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COMMENTSAPPROVALSDATE <br />UNDEH GROUND <br />Waste & Vent <br />Gas-Underfloor <br />Buildinq Sewer <br />Area/Storm Drain <br />lnterceptor/ Clarif ier <br />TOP OUT <br />Waste & Vent <br />Water Pipinq <br />Gas Pipinq <br />Tubishower Test <br />Rouoh Water Heater <br />P-trap/Drain Line <br />It/ain 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 />Bough Plumbing <br />Final Gas Test <br />Meter Release /w/-lrytn,Ar)FINAL u r \....--/Notes, Remarks, Etc "tl <br />(rlvN[R Btrtl-Dtil{ DIL( AR,\'l I()N <br />t hcrchy lnnnr undu pcmhy of pcrjrry rhd I !n cxcmtr trom rh. cotrtrckrr l-i.cnrc lrs lor lhc follo$in8 !ca$i (s"70115 <br />llu\inu\\ dkl Proli$ion C{xlcr: Any Cii, or Colnry $hich r.qut s P.nnir b $Ntrucr. lllcr. an|]lovc dcn'lish or mNn 'nv <br />\rtucrur.. pri(trh irs i\u!i.c. rko rcquircs rhc lprli.inr rd such tlcrmii x,lilci si8ncd shr.mnr rldhcor+'kliccnscd I'lF!'Inl <br />rr rhc |s'vi\trrs .f rh. Conrracroas Li..n*d Ll* (ClEnrcr IC.nncncin-! *irh s.criotr ,ux) of Diri\nnr :l olthc Bu\incst rtrd <br />Itolt\sio C.dc)orth.l hcor\h. is cxcnry rh.r.frornod rhcbast,br rhc.ll.scd cxcnlPtnrn An, vi.ldionofs(riJn70ll5 hy rnv <br />aruli.anr hr i !.flnil \uhjsh rhc .Pplic{nl lo.civilPctraky.lnot Dnnc rns livc hundrcd dour\ ($50o) <br />L n\ osn$ olrhc ntr)r,cny,.r nrycnDlolccs $irh wr8c\.s th.n sot conrlt tr'.(ion. $illdo rlt s(,k flxl rlE sltuDrc t mr <br />inr.'xl.,l .. oltiRl .,tr { . rSL!.?i!4- Ausim\\ ,nd Pn,ic$iotrs Co.lc 'I'hc Coihdois l.d(n{ tiw noc\ nor amly ro m o'mr of <br />rhc pmncny $hhu ds .r improw\ rhcdrl .nd who d{{r {Kh tr on h iNcli or hcr{lr or rhnrgh hn or h$ owtr cnPl')?cs. <br />pm'i id llr .uch irtrn*tnnts m mr inrcnH or olttrcd {or sh. lll ho*ctr. rh huitli,rg or i'rrnrEnEnr i\ v'Lt wirhin om )tu <br />;Ic.nrrh'inr rh.o*fur Builtl *illhtt rhc budcn.lpDvins rh,r !Eo! rhc did n huir,l or irl{m* rhc pmllnv for rrr Putlos ol <br />-1. <br />r\owtrcrolrtu pn,p.ny. rnr.rclusnclyconrracrinE wnh liccnscd contrr&trs tu clnsrtucr rhc l)n'jct (Scc 7014. Btr\ims <br />rtul l,r!l!s\i'nCodc:l-hc Conlllctor\ Li.cnsc Laq docs nor lPPll io .n oqm. of Pb!.dy who builds.r nn[oves rhc on. <br />rd who conlmclsnr\trch ptoFrls viln ! Contacro(s) liccnscd runuani b rlr (inrrucn, \Liccnsc l.as) <br />lnmcrcmpl unde. Sc.rbn-.3 &PC turrhirrcr*nr' <br />l),!r Ormr . <br />IABKE&T:IQMTENIAIION <br />DECI.ASAIUN <br />I lrrcby.fifln u.dcr p€nalry.lpcrjuryone ofrtt folbNins d.cldnlion\i <br />-l <br />h0!c undqill nrn lin!Ccdifi.rlcofconsenrlosclfln\ficforsorkcrs.oflpcnr n'tr.4\IrnvidcdlorbvSccriotrllm'rrhc <br />htxr Cdc. nn lh.l,ofoir Nc ol r,E wotl( for *hich lhc pcmir t hsu.d <br />Ih,!cotrdrill'nai.roi.workcrscon{anrtrioninsuromc-asrcqundbyselioa:17(x)olrhtljtiotCodclurrhcpcrfi'ntunccot <br />rM work forwhichrhh pqmn is issued. M, worids $nrt nsal ion nsumm coFicr and Fli.v nu,nbcr arc: <br />piElr-- <br />-l <br />ccnify lhd i. rh. Frao,Nne of rh. work ftr *hkt ltjr fcrnir B 6!uci.l rhdll not cmphv an, F'sn in anv MN <br />s 'r ro b.sm subFl to tlE wkf, mmFndFn l,wr ol Cdrfomia. lrd lgr rhd il I <br />'hould <br />tcom sbFl ro th' <br />@*c6 omFrslk n tDvirions of S€lion lT0O 6l ihc hbor Codc. l rlell fonhwilh strlplv wirh lno$ lrcli.ions <br />WARNINC: Frdlurc ro wure *o,kc^ <br />ciril linc! up t, onc hundrcd thorsand <br />Scdliotr :10?6 ol rh. tjrDr Codc. hrcidsr <br />I hcrch, rmnr lhdn pctrdly of pctlury lh l om licen*d ud.t <br />ol lhc Busincss tnd PmicssiotrsCodc. ud my licens Ls tu tuU <br />Chuptr 9 (commncing wilh Satbn ?firo) ofDivhion:l <br />7 <br />I hcEby nrtrn und6 p.ully of Frjlry lh <br />h$cd lse. 309?. Civ. C.). <br />y f.r ri. pofo,rMcc of lh. wor* ior which lhir lxon <br />t ,id.a. Nlftl <br />Irnd.r'r Addrrs: <br />AITLLCANIIECIABAIIAN <br />t hodry afm uMcr rcnalr, orFlury om oflhc follosinBdclMtinns: <br />D.nrlirion Pcmn*AstEstos Norincarion Fcd.t.l Rcslldionr (Tirlc 40. Pan6) <br />_Rcqutcd t lrcr ol Ndifrarirn <br />-l <br />ccnily rhlr thc fcdml rcguhions Gs&di.8 sb.slos rcmlll m nor qPlicsblc m lhis Prcj.d <br />hrv. rcad rhn rpplicstion,nd shrc rhsl rlt ahow inlb.mlin n cotrd.l agBlocodplvwilh rll Cirvand Cou.lv <br />Llws Ehrins ro huildinS conslrucl <br />ncny lor hspc€lion PurFJss <br />ioa. ext h.rcby eulbn& tnr.eolalivcs of this Cil y md <br />PLUMBING-INSPECTOR RECORD <br />ID/SIG. <br />Water-Under floor <br />Roof Drain <br />POOL/SPA <br />fll).r18