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APPROVALS DATE ID/SIG.COMMENTS
<br />UNDER GROUND
<br />WaterUnder floor
<br />Gas-Underfloor
<br />Buildin g Sewer
<br />Area/Storm Drain
<br />lnterceptor/ Clarif ier
<br />TOP OUT
<br />Waste & Vent
<br />Water Pipinq AlHfiK >}\<(
<br />Gas Pi ptng
<br />Tub/Shower Test
<br />Roqgh 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 />Water Service
<br />Lawn Sprinkler
<br />Sani tary Sewer/Cap
<br />Back Flow Device
<br />Rou gh Plumbing
<br />Final Gas Tesl
<br />Meter Release
<br />FINAL bh-il|6 I ;t\,<x
<br />Notes , Remarks, Etc.I
<br />OWNI'R Bt]ILD!R DOLCARA'I'ION
<br />I h.ahy rftr undcr lcnilr, ,,f pcrjury rhd I if crcn/ lm,n rhc Conh.kns Lkcnr bs for rhr folnlaiig Er\on (S.r.7tr.ll t
<br />Burnr\\ rld ltnLsrn,n Odc) Atry Ciry or Coutrry whrh rcquncl a lf,rmit lo .otrslruc|, 01r.r, nnprovc. dcnnnish r r.t'rn ,ny
<br />(ru.rurc. prirrro irs is\ui cr. al$ r.quhs rh.,p ;crnr t, such lErnir h rilc tr signclt ndrcmnr rhrr hcor \h. is li.cn{{l pursurtrr
<br />ro lhc pr.vhion\ ol rl.. Conlruclr, \ l,iccnrd hw (Chaprcr I, ConrnrminE sirh Scctiotr ?ux) of Divilion I oI lhc Busincss rnd
<br />Pn,rc\\bn\ Codr)orlhrl hcorrh. nci.nrpl rhcrcfron dlhcbtrsi\forrncrllcScdcxcnDltlr.Atryvidationofscdi.n'70.ll5htnn,
<br />dtpli.,nr nn I l.rnir \ubjc.r\rhc arplic,d b aci!ilp.niltyofnor nucrhan rirc h!nnrcd dollar! (55(x))
<br />l. d\ osrcrorlhc prop.nt,or mlcnDl{'yce{ qithsrecrr\ rMt ('lc .otr'pcn\uon, sillJo rlr{(rk rod
<br />'hc
<br />nfr1ur n nor
<br />inknl.i f onrrcd fu ek t Str ?Orl. Businrs rnd l,roli$ions C(rl. -l h. C.nr r.ktr \ l-icci{ l rs doc\ nor { yror uqnrrol
<br />rhcnml](ry tr h) lrurlds or impNvc\ rh.N ,trid*hodoc!suchsorkhim\cliorhc^cllorrltr.ulhhis.rh$o$rc Db!cc\.
<br />[ovnludrhrn'ch iDpmEnrtrhlrcBni clr]et or flt ]turst tlt lrNlrcr. rh.buillingor irpnvctrEnr t $ktwirhhonc )rd
<br />ol.omplcri{'n. rhc Owncr Bulldq will irve thc tndcnoffoving rhtrthc or \hr dil nor huild or i prcvu rho potilly nrrhcnurrx,$of
<br />-1.
<br />a\ ower of tlE pq)cny. m .xclusiwly conkacring wirh liccns.d snracroE ro oNlnrl tE pmj<r (S!.. 7oa4. Busmc$
<br />and E!ftsrbn Codc: Thc Corurclols Lic.Bc t w docs not apply ro aoosn€rdtphlcny who builds o. in[ovca lhdcon.and sho mnrers lor iu.h linitr3 wnh a Co rero(,ltensd pu*uMr to rh.C.nrturtr s LiccM t w).
<br />I nncx.frtr !'rid S(l
<br />lllaaESs:raMrENsAllox
<br />PECI.AMIII}N
<br />I hocby lffirn undcr pcmlly oi pn ury om ol lh. lollowin8 deLnridnrl
<br />Ihakrndwillnmt riri(cnificrrcolC.nscDr!oScllltr\ur.itrsorkc^ rotr'pan\trridr. r\ nmiddnnbtScrrnn.ll(I)ofrhc
<br />l,otq (.rlc. tir rhc p$fonn mcofrhc worh frshich th.prmir is i\\ucd
<br />_l hoE and Qill hoinloin wortcs conFnsalion iBuran c. a requircd by Secrjon 1700 of rhe t bor Code. for thc tjcrformncc ol
<br />lhc work for which lhjs pmil is is$cd. My wort6 ootc.$lion iBurftc @tr a.d lDlicy .unftr e:
<br />t\
<br />I ccnityrhar in lhc pcrao,mne ot rhe sor( forwhichlhk pcrmn ir issucd.l shallflol cn loy sny,E6o. inanyflurcr
<br />s s lo bc$m rubj.ri ro thc qo*e* ompcB.it,n hss Df Cllifohia, 0.d .sN thar il I sholld trcotu slbjdt ro !,8
<br />wort$s' comt*.dion Imvnions of S.dion 37{10 of rhl L,bor Code. I slEll. fonleith cDryly with rhoc pDvisions..
<br />WARNINC: FliluE lo $curc wo*crs
<br />civi! liflcs up lo on. hundrcd lhous.nd
<br />S6rion 1076 of rtc Llhor Code. inlcrcsr
<br />an crploy.r ro ai'nnrl p.mLrics rtr
<br />.onrf.n\dioo. d$rgcs d\ prnvid.d for rhc
<br />I heaby ril]rm unds pcMlly of p.rjury th0t I Fovkio. orchryrcr 9 (..mnci.E eilh S(rion 7000) of Divisioo l
<br />ol llE Busi6s !d Prolcssion3 Codc. an hy [ccn* n in aull fttre lrn cffst.
<br />,.'.",,.".,,,,*. e Jl r.ic.tr\cNun$1,:
<br />q((zfi--
<br />t,1", -r,t1.I b
<br />I hcrc6y d6rn undcr p.Dahy of Frjury lhal I
<br />isstrcd (s6. J097, civ. c)
<br />i'r! r!.my fd rhc Frtumrn.c ('f rhc qork ltr whi.h rhi\ lf,inir i{
<br />AIIU!;ANI.IECTASAIIAN
<br />I tErhynfinnundcr pcnaliy of pcrjury otrc ofrhc lnllowirg dclrllio.s:
<br />Dcmlition PcnniIs.Ash-sr.sNorificdn,nrrdcnl R.Axhr .s(Tirle40. Ptrd6)
<br />-Rcquncd
<br />L.iicr of Norifi caio.
<br />rcsularions ESddinB asb.nos rcmu! lrc rct sprlicol,lc lo thh rrojc.l
<br />Bbovc i.formrion n.omcr I acN ro contly wirh all Ciry and Counry
<br />n, dd hcEby surbri& &F.*lnarilcs ofrN. Cny lnd Counry ro c d uliDrh.
<br />PcmiieEne(\UufA/^,.
<br />-t. ll .t 0
<br />PLUMBING.INSPECTOR RECORD
<br />I
<br />Waste & Vent
<br />Rool Drain
<br />,". -7'l4.lt)
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