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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.OWNI]R BTIILDDR TIEI,CARATION
<br />I hcrcl,y a i.nr un.ler ri.oall, ('f p.rjury rlur I am.xcnDr from rlt Grnrru.ros Li.c st t,rw rur rh. nr[rwing rcnson (5(.7031.5
<br />Burnr.\\ Dd Protu(rnn Gd.) Any Ciry or Counry *hi.h r.quircs x rcrmir ro co.struct. .lrs. impnnr. dc'nohh or rcnrt any
<br />qtu.htrc. rior r, irr irsuakc, nko rcquir.\ rhc ulplkrr tur ru.[ F ni nr filc r siBmd {orcmnt rhot hcor rhc is liccn{d rur\uanr
<br />ro rhc pn,vnions olrh Colr8crq \ l,iccn\cd ljs rchnprcr 9. Con(.kin! sirh sccrnrn 7fiI) of Divisbn I oflhc Busitrc\s lnd
<br />Pn,fc$ ions Codc r or rh h.orrhc iscx.mpr rh.rcf.on Md rh. b.rt nr rhc rllc8cd ckrnption Anl vi{,loti{n,ofScrri)n?0.ll5 by rny
<br />rrpli.lnr forapcmir suhjcch rnc amlicaor h rcivilpcnnlrroanor mnurhan nlc hundrcddollrs (s50o)
<br />-1.
<br />N owr of rhc l,oFny.6 ny.rploy.tr wnh ea8c5 6 rlEn sL odv.Nrioe wiI do 0E po rd 0! sltudr i ml
<br />i.torhd d o0.cd fo Flc (5€.7044. Bulims ..d PiDf.$ioni Cod.: tE C. r&l@'t II..s r,w {bc nol rpply lo o osm ot
<br />rlE ForEty {,b h{itli s itrlmB tlEdn. &n db d6 nd! udrt nirelfor h.eltor rhrcugi hi. or tf,r own cnphtt s,
<br />prcvtcd rt lsu.h irrFDm .@mri cd.d sofisd lor sh.lf. nME,rlEhililiigdirlF@dE i. sld winii om rdofonpb&[ dE Ol€ Built willhrE [E hidcn of FlviIgll81l! d s]E dn d bjld o inpmw di FDpdry fd llt F)r?oeof
<br />_1. !sDrrc,ofrhe pepcny, o.rclusivel,.o.r.cr,ng wift lic.n*d codrd.roB'o onsdd r proj.ct (Ss.7044. Bu:inN
<br />and EDf6sion Codc: Th. Conta.rols Lieisc hs dds ror anrly ro M osncr ofp,op.nywh. builds or i6orov.s ficron.
<br />lnd vho conhcrs ror such FoFcrs wilh r C.nrBdo(n licensd pusunr io thc Conrachls Liccns Law).
<br />I dn.x.n!, undcr Sc.rn,
<br />l) rr (),rrr
<br />II}BtrEBII:OMSENSAIION
<br />DtrCIAf,^IION
<br />t hcrcby nmrn nndcr Ir.alry .f Fju,y o.c or rhc f.lk,wing d*lrda.ns
<br />-l
<br />naE on will minllin ! CefliaEarc otconE ro Self-lnsurc for hrk6 @r{Etri8lio!. e prcvidcn tor bySelion 3?00 oflh.
<br />L.hor Codc. fu th Fnol]im. olrl* *o* for whi.fi llE p.mil ir isocd.
<br />_l hlrc dnd will duinrdan w.,tcn .oq,.n$r ion insuhmc. ar rcqun d by Seriotr 37(r of lnc Llbor Code. for rE potomrc or
<br />d. \nrk lorwhkhth,i Fmr tr ^nEd. M,wml6 d,qrn$uon rn\urlmc cMicr drrd Flky nurhq ec
<br />crE. sr\ap EAA\D-t6 1- t-tq
<br />-l
<br />edify rhat ii rte I'.rformnc. olrhc wo.k tor *hth rhis tr.rni is i!su.d.I shnll mr cmploy ory p.mn in any nurcr
<br />so * lo t*@e sxbjccr ro rhc $orkdj .o'n .ns.rion hws of Californi!. ond ,gE lhsl if I sholld hesm {bjld ro E
<br />workss .onr.nsari6n pF Lsions or s{tion 3700 or lh. tjbor Cod.. I stull ronNi$ oflr,y $ilh rhoe ,n'vhioos..
<br />WARNING: F.i,ur. ro scurc workcn' compcn$r ion corcrosc is unhwtuL lnd shall subjc.r ro .rylo'tr to aiminal lEDllics !.d
<br />civil fincs ut ro onc hundrcd rhousnnd dollas (S!00.OO0). in lddirion ro rhc.osr ol.dnp.nsalio!. d0m8c* rs flovidcd for rhe
<br />Serion 10?6 ofrhe tihor Codc. inrcrcn&dllromy s tccs1-\7l4
<br />DIiCIASATAN
<br />I horhy nrnund$ pcndlryurlrriury rhd I rn ln!flkrl utrd* provi\ion olChnplc.9 (.l'mnM(ir! wirh Serion 7Ux)) nlDirrvon ]
<br />ol rhc Bu\incssund hofc\\ii,i\ Cnlc. urd i,ylircd{ n i'r lull nr.c mlcl(cr
<br />b 1'7-\'L 4 rl.Wtrce-
<br />CQNIIAICIII)NIINDITTGAGENCI
<br />I h.eh, !,tirn undcr |f,DrlryoiF-rjry rhur rhuu is r cotr(rucrion [ndirs !!ch-'y ror rhr F.rornu..c orihc sork iot shich lhn Fn,ir is
<br />hsu.d(se .r097.ci! ( ).
<br />aftultttlDlg.AaalllN
<br />I h(n$t llnnuM.r lftuk, olpcrjury rrc olrlE hlbwnrt dNhrurior\:
<br />Driinirion Pomi( A*.{os Norin.di({ Fcd.hlR.guldrn[1{Tirlc.10. P 6}
<br />RcquRd ktrfi of Norifi L_nrnr
<br />-l
<br />csriry rhal thc fcdcol esrhrirni Egdding &rb$ro. Emvdl m not aptlt,6L lo lhn !mi.al.
<br />I ..nify rh0r I hav. Ead rhi +plic,rion a,n slatc thd rlE !t-e infonur ion is cotur I ag@ ro ootly sirh "ll Cily .nd Coonl,
<br />.rdin,mcs and Slarc tj*s EhrinS io building con(rucrion. un qft*nLliws 6f lhic Cny ,rd Counlt ro cnts upotr lhc
<br />,tb!c rtumn,kd pR,J*ny fd i,r\ti..riotr
<br />Appli(anl o. Aa€ni Si8rulu
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor
<br />Buildino Sewer
<br />Area/Slorm Drain
<br />lnterceptor/ Clarifier
<br />TOP OUT
<br />Water Piping
<br />Gas Pipinq
<br />Roof Drain
<br />Tub/Shower Test
<br />Bough Water Heater
<br />P{rap/Drain Line
<br />Main Drain/Pool Pipinq
<br />Fill Line/Back Flow
<br />Pool HeateriGas Line
<br />Miscellaneous
<br />Gas Service
<br />Waler Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbinq
<br />Final Gas Test
<br />FINAL r\v\t9 (M/,(111
<br />Notes, Remarks, Etc.
<br />COMMENTS
<br />UNDER GROUND
<br />Waste & Vent
<br />POOL/SPA
<br />Meter Release
<br />.*,."*-\ ok4\
<br />kDdE i N@r-
<br />LaxLrt Addrclr
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<br />*," -?' l'L< (
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