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PLUMBING-INSPECTOR RECOHD
<br />APPROVALS DATE ID/SIG.COMMENTS owNtif, 6uIl-DriR Du-cARA'fl oN
<br />t hcrchy urjnm un(l.r |Dnnhy {,i Nrjurr rllr I u cxcmfl fi,fl rltr Cotrtn n t-iccn{ Lrw rbr rh. lnll'$int r.av)n lscc 70ll 5
<br />Bu\i',.s\ xnd P(,tu1\ior Ct c) Ai, Ciry or Counry whlch r.quirc\ r Fnnil r,, cotrnrud. rlrcr. i,nnotc. dcn,li\h itr rcrtrr rny
<br />sfl.rurc. fridr, ir{ isuri.c. rlso rcqutrcs rhc {rtii.x lr \!ch Nnnirt' lll.! \tn. nrrc f,N rhrr hcor shc is li.cnscd funua'l!
<br />xr 'ht rDvnion\ or rhc Conrru.lois l-icensed LN (ChrDrcr 9. Cnm{rcNine sirh Sccrion ?(xxr of l)ivnio. ll ofrhe Blsincs d
<br />l'rotussi{nr\Ci.rorrharlror\lki\crcnurrhcr.fro'nlndrhchrsi\lirrrh.rllcg.dcrcnlplnn, nt vi{ rtunolSr.lotr70.115bra.,
<br />lDpll.{trr ktr n ,)tnd suliccrsrhc nptlicrtrr ro rcivilpcmlryofnornntrc tlrn fiv. hu.drcd d.ll$\(S50{)
<br />-1.
<br />trs owE oaih. pmFny. or sy cnplores wilt! wrgcs a. ttEir $lc mnFN.lion. will do tF wnt .id tlE cnat@ is ml
<br />idc{rl€n or offcrcd for $k (Sa,7044. BrsiBs ud Prcfcsk'tr Codc Tlf, Colnmrols LadE Liw &rs ror dr)|)I, ro d owr of
<br />lhc FoFny *ho hoilrt or i"pruB ttaEtr .d sno d6 rh tr* hiBelf or h.sll o. ihouSn nir tr h.r ow..rplor.s.
<br />prcviircd rhir slch inqewmln3e ml htci<k<l dofiq.d forsb lt lbefti rlE tuildig n inlrorc.n a.r $li sirhinom Js,
<br />of.otr{rlclbr llt O*rcr Builc. wil lEw dE hod.n ofpmvine dEr lf or slE dii ml hrild or iryrcw tlE preFly 6r tlt FqDs of
<br />I. ns owmr of rh. Forcnr. am .r.lDsiwly .onta.rins wirh liccnsd .oorr,cror ro .snndd 'lr prcirc' (Sec. 7044, Busms
<br />ud Pn,fssbtr Codc: Th! Conrrctor\ Liccnsc kw des not lrply ro an owncr ofl'lot'crry who huilds or impmws rhcrq,,.
<br />8nd who ontrudsror such pmirls wnh o Conrra.ro(t l;..r*d puBum rorhcConr.cror's Li..n$ rlB).
<br />-l
<br />a'ncrcmrl ufldcr Sccl
<br />lrq85[8l:gr!18!!tal1aN
<br />DECIASAIION
<br />I nceby rffird undf l'c lly of pcroty o.c ofthc follo*in8 d..lmlhns:
<br />lhrv.dtul trrll rinrdirCcdiicrrcofCon\cnrt,Sclflnsur.tur{ort.^ .onrrrnsrii,nr. \ F,rntttnrbySc.ridr3?mofrhc
<br />Ltxtr Codc. lnrrhc odornln..orlhc work lnrwhich lhc t4-.flnir is issucd
<br />I htrw and will minrlin work ^ .onFnsarion i.slhocc. &i rquied by Sccr !,n :1700 of lhc bb.r Codc, lor lh. p..lo.Mc. ol
<br />rhc work ror whkh lhh Frmn is i*$.{. My work 6 coo{rnsrion insurad. 6ifi ,,n plicy numhd e.:
<br />-l.cdily
<br />rhn io rlt pqfnm*c otlh. vork ror *hi.h rhis p(nir ir ilrurd.l shallmr.nployuy pcFo. in any run.r
<br />s ns kr bcs'm sutljel lo lhc *orlGl conFn$tion bws ol C.lifomh, and agB lh0l if l slDUlI trconE slbF ro lh.
<br />$or&cB mBlEnetion pmvisions of Sc.lion 3T00 oflhc t borCodc.l snal. fonhwnh mryrlr eilhllns prcvisioni.
<br />WARNING: tuhr. ro Euc vorlcB onFrs{ion cov.68c Lr unhwtul ed shlll iubis an .np,oFr lo sininal Fellis and
<br />.ivil fiNs up 16 on. hundEn rnous,nd dolls (S100.000). in lddnion ro rtE @( of.orlEnslion. &o8cs as p6v en fo, rtu
<br />S.{rn 3076 orrhc t2hr C,xl.. n cr.ddndanorfty
<br />K SuJ\,'c,.,", di(-6 -G L!rl]lSljDl!N13,!(]!B
<br />IIEELABAIION
<br />I hcL-byut,tm urdcr Nnrliyolpcrjurylnd I u liensd u.dq pmvhion ol Ch0fls I (cofllrE.ciDg *ilh
<br />oI thc Burim$ ntrd Profcssn,N Codc. 0 d nry liccn( h h lnll ture d.d cn cr.
<br />L
<br />D.o,'.-:i
<br />F1t+-$,trs--e.U<aeOP
<br />(1)lttBtguQtL.ElDlrc il.(r
<br />I hcruh! nflirm trdcr rcnnliyorpc.juryrhn, lhcrc i\ a con(rucrion kndiry a8cmy nn lhc p.rnrnt4c otrhc sort fitr which rhi\ Frmil i\
<br />nsucd lscc 10e7. Ci! C.).
<br />AIIU(ANLIECIABTIIQ!
<br />I ncd,, dlllnn udcr pcnilrr.lpcrrlry onc olllE folloPin8 dNlararions:
<br />Dcm.lirion Pernrirs Ashc\lo( Notinclion Fcdcral RcBul.tio.sl lillc.r0. P0n6)
<br />-RcqoiBl
<br />l-cnc, otNoriltr ion
<br />-l
<br />ccnify rh"r !h. (.dchlrcguhd)E8,rdi!g *h.$ros emral @ .or OplicnbL lo rh* ,ejc.r
<br />^trryrhlr
<br />I tu\crcdd rhi\ dr.pl
<br />tldirENa. !o'l Sr.rc riws rcldru ro
<br />a$vc mtrlion.d tmpcny tot insl.c'
<br />mdsrrcth,rhdrh,v.nnnrnun i\.onc.r I+rNb.o Ult *irh all Cir, rM Counry
<br />io.. ind h€ftby,urh.ria .cprcscmrtivcs oarhh Ciry Md Counryro cmcr ur.tr (h.
<br />.\DDliff lorAr( lSirntrlur!:n*" o{
<br />UNDER GROUND
<br />Waste & Vent pL'/tO fu44 /-ct-
<br />Water-Under floor / a/,, 2.**za-za-.ir
<br />Gas-Underfloor
<br />Building Sewer /cL--'/'-
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent /o/////1-,14 .c7r*-/0L
<br />Water Pipino n/z7i,e,,4rp*''/.tz-
<br />Gas Piping
<br />Tub/Shower Test
<br />Rouqh Water Heater
<br />POOL/SPA
<br />P{rap/Drain Line
<br />Main Drain/Pool Pipinq
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Gas Service
<br />Water Service
<br />Lawn Sprinkler
<br />Sanitary Sewer/Cap
<br />Back Flow Device
<br />Rough Plumbing to/rr /r*/s-
<br />Final Gas Test
<br />Meler Release
<br />FINAL 'llflil/t tu1rtt(L -'r,,fi
<br />Notes, Remarks, Etc
<br />'Y1-va---- ,2"
<br />'ltu y'"
<br />t tD) /t.- ?,-+
<br />/Dltfu
<br />Area/Storm Drain
<br />Roof Drain
<br />n/q( ..?zf.n 1 ,u4
<br />';.tL4.,.,.../- 4,il81
<br />D.re O*ner
<br />€\ I -zq ll
<br />L:ndc.r Ad.tsr
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