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Site Work Remarks Date Signature I.D <br />Sanitary Sewer <br />Area / Storm Drain <br />Water Piping / Service <br />Gas Service <br />Gas Pipinq <br />Pool P-Trap & Backwash <br />I, ao, circ. Pipinq <br />Pool Fill Line t Backflow <br />Pool Heater - Vent <br />Lawn Sprinller / Backflow <br />Other - Backllow <br />Waste lnterceptor / Clarilier <br />Address Unit/Suite: <br />PLI.JMBING .-. INSPECTION RECORD <br />Notes, Remarks, etc.: <br />OWNERAUILDER DECLARAT]ON <br />I hereby aflirm under penalty of perjury lhal I am exempl from lhe Conlrac,lors' License Lanr for the following reason <br />(Sec. 7031.5 Business and Professions Code): Any City or County wftich requires a po,mit lo conslruc.t, aller, <br />improve, demolish, or repair any Glructuro, prior to ita iasuanco,.lso requira lhe applicanl for such permil lo lile e <br />signed stalement that he or she is licensed purauant lo lhe prolrisions of the Conlraclors' Licensa Law (Chepler 9. <br />commencing with Seclion 7fiD of Division 3 of the Business and Professions Code) or thal he or she is oxempl <br />lherefrom and tho basis for the alloged exemplion. Any violation of Sec.lion 7Gt1.5 by any applicant for a permil <br />subjec'ls lhe applicanl lo a civil penalty of nol more than five hundred dollars (35d)). <br />_1, as ovtrner of lho property, or my employrea wilh u,ege3 eB their sole compensation, will do the v\rork, and the <br />struclure is not intended or ofiered for tale (Sec. 7(X4, Busincs and Professions Code: The Contrac-tors' Licengo <br />Law doet nol apply lo an ovlrner of lhe properly wtro builds or impaovc lhereon, and wtro does such y\rork himsolf ot <br />herself or through his or her orrn employeee. providod lhat such improvemenls are nol inlendod or ofiered for aalc. lf, <br />honqwr, lhe building or improvemenl ie sold within one yrar of completion, lhe Omer-Builder will have lhe burden <br />of ptoving that he or she did nol build or improve for the purpce of sale). <br />_1, as owncr of the propody. am exclusively contrac.ling with licensed contreclom to construc-t the projec.t (Sec. <br />7(X4, Bueinecs and Prcfessionc Cod6: Ths Conlractors' Licen:a Law doec not apply to en olvner of property who <br />builds or improm thereon, and wtro contrec-ts for such projeclr with a Conlraclor(B) liconsed purauanl to tho <br />Contrecdorr' Licenr Law.). <br />_l am exempt under <br />Remarks Date Signature I.D.Building <br />Under Floor / Slab - W. A V. <br />- Water <br />- Gas <br />- Other <br />Waste & Vent Top Test <br />Roof Drain - Oownsgout <br />Tub / Shower+an Water Tesl <br />Water Heater - Vent <br />Gas /Water Re+ipe <br />ROUGH PLUMBING **ar/-. t <br />FINAL GAS+RESSURE TEST /,:7_Y:-,/ I <br />FINAL PLUMBING -T O ea,vl <br />Omer: <br />B. E P.C. for lhis reeson. <br />I <br />+ <br />I + <br />+ <br />t -/ ,"/ 7.r I <br />1t