r in rh. pnforflmc ofllE $ork rbr which rhis pcrmil is hrucd, t shrllnol eryloy lny lctson in a.y tun( <br />s a. to hcc.ft slbjer r. rhc wort 6 ..mp.nsdion laws ol C.lifornia. ind lBE lh.l it I should t .om s!6i*l ro rhc <br />so*cn'compcn*rionpmririDnsofsdionllT0(,ofihcrib.C.dclshnll.fonhwnhcomrlywirhrrocpmvlcions. <br />WARNING: F ilurc to suB workcr'compensation colcmrc h u.hwful lnd rhdl subj.rt rn cmllors lo dininal lEMlris.nd <br />civil tin.s ul) ro oE hundrcd lhouslnd dollus lt <br />., rhc Busirc$ ind flolt$ions(inlc. unl nryliccne i\ in lull,,nr rlcltt.r <br />C-6G Ls?- \to\ <br />.\3.x <br />(ON TASCIIONI,ENDINC.ACEIC1 <br />I hcNby (iirm undcr Fmky.rp.rjury rhd rhcrc h J.onetucri,n lctrdinS a8cmy nn rh. rdoh'un.. ofrhc vork lbr which lhh Pcrdir h <br />is\ucd (sc..l097.Civ. C ). <br />AIPTI{:AII.DISIdSAIIIIN <br />I ffiy .flm un&r pcnalty of Frjury om of rlt folloqins ddhor ioor: <br />Dcrelir i.. Pcrmirs-Albc$or Nolific!! ion Fcdcrll Rcg!l!! k ns lTirlc 40. Prn6) <br />R.quncd krrcroiNolificari,n <br />I c..liiylh0rtl'eltdcrilresularbns rc8ddirrs r\hLnos rcnr)ul Jr. tur rfpliclhlc ro lnis pr+d <br />-l <br />ccnif, rha, I hNc rud rhh orplica d storc rhd rhc atnr inlomrb. h.oret l,Em ro oq,,y wnh allCnrlnd Coxnry <br />drdinams a.d sldc tlws rclalin8lo <br />ahorc mnrio.ed pmFny f.. insFd <br />6pEscn'div.s oflhis City and Colmy ro..r.r ut$n tlr <br />Appli$nl o.1[.nlSiAn u 4.rj'\x <br />UNDER GROUND <br />Waste & Vent <br />Water-Under floor <br />Building Sewer <br />Area/Storm Drain <br />lnterceptor/ Clarif ier <br />TOP OUT <br />Waste & Vent <br />Water Pipinq <br />Gas Pipino <br />Tub/Shower Test <br />Rouqh Water Healer <br />POOL/SPA <br />P-trap/Drain Line <br />Ivlain Drain/Pool Pipino <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 1 1.1 r('fi l,^rro rJ 'rub ) <br />Final Gas Test u\ <br />Meter Release lrt ?va-m 4? <br />Notes, Remarks, Etc. <br />Gas-Underfloor <br />Rool Drain <br />FINAL <br />in add ion ro lh..os of conqrnslion. .hmB.s !s lolidcd fot rlE <br />,r",{.']31 <br />lrrl." \N'n. <br />- <br />I c' 'lr''. JJ'r$ <br />v/\*