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PLUMBING-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG,COMMENTS oWN F:R ItTIII,DI]R l)trI,(ARATloN <br />Ihcrcbyrrir xndcr !. rlry.fnruryrhrr I rnr.r.nlnr lio,n rh. G, rrttr! Li$n* li* ttr rhc f.llosnrg rcr{ (Sc..7llll5 <br />Bu\inc\r !frI Pmtlssh Cdc) An, Ciry or ('rrnry vhi.h rcqxncs r ,'dnrir r) cnrstnrr- rlrcr. im|tovc. dcnF]ish or rcnin rDy <br />{rucrur.. pritr b i( i\\urtrcc, il{ rcqunc\ rhc rplli. ni l.r\uch p.rmit n' lil.r \igncd nrrc'mnt rhrr h.or \hc is licc.\r,t pur\urni <br />h rhc lr(,vniqN or rh! Codrncktr \ l,jccn{n Lrw (Chrt'icr 9. Connncn.if8 rvirh Sccrnnr iun oi Divni :l olrhc Bn\incs rnd <br />lPIlicanr lirrr pcmrir rubjcck rhc aplli.rnrx,acivilD.nalryorforntrcrhnn,ivchurdrcndoll.n(:l5lx)) <br />-1. <br />as own$ of th. prcFdy. or ny cnployecs wnh wdgc. ns rhcn $b enr.nsorion. wiU .lo iE w.rk rrd aE nBl@ ir nol <br />i,l.nd.d or oftcr.d for eh 1Se.7044. Busircs dd Proldrh6 Cod.: Thc Coolracio s Lirc Lrs de. rcl .pply lo b osffi of <br />lhc rfttEaly *ho b'rillls d impmu llrcmn. 3rd vlD &fs Mh w* himll u h.mlf o. lhreu8h his o. hcr own.q,Ltrcs, <br />pmvidcd thal such iorbwmnG m nol i .r .d oi olIeEd for slc lf. how@, {r ltuildirs or itr{ftEm is $!d wnhi. oft ,urolorplxb.! rlE Oleft, Auitts *iI h.w llE hnlcn of poving llbr lE or ar dU m hrld or aqer th. pspdry fo, tlE pu{m of <br />L as ownr ol fic poFnr. nn .lurivcly conradin! *irh licc.scd coflra.ros ro sn{ru.r 0E prciccr {S(. 7ora. Bu{fts <br />and PBftrsi.nCodc: Thc Conlro.loas Liccnsc Law d@s mr atrlyro mowncr orprup. y who builds or improrcs lncrcon.ord who .lmtuds ld such no.i4rs wirh ! ContBcru{s) licens.{ rursla ro rhc C.nrdcror'r Lbnsc L!w). <br />-l <br />uc&trrpr u.dd Scdon-, B. & P.c, for rhk Een <br />lhle rri M <br />\\()R(t.tRs' ( (11ttlaNs.\'t IrtN <br />DlclrlllAllQl <br />I I'cr(hy rlrnh trtrii.r t)ctr.'lrt !,ltrrlr\ otrc ol rh.loll,r\ tr ! Jrrl,trxri(r\ <br />l.JIu Co(lc. ri)r rltr p.ni)nniR..llh. trork lnr qhich thc |[rnir i! i!{rd <br />_l hnw and will mdinhin workcB @npcnrarion insuBnce. ar rtlirn by Sedion l70O ofrhc Llbor Code, for rtr lEdo,r1l,N of <br />th. so* ld shich this [l.rm is n$cd. My sorlcG @trrp.salion inslrarc dicr und policy nuhbq del <br />-l <br />ccniry r,ur in rhc I'.rformia or lhc Bork aor which lhis rrcnDir is issucd,I \hall nor cmploy an, ,I(rmn in lny mdMr <br />s 0s h rEs'E suhitr lo rrE s*sr con{RNaiion b*r of C.liromia. dd r8G rhar ir I rhould hrtom subirt Io ttE <br />srkcs' con{Ensarion lmyisions of Serion 3?m of rh. trbo. Cod.. I srtrll, lonhwnh ompl, wirh thos pmvkions.. <br />IVARNINC: Failurc !o suc krrlrcn comp€nsoliotr hFct an cDplord <br />'6 <br />diiinll Fiahix rnd <br />civil lln.\ up b on huidrcd rlbtr\dnd d.lhrs (Slm,(Xx)),compcn\arion. dumgcq !s Fovid.d for rhc <br />Serion 3076 olrhc Iirr Cod., inlmsl snd llbrmy s <br />I hcftby ar6nn unddr pcnahy.rFrjury rhrr I am lircnEd ofChaflcr I (onturing lirh Sc.rb. 7ffXJr .l Divirion l <br />of thc Busircs md PDfcssios Codc. and my li.c.r is in tul <br />I ncmby riltrm undcr Fnally ol p.dury rhal th@ t a snifl.l <br />iesucd (S.c. 1097, Civ. C.). <br />ug.trcy lor lhc lErfornunc. oi lhc work for *hth thn lEnnn s <br />APPI TCANT DECLATTATION <br />I holhy afm ondr pctuh, of pcdlr, om of llE follo{in8 dc.hnl ionsl <br />Dcmlilion Pnmils'Ast slos Nolificlliotr Fcdcnl Rcgulelnrns (Tirlc tlo, Pan6) <br />-Rcqlircd <br />t rlcr oa Norifsrion <br />-l <br />ccnilyrhlr thc fcdero I rcgu lar ions rcBudiu asbc$os Enmvrluc mr opdicablc to Ihis lnjccr. <br />I c.nifvrhnr lharc r.ad rhn nh,vc intorrorion t cotrccr. I arra ro co'nFly wnh allCiryand Coxnry <br />Didn ncc\rnd Srrrc llss r.hri"g b bo prrscnhrnc olrhc ciry!.d c{,u yt,..r& upoi rhc <br />,bo!c mntioncd trurEny for <br />Applionl o. AA$l Si8nrlo <br />UNDER GROUND <br />Waste & Vent <br />Water-Under floor <br />Gas-Underfloor <br />Buildinq Sewer <br />lnterceptor/ Clarif ier <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-trap/Drain Line <br />Main Drain/Pool Pipinq <br />Fill Line/Back Flow <br />Pool Heater/Gas Line <br />Miscellaneous <br />Gas Service <br />Lawn Sprinkler <br />Sanitary Sewer/Cap <br />Back Flow Device <br />Rough Plumbing alqt I K'i7;wdZ >b) <br />Final Gas Test ul\ <br />Meter Release <br />FINAL //5//t fuzaz*d) <br />Notes Remarks, Etc <br />trndcas A&Ic$ <br />Area/Storm Drain <br />Water Service