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PLUMBING-INSPECTOR RECORD <br />APPBOVALS DATE ID/SIG.COMMENTS ()wNER Btit l-DER DDI-CA RA',l l( )N <br />hr\in.\ nrl hor'c$i{nr Codc) Ar! Ciry rr Cotdy {l'i.[ rcqutc\ r Ifn ir k, .ot{ru.l. rlrcr. nnuolc. (lcmli\h or rPrn rrt <br />{nrcruru. fihrro ir\ i\\!rrt-c. d\o rcqurc\ rh. rfin'crd,nr \!.hlf,nn ro r]lca \i8trcd $$.nrrr rhlrk(.rsM i\ liccn\cd p0^rxnr <br />to rh. |x'v]snnrs ol rlk Contr crtr\ l-iccns.d lnw l( hrpr.r 9. (innnrDcirg rirh sr.ri{,n 7lx[ urDivni ]olrhc&r\ire$ nl <br />rffli.rnrturn!rnnirsuhjc.rrrh.qrplicrtrrtrx.ivilJtBlly.lmrnxx.rl,rnlir.hu(i'.rldolld\(S5(x)) <br />-1. <br />as oqrcr oalh. loFrrr, or h, cmrlo)rcs wirh eogcs &s Ihcn sk @nllcLisliotr wiu do tlE atrt .!d tlE drEr@ n ml <br />inrcd.d or oileEd fd slc (56,7044. BuiiEs Dd PDf.siotr Co{hi Th. Cont clols Li.rns L3v d@s nol &oly io N owE of <br />llE P,DFny qh. boilds or inprowr 0eoc md *ho dc uh w liiscr o, h@lf or rnmuSh hir or hs own.noloyes. <br />phvidedinll:r.h iqrewmik m mi htnd.d or ofr.Ed lM slc. ll tn*ei tlf hritdins or inlmEtun is $U wiihin orc Fa <br />ofdtrpklior. rt* ol*mr Bliltd will h8w rlE hrd.n ot ploviig lhd lE or !h€ dil nor hild or itrpmr th. Flpqty for dt porpo* of <br />-1.Iosnoof <br />rhc p6r.ny. rn.x.lxsivclycont .lin8 wirh lic.nsd uontftdos r. otrsltocl ric lrlr*r (56.7&:1. BusinN <br />d hDf6sh, Cod.: Thc Co.lm.rois Liccn( t,aw dGs .or ,Dply rd .o owmr of pmn rly *ho builds or improvcs lhc@n. <br />,nd who @nrE.rs 16r su.h poi(h snh 3 conhclo(pusui ro r h. contracrois l-icc.sc L4). <br />*. q/illt <br />DNCLARATTON <br />I hereby lffi rm!.dcr F.llryolp.rrxry.ncof rh. aollo*ing d..ld,rions: <br />_l h!!c and *ill roioroh ! ccnir&{c or co.scnr ro s.lr-lnsurc ror worketr ompcnsrbtr. as ,mvidcd for b, s(rion 3700 .a thc <br />Libor Codc. i'or lhc pcriorman* of rh. mr* fot ehi.h rh. p.rnir is k\r.d. <br />-l hav. 0nd will minlaitr worlc,s compc.srlion in{nncc. as Eqlircn by SF ion lTm or rlE ljhor Codc. tu th. pcrfotudc of <br />lhc qort fo. which lhls p.nnil is is$.t. My eorkc6' co'llnsriofl insudncc odhi trnd polh, ntrmb.r e <br />Crhr:- <br />lftnilirh.i in rtE pcrfo.mRc ofrh. wort lor whthfiirp.rmit is is$cd.l sh.ll nol cn,hy rny lcBon in tny mnncr <br />$ $ ro beom subjccr ro thc so*cn compcnstion la$s ot C.lifornia. {nd tg@ rhd ir I should bcom subj.rl lo llt <br />sodGl comFnsrion lmvlsions otScdion ]700 ofthc ljtnr Codq I ilEll. fdhBilh.oq,ly wnh lhos prclnionr.. <br />subirl ,n cr$loltr ro aiminal lrMlli$ lrl <br />comncnsarion, damgcs as pr(,vidcd for lhc <br />DICLASAIION <br />I hcr.hy rlllnr undcr rtrrliyolpd'jury rhd I d lic.nyd rndcr rn'ri\nnr orC[rrrd 9 (con]nEncir8 *irh Scdior 7UX)r.lDivhiotr l <br />ol rtu Eusircsrxl Pnresn,nrCo,lc. Jnd n,! liccn\c i\ ir lnlllnrtrn'rlcllccr <br />EONiIA.ICIIQ I.ETDING-&{j!!II <br />i(sucd(sLr .r09?, civ. c ) <br />Lttuc NLxxct SarIgN <br />l,rLhr_nlnD nd.' |tnrlrvol |*turyotrc.lIh.lbll,)qitrlrd..l riois <br />l)cD. iri,)n P.nnir\ Ashcnos Norificdnr licdcrrl Rcgrhrnni\ (lirl..l0. Pd6r <br />R.qrnrd lrrt.rolNoiific i(trr <br />-l <br />.dify th{ rh. f.ncEl rcFubtions Esedins lslrsros rcmvll arc nor llplicrhL <br />'6 <br />rhk tmir' <br />-t <br />*nity rhtrr I harc rc{d rhir dlpli.rlhn nd sl0lc rhar lhc *ovc informali.n is cotrd I dsN r sqrly wnh allCilyotrd County <br />coNrrucliotr.udhcrcl,yaurhorizcrcFc\cnrarivdsorrhirCi(y dCounlyx) <br />tT)It ;7*- <br />UNDER GBOUND <br />Waste & Vent <br />Water-Under f loor <br />Gas-Underfloor <br />Building Sewer <br />lnterceptor/ Clarilier <br />TOP OUT <br />Waste & Vent <br />Water Piping <br />Gas Pipino <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 />Water Service <br />Lawn Sprinkler <br />Sanitary Sewer/Cap <br />Back Flow Device <br />Rough Plumbing <br />Final Gas Test <br />Meter Release <br />FINAL ilz\t1,{r w6) <br />Notes, Remarks, Etc. <br />L,.dcir AddEs: <br />- <br />Area/Storm Drain <br />Roof Drain