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PLUMBING-INSPECTOR RECORD
<br />DATE COMMENTS OwNr:R Ir(,LDril. DI,ILCAnATl()N
<br />! h.rchr nitm undcr ncnalry(,fn rjrry rha! I am crrmpr rio !tu Cotrlrr.nri l,ir. \t trs tu rhc lol[,winc t r$! (s..70J1-:
<br />hrircss rnd ltotcsion C.d.r. Any cry or Cotr t whi.h rcqur.s a F-nnir k, .o,rnfld. rlln. nnPro$. dc'n,h[ ,t rcl1'n sy
<br />srrucrurc. pritrtu irs i*u.ncc. rho,.quncs rhc up0licatrr litr \(h |tnhirro lilcr siSndl rldientDt lhtrr h. or\hc i\ liccnscd Nrsulnl
<br />ro rhc F)vnn,ns ol rhc Conlrrcntrr l-i.cn\rd Itrq (chdnr.r e, Conn.cncin! {irh srcri, 70(x).i Divish..l ol rhr Bn'i"t\\ and
<br />Itoiession\C.dc)orlhrr hcor shc scxctrf rhcrcli nrnd rhc hi\i\ ln!rhc rlll!.d crcnl ion. Anyriohli,Dorsc.ri(,i70]l.5hyanv
<br />dp!l'.r nn r Fi,nir {rhlccls lhc aptlica nracivil!.nxhyofnor krcrlrdtr fivc h!nircd doll*\ ($5(x))
<br />-1.
<br />d owE. of lhc popcny. or iy cnPlolss wilh wagei {s lhei. sh omFnslion. will do llt sut .d tlE st8re t ml
<br />hrcndd or otrcEd I'd sle (Sc.?O14, Bulicsr sd Prof$sions Cod.: Thc Co.lticlol s Liccns Lrw d6s tul srply to u own.r of
<br />ltc pmFrty who tuiEs or itpmB lrElE^ dd *ln d.s tuh $dtri hiNlf or lEBclf or lhrc.8h his or lrr oDn.mployss,
<br />tbvklcd Ihar such imProEmnts N bl i'neftled dotu forsh.lt howE lhc hllding or inPtokr.d ir mld wnhin o* )qt
<br />ofcongkrbn. UE Owncr EuiBer wil hlt dE htrdcn of povi.g rh,l hc or she dh mt hiild or iqt$w lne p@Fny ltr tlE PUqnrc of
<br />l, \uqtrcrol'rhc |)olicr1y. xr cxch\iv.ly ..trttr.ri'rg wrh li.ctr{cd .onlrr[6 t, cotrdtu.r rhL r,tjc.r (S.c 70lt.l]u)inr\
<br />rRI h,li\\i Codc lhcC.nkidoisliccn\cl,asdoc\Dorrlplyn,nDosEr.llfupc y*ho huilds.r i'nlrovcs rhcr.or.
<br />/nd $h eoM dl n,r s!.h ,roj.ctr sirh a cd n.ruris| ltrcrr*d ,'ursurnr tirlto,nn'.rn-s LE.n{ Itrw)
<br />I afl.xcmfl utucrS*ln'n- B. & P.C. anthh rcaso.
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<br />Orn r:-
<br />TOBf,D8LCAMIINSAIION
<br />DECLAAAIION
<br />I hcEhy aflirm undcr p.nslly of i'sjury 6rc of Oc folto*ine del.fdiom:
<br />-l
<br />h,E rrd *ill Binlai ! CenifEllc of Coneol lo Sclf-ln@ lq vort6 oq).Mtion. e piDviLd for 6y Selion l7iJ0 ol rlE
<br />t bor Codc. lo, E Frloffi ofrh. hrt for ahlch rh. Idnit i! Bu.d.
<br />-l hlE rid Rill Minrlir eori6 .onp.Mtion insuoftc. !s reqoiEd by Setio, 37m of lhc Lrhor C6&, lor lh. p.rfomm of
<br />rhc qork tushichrhis pcmn as ks.n. Myworkss in$o@ 6ir s,n l[[cy nunb€r m:
<br />tlljv/ca (nfr,.t.\.\4
<br />t cnify thal inlhc pcrformm. ofthc sork 16, {hkh this Frn is nsucd.I shlll nol eoplot lny pcmn hdnyMftr
<br />$ &s to b..otu subicr ro rl* M,tm onp..slion kwr of Crliforniq anrt agm rt{ if I stDlH bc{om rubjc.l to llE
<br />*orkcB'corycnlarionptulisioosolS..lionSrO0oflhcL.borCodc.lshall.ionhvilhsmplyqilhtho*r,Nvkions..
<br />WARNIN(;. Frlilurc ro ccurc qorketr conrpcosarion cov.Dsc i\ utrhwtul. md shall slhJlrr m cnDloycr ro simiorllrMlrtr and
<br />civil 6rcs up ro onc hundrcd rholsnd dollds ($10{).000). in addnhn lo lhc cosr orcoopcrsar
<br />sc.rt,n 10?6 of rh. tjtnr C{xlc, inrcrc{ ,nd ,lr.my
<br />o"r I l^ AQ 1If[rU v v r
<br />DECIdAA.IIAN
<br />I hcrc$yaifirnundcr Fnall, orr.rjxryrhar I am liansd under prcrision olChsflc.9 (smmncing wirh Sccrion 7000).rDiviln'n I
<br />of ihc ausincs ed Pofc$ions Cod€, and d, li.c.{ i\ tu lill forN Nld cl'lal.
<br />Z_?
<br />ri."n."ctu-. /' t."*"'r,-t"-" U6 00 2019"""n**,, h'\o!41(,4,tilz*-
<br />c0N5ralcIIaNMlJlKlc[N{.:r
<br />I h.tuhtrfln uMcr Nrrlly oi |t jury rhar rhcrc ns.onnru.ri.n lc irga$nuylbrrhcnc ahtuh-c of rhc wott lbr *hich rhir Frnrir is
<br />is\ucd(Stc .r(r97. Civ. C ).
<br />A.IIUIANLDICLAEAIION
<br />I lmhy timunncrpcnrlry.rtcrjDryoncof thc r'ollo{insdc(l rriods
<br />D.nn,lirtun Pc nirr Ash.{or Norili.rriotr Fcdcml Rcguhri.trs (firb.l0. Pd6)
<br />-Rcquirud
<br />l.rr.r ol Norifi .rriotr
<br />ffir*r, ** n* rnoappliqrion sld tur rnar 0E sl[r inrornErhn ii t omrly wirh lllCny.nd Counly
<br />f rtis Cir, dd Cou.'y lo .nts lpon llEordinrnes lnd Srarc ljqs Glding b buildine conhclio..
<br />abov. .Enriorcd ps,tny lbr inst crio.l)urpoB.
<br />Appli.rnl or AA€nt SiXmlue:-mr€ 0F nntn
<br />UNDER GHOUND
<br />Waste & Vent
<br />Water-Under floor
<br />Buildinq Sewer
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Pipinq
<br />Gas Pipino
<br />Tub/Shower Test
<br />Rouoh Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />Main Drain/Pool Pipino
<br />Fill Line/Back Flow
<br />Pool HeateriGas Line
<br />Mascellaneous
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbing $/t1/tz 1n(g
<br />Final Gas Test
<br />Meter Release
<br />FINAL 1/b/lg ,xq{
<br />Notes, Remarks, Etc.
<br />APPROVALS ID/SIG.
<br />Lcndq\ Add'csr
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<br />enily lnd ihc fcdml rcBlhrions tsatdi.S NtEsros rcmvil ,r. .ol alllicablc to lhb pmj$r.
<br />*ar
<br />Gas-Underfloor
<br />Area/Storm Drain
<br />Roof Drain
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