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PLUMBING.INSPECTOR RECORD <br />DATE ID/SIG.COMMENTS OWNTJR BT]ILDi]R DELCAR 'TION <br />I hclcby affirnr undcrynilr! o, |erjury rhar I nm cxcr,lr irom lhc Conlncron l,iccnsc llw Lr rhc fink,$in! rcnvr lst.70ll5 <br />Bu\t$\ and PmL$ion C{dc) Any Ciry or Cornry which r.qut \ ! FJrnit b .ohdd.r, rlrcr, nnrirnq d.rmlirh ,{ rtrtr any <br />{ructryc. lrnn b ns issudncc, &o rcqutcsrhc Jl)pli.ri f(, \u.h p.nnir ro lilc r silncd stdcnrtrr rhr! tf, or $o i\ li(cn*d prEusnr <br />n, rh. Irovnion\ of rhc Conkackn s l-ttn\dd lrw tchrprcr q. C{,Dmnci'rg uirh Sc.rior 7{Xl) of Divinon .1 oi rhc Burincls a.d <br />Pmlcsions Colc)otrhrr h(o.shc k.rcnu thcrcf nudrlrhrshntrrhcilcrcdcxcmDii.n. AnyviollliorofSccri,,nT0ll5byany <br />!pplic!nr iq ! prmrir suhjccls lhc applicanl <br />'o <br />!civilpcnallyoanor nmrclnrnfivc hund.cd dollnrs (55fi)) <br />-1. <br />!s ownd of th. ptuIEny. or ny rmployes wirn qaecs * thcn sb omp.nsrlion. *il, do llt *dl( ad llE $tudm b rcr <br />h&idcd dofr.ed for s]c (Se.?O14. Busiftss dd Prof€ssirnsCodc: TIE Co turoas Uen* tlw d6a mr.prly lo !n o*mr of <br />fie Fopdy who bunds or iq,o6llEMn. lrd *ho dB Mi mlk himclf or h.mlt or lhmlgh hh or nf own .n{iloyc.r. <br />pbvid.d lnar such i.'thvw.B G m( idq'd.d or6,H for sb. !( hogffi. tlE t{ilrtilB o. inq'leDd ii sld sithin m ]{a <br />ol orglclim, lhc Oafti Builict will hrn lh. hndo of pbving tlDr hc .r slE did mt huM or inproE lhc p6rEty lor dE l,urpo$ of <br />-1. <br />esowmrofrlE prcFdy. !mcxclusivcly conrracrine *nh li..n*d.o.rah6 ro onsrdcl thc Foj(l (56 7044. Burir{i <br />airl Potscin Codc: Ttc Conhcrois Lic.ne l-Iw d@s mr lmly ro an owfls ofprcFnysho builds o. iopows lhcEon. <br />and who .onh.ls for srh pmFls wfth a conrr.cro(o lhcnkd !u6u.r ro $c conrrarorr LiEnsc tiw). <br />lrDrcxcnt und& Sc.rirrr .B &P.( fd rhis rcdnnr <br />laBtr!8gl:ollfENtArlaN <br />DIct.ANAItoN <br />I h.rchy !fiinn undd n ..lry of rrjury om of lhc followin8 dc.lnrnrions: <br />-l <br />hre ard will Mi .a! . Ccnifrlr. of CoM to SdllB@ tor mrt6 6EFosdio., os pmvilcd for 6y Sslior 1700 of lhc <br />Llbd Codc. for rhc Ffmlle. of E qdL fd Dhich rh. Idnn ir Btucd. <br />_l nrvc .nd eill flinllir uo*6r conpcNalion hsnmq a\ r.quircd by Selion 3?00 of lhc ljbor A{,.. for ir nsro,itec or <br />wo*cB omDcns0iion insurancc fficr and rnlicy .odbo e: <br />s-8 tc <br />I c.niry rh,r i! 'h. <br />p.rroflrun.c ollhc work ror *hkh rhh Frntir h issucd.l rhall ml cmplo, atry p€ren in !fly mlntr <br />m s ro b..om sut'rer io lhc woircs' con{rcnsarion hws ol Clliromi4 lnd sgE ltar if I 3lEuld lEorc $bitr ro rlf, <br />qortcn' compcnsrlion pmvhions of Sdion 3?00 of rhc titDr Codc. I shall. fonh$nn coitl, wirh rho* Piuvl\ions.. <br />lv,{RNIN(:: arhrc b {curc sr,kcN .onf.n\dn,i corrBlc r\ unlrtrtul. dtrd \hnll ruhjt]ct {r cflr/oJtr to ri ir Ftr hi.\ Md <br />civil fincs up to ore hundrd rhousod doll&r {SI00,000). in nion ro lhc .osl of coolxnsrion. d.mgcs !s providcd lor lic <br />;::41*TE-Y <br />I hcrhy attum undcr,Enallyottcrjurythll I am licrnrn undcr Fovi\ionofChapr( 9 (c.mmftin8 uith SNrion ?()OO) ofDivnion 3 <br />ol lh. Busi..ssand Profcssions Codc. ud nry li.cnsc is h tulliorccfl(criccl'6 I0nq\v) <br />30 It "-,C <br />IOISIAICTANIDNUNE.&ADNCI <br />I hcreby dlir,.undcr F-nolryol rrjlrr rhar rhcrc n, connddhn lcndina r8cncy ror lhc pcriornDncc oithc sork for qhich lhis p.nnir n <br />n\uql lsec.1097, Civ. C.) <br />A.tILICANIIJECIA.BAII(Ai <br />I tu[hynrtn u cr pctrihyolncriuryonc oilhc,nlhqirsdcclamriotrs: <br />DLmolnion Pcrnrir{ A$.do\ Norifi.lxun F.'lcrrlRcguLrnnr\ (lirlc 40. P d6) <br />RL9!trcd Irrrf of Norifi .rrirr <br />-l <br />ccniiyrhd rhc lcdcrul.csulario.s rcsdrdins rh.\ros rcmoval lrc noramlic$|. t, rhilli.jcd. <br />|4l..diryrhd I hnro rcrd rhis ndi..li.ndd s,r. rhdr rhc rbr. inrormio.fl is.oftccr l,srLtk'.oDpry'ilhrrlcirynnd(otrrry <br />ordimmca and Srtrr. kws Ehring 0urhortc rcprcscnrariv.s ofthh City,nd Countyt,.,rcr ug,n tlr <br />olc cnrnrncd lrrFnvfff <br />Aptlic!tr1 o. Aaetri SIaNlu <br />UNDER GROUND <br />Waste & Vent <br />Water-Under lloor <br />Gas-Underfloor <br />Buildino Sewer <br />Area/Storm Drain <br />lnterceptor/ Clarilier <br />TOP OUT <br />Waste & Vent <br />Water Piping <br />Gas Piping <br />Roof Drain <br />Tub/Shower Test <br />Rough Water Heater <br />P-trap/Drain Line <br />Main Drain/Pool Pipino <br />Fill Line/Back Flow <br />Pool HeateriGas Line <br />Miscellaneous <br />Gas Service <br />Water Service <br />Lawn Sprinkler <br />Sanitary Sewer/Cap <br />Rough Plumbinq ?/t//*,t\?b <br />Final Gas Test <br />Meter Release <br />FINAL 1/u /rs e\Bg <br />Notes, Remarks, Etc. <br />APPROVALS <br />POOL/SPA <br />Back Flow Device <br />2lr <br />tr "J.' \ AJ'1r... <br />-------T------ <br />-------T------ <br />=