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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.OWNET BUIT.DER DELCARATION
<br />I hctby amm udcr Fnahy ol pdiury lh, I m .x.nQr rom rlE Co Mrou Lie.e hw fo, tlE folloehg lten (S€ 7011.5
<br />Bu.inc$ ,r!d Prof.sioi An.): Any Cny or Co!'ry *hhn Equn s . pdmn lo oislnEr. ,16. ihpbve .Lmlnn or EFEr rny
<br />sltucluE. prior lo ns irsu,B, at$ requiE $c anpli.st tor seh pemir to ,iL ! sig*d stncm lnar hc or rlE k lictrrd I,uNa'
<br />lo lh. Imvhionr of tlE C..mcbis Lienscd k* (Chlprd 9. Comn.ing wnh S.crior 7000 of Divirion I of thc Blsifts .rd
<br />Pofc*ions Codc) or thsr h. or sh. is cxcmpr th.rcfioE md tlE b{rk for rhc arhecd crcmptio.. Ary viohrion ot Sc.lhn 70:11.5 by a.,
<br />{pllicaot fo, a p€mir subjttsrlE applicafl ro a cidl pcElryofrcI mE rhd fir. hunr,!.d dolld3 ($500}.
<br />-1.3s
<br />osE of lh€ plFny. u my.nployBc wi$ sig6 a t&n $le enqrBdion, Mll d., tlE tut drd rlt ntur@ i\ mt
<br />in&idcd nr ored for *t 1Sr.7044. BBi6s and Prtrfcsions Cdrc: TIE CoitBrofr Lie.c hr d.c. mt lpply to s owe, ol
<br />Its poFny who toildi iqilxs lhcm&.nd wt &6nri elt hirelf or hcrclaorthrclgn tis or hd own cmobrqs.
<br />providcd rhlt ech iniprevm' i e mt i'nddcd oroff.Ed lor eb Il howc6.lhc tniLlinS or iqxmmnr Ls sld shhin m Fr
<br />ot conpklion. llE Owmr BuiU6 wil hrE dE hrd.. of nrcving rhll hc d slE dit mt hild or iolmE lnc pof(ny ld lh. n!rF$ of
<br />_1. as owner of ttc l,mFny. !m crclusively conlr&ring whh lien*d conmclos ro consrrucr th. pioj6r (56. 7044 Burinc$
<br />snd PJd6skln C.dci Thc Conrr&roai Liccnsc Llw doca nor q,tly ro .n own.r of pmpcrry who builds or inprores lhcrco..lnd who o Brs aor such ,,ol..ls wirh 0 C.ntadorl, lier<{ lu^@t 16 rlE Conh.toas Licen* Lrw).
<br />-l
<br />arcxcmnt undcr sdion , A. & P C. fqrnis rcr$nr
<br />offi--,__
<br />]TOA6EBa..COMfINIAIION
<br />DECIABA]JON
<br />I h&cby lffiln undcr pcnall y ot Frj!ry one ol thc folbwinS d.c1tr0tions
<br />_l haw ad will einl8in a CcnifEatc of Consnl ro S.lf- lrouE for workds. mmFnslion. a pmtid.d lor by Serhn 3700 oa llE
<br />t bor Cod.. fd rh. pdfomftc of rlI m* for which rtF Fmni n Lsu.d.
<br />-l hrvc md will @i.r,io worich c.mFnsarhn insumtuc. &s rcaln d by Scrioi 3700 of rhc t bor tue. fo. rhc I'erfotrrw€ of
<br />lh. mrk fo. which rhl\ l.rn ir i4srdl. My wd*ss drqEn$lion insuErcc c.trhr ad policy numhs @:
<br />PnlilvNudbd
<br />-ErD'rc{
<br />-l
<br />ccnif, thlI in lhc pofordkc oilh. work for whhi lhir pcmil is is3ued.l.hdl ml enirloy any IrMn in an, mrnm$ .r r. trmm $hitl lo lhc sorkc6'@tr{Enslion laws ofc|lifomi& Md r!rc th{ if I rhould he.onE sub}rr ro rh.
<br />wo&ds onp..stion povisions of S.llion l7m of tnc latrT C.dc, I slqll. fonhwilh oirply with irDs l,mvlrions .
<br />ll^RNlNc: Frilurd h sctrrc Norkcr' conpen\!ion ..tsnsc is nnh*ful. rtrl shrll $bicr rn cnDl.ycr ro ainrinll rcmlrics rnd
<br />.iuil llncs !p b onc hundrcd rhou\rnd dolh tsl(x).lxxr), irr adiliri.n l. rhc cosr ol conrpensdion. dlm8c\ a! prvidd nn tnc
<br />Sccri$ 1016 ofrlrc uhtr Cud.. inr.ic{ rnd rnormr'\ lrc\.
<br />Lltutr,rl])-EoNra llaa
<br />DITCLAAAIIOI
<br />I h.Eby 3fflm und6l,erElry of Fdui, Un I !n lienicd ! lcr prelisk'n ofchryrd 9 {ohftrcing *nh SGcIion 7100) otDirirbn l
<br />ol rlE Busircss ed Prcf*rions Cod.. anl d, lic€rr h in tull fo@ .,n .ft .r.
<br />taxtirai.IclloNrElDltc-AliliNcr
<br />I hcEby rlfii,n utrd.r Ir alr! oi Irtrjrrt rh3r rhr.. il r cntrnn,.rhn Lndins aAcncy ntr rhc n rtorlruNc olthc work tur shi.h rti\ p..nri n
<br />i\\0!d (Sc. .1097. Civ C )
<br />i IIIIICAILDECId.BAIIO
<br />I tENh, rnlm und.r l[.aht oI p.rtury onc urrhc tullo*ins dslfflrio"sr
<br />o.ft'lnion Pcrnrir\ Ashc{or Norilicdn'n Fc(cral Rcsuldi.ns (Tirlc,10. Pin6)
<br />Rcrluftd Ir crof Norili.rrn
<br />_l ccnifythar rhc rcdcrnl rcgulrrions rcgddirg drhc\lo{ rcnn,vrl e nor er'pli.dhk 16 rhis prcjcc!
<br />lcsrilrrh.rI ltrvc lcad rhis ry,rlicarn,na srllcrhd rlrih,vc inloflmrion is.oner.l0!rdIoconlrywirh,llCirynnd Counly
<br />ordinanccs md Srorc lj*s rchring ro buildinEcoDsrrucrnr and lrrcby,u'horizc rcprcscnrlrivcs .fthis Cily Md Coutrtyio cnicr Won rhc
<br />uk'vc nf, iotrcd l,nJp.ny hr inqEcln[ purrbscs.
<br />Applimnl o. AEenl signnlun:
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor
<br />El uilding Sewer
<br />Area,/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Pipino
<br />Gas Piping
<br />Roof Drain
<br />Tub/Shower Test
<br />Rou h Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />Main 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 />Sa nitary Sewer/Cap
<br />Back Flow Device
<br />Eough Plumbing
<br />Final Gas Test
<br />Meter Release I I
<br />FINAL 7 l? \ty unfl 7y t/I' r
<br />COMMENTS
<br />UNDER GROUND
<br />Notes, Remarks, Etc.
<br />D.t.:
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