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PLUMBING-INSPECTOR RECORD
<br />APPROVALS DATE COMMENTS orvNLR BUll-Dlllt Dl:l.caRA l l()N
<br />I h.'dv rintri uMcr ncMlrl olrcrjur! Ihir I rn.rcnrpr fn,n, rh. (onirrcro6 l-iccnsc l.xw turrlr li,llos rs renq lsecTl).115
<br />Intrnes 0 l Prolissi.n {inl.) ny ciry or coudr} trhtli rcqrtrc{ . Nnn[ nr n,n$tu.r, .]r$, $Dn)re. dcuohsh .r tcPrr oi
<br />{nrrurc. pnort, irs Fnrxncr, rln) r.\Nt.s rh. afnlrmr for {rch Fnn t) liltr r3'Kl sd. t rhd heorshc
<br />'s
<br />lLC.n\8] fu^uhr
<br />rpplca hr a lrern suhtccr{rlr rlnlicnnr tu r. \rlpcnrir} ol frn !r-. rhr firt hundal d.llnn(S5l)1r)
<br />l..s.MerotrhcF)reny.orDycnDloyeswirhw.s.iNrlrrsneco,Drdsnotr.ullldorlEnorirn!rh.{n(nr.sn.r
<br />rni.d.n orufltr.d lir sl.lS{ ?0.1.1. Uusitrussrn ho,tss. sCoic lheContr r'sLic.ntt-N'.!).snorrrnlvhrio(D.roi
<br />r[cnm|tny Nh,huikhor tn )!.s rlr..$r! .'xl u h] do.s such \ orL hms.ll'or hcmell N lh^ Shh6orhcr.qnemfl.rcer.
<br />pror .nrh suc[ rmnmydEnhircto inrcndd or ofli:RJ nr {rlc I li lx$ Aar. rtu hrikliDs or ]nDmvctrE Fsldwrhnotu,tr
<br />ol.omrlrrKrrrh.O( r Au d{ n'ill har rh. huden olpnvrng rlnrlporrhr d(l,nr hurld or nnm\t rhe pmpdr litr rlt pt{x,*.,
<br />l, ,s osno di rlr r$nen v. rtr' .rclun\ ely ronrnc! rr! { nh I'cciscd coMicro6 t, .otrsrtud rtu foF..r (s.c 7(144. tltrs N$
<br />.d Pnnhshtrc.ne fh.Conhcro.s l.Mnrc I r\'(l.cs tor.ltrlyro ino$ncrorln,pdy{ho huil&or mrii,v.r rl!crn{.
<br />rnd \'ho conrntcr,itr suchnmjcchwrh0 (i, .rcb(s) licenyd prnrmr h dt(onlr.cl,r's Lrccns.lrn')
<br />I am c\emfl ud.r sdro
<br />woRxERs' conlPf, NsATloN
<br />.UECIASAITO!
<br />! h.reby aflim n.d.r F@hy ofD.rjury oE oflhc foll.wins dertr.tions:
<br />-l
<br />ta\c sdl will mrinr0i. a C.nificar. olcotrEnr to stll lnsuE for Rorkdt onrpensrion, ar lmvid.d f.r hy Sdrion 1700 6 f rh.
<br />Lrhor Cod., Ior rhe Drh@ft. o ath. qolt fo. which lhe p.mir k irsn d
<br />-lhav.r
<br />nilltrri rir$orkers corDcnsrr q, ,nshtur. .s rcqtr rcd hvS.cinn lTlr(rol rhc lrhor(bde, n rlt P.rli)mrnceoi
<br />ihr * rl nrvhrl r[is nennrl r( s$<l M, work(a c. lnrn$r or Ntrnme.irEr irx] nolLcy nunrb$.R
<br />-l..nifyrh,t
<br />in rh. r.rfomtuc.f rh. {ork for which rhis t.mn n i$u.d,I shall ml oploy.ny F$n in.nymnE.
<br />s .s lo b.om. sbj*! lo !h. @tt6' comp.Mio. l,ws oacalifomin. std cgm lhot il I stsuld b6orc sbrcl lo rlE
<br />wort6' otr]).Mrion Dmqsaons of sftrion 1700 of lh. L.trr Codc, I dDll, hnhwilh smrly eilh tln* lmvi.ioni.
<br />D.r.. Apptenl
<br />ucfNt[D-coll3Acloa
<br />DlCLASAUari
<br />I hceby r,Iuounds pemlryofp.rluryrld I.n liccn*d under pnvtion olCh0lld 9lcomnErirr8 wiln S€clion 70110) ofDn'i.'on:l
<br />of rh. Busimss.nd Pmf.*cions Cod€. trrd mtlicenre n in tullIorL!afllcr(r
<br />ATILICANLDICI,rIBAIION
<br />I rud,y amm undr n.nihy olpcrury onc oflh. follo*ns d(ladlons:
<br />D.molnion I'ermirs sbc{os Norin. n. ljedcml RCEUhlhns('lrtlc4(,. Pdn6l
<br />-Requned
<br />Lerrc, olNorifi .dr&,n
<br />l.dlily rtu rlP l'.de6l rcsulalions Bgedrng isttnosr.Do\alnr. n nnplicabl. ro thN pol4l
<br />-lccniryrh
<br />ltsver.adrhis !! rdh. turd st.tl tllil lh. .h)* inlomul nn n c.rer I .3.8 b comply *irh rll cn, xnd Cornrv
<br />o inrrcesandSrarrh*seld'ngubuildi.scon$rucrio..adh.rehy.urtrn,rr.t'r.s.ni.riv.softh]sCilyandC.! ryro$1trupontlr
<br />ihovc nrnnoncd pmp.ny for insp.crionpuflftr
<br />Appll.rrl or Agdtslgnrlur.:__- D.1",
<br />P.rn len.nr(prlnor-
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under floor
<br />Gas-Underfloor
<br />Buildinq Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarifier
<br />TOP OUT
<br />Waste & Vent
<br />Water Piping
<br />Gas Pipinq
<br />Roof Drain
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P-1rap/Drain Line
<br />Main Drain/Pool Piping
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbing r\-l.lb'1"1 .[-v.it L)
<br />Meter Release
<br />x -uGlol k{LtD(
<br />Notes, Remarks Etc
<br />lD/stG.
<br />Miscellaneous
<br />Final Gas Test
<br />v /N
<br />FINAL
<br />WARNINC l.ilurc ro s!.€ srtrk ^'cohn nsirion $vcm$ r. unh*'tul. ,nn rhrll iubjd .n onnloltr l. din'n.l P.Mkid md
<br />civil fin.s ur ro om fiundr.rl ihrue.d dollm (sl0{,.lxr0), in .ddirion ro rn. co{ of conr0eMtion, danms.r tr flord.d for rhc
<br />s.chon 1076.lrh.L0borCodc. inr€..{ lnd !fiutr* 3 L.s
<br />sa! trucl(lltu,ltll!0.Ac1:Ncr
<br />I h.r.by.mr und.r pcnrhyolr.rjurytl lhseisaconsltuclirnlendrnsagtncylorrn.p6lo.morccorrh.sorkLr\hichihirnnnih
<br />issu.d{Se. 109?, Cn'. C.)
<br />Lcndo q NrnE
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