2010 I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN S
COMPENSATION LAWS OF THE STATE OF CALIFORNIA,
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I J - MAIN DRAIN
UNITS FEES UNITS FEES
Water Heater Size
Water Closets Matera_
Hath Tubs To Curb
Showers - To Prop. Line
Lavatories _ To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines Size
\Water Softeners Material
Bar Sinks -To'Main Drain.
Comb. Sink c Trays To Curb
Dental Units
Drinking,Fountains -
Floor Drains WATER SYSTEMi _
Hoppers Size
Restaurant Sinks Material
SanJTraps- TOTAL FEES
Urinals Fixture Fee
11 Area Drains - Main Drain Fee 7
Water Leaders _ Storm Drain Pee ', t!,
Sprinkler Vowes 12i Water Sys. Fee fs,
Permit Fee
TOTAL - TOTAL PEE
RECORD OF INSPECTION
Underground Rough... 17
.P
ERough.. -
�Rgh. Complete_ -
Main Drain 1
Final._ .11