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PLUMBING.!NSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS Oma-Buil&r Dcclantim <br />I hacby rfEm u&r FoElty of pqjury thlt I m cx@pr fm thc Cqt$toa' Limc llw ftr thc following Bn (16.7031.5 BuitrB <br />md hofeio Codc): Any City 6 Cmty which EquiB t pqoit to cffitrut alts, improvc, dmolilh c rcpoir uy stucm, pric o irs <br />isucc, abo rcquiro thc ryplimt fa ruch pcmit to filc a signcd st8&m6t that hc tr rhc is limcd pmwt to thc provirim of thc <br />Cmtrfq'r Licascd 9, Comcirg with Serion 7000 of Divisiq f, of thc Bwine od Profeimr Codc) r thar hc r <br />fc $c allcgcd cxmptim .Any violetim of Sctim 7031.5 by uy applior ftr a pamil subjca thcshc is <br />a civil pcnslty of not mm th8 fivc hutrdrcd dollm (X500). <br />will do thc wqk ud thc atruclw is not intandcdtrla* dG nd apply lo e oma of thc propcrty <br />vho buil& r irnFova $m, md who dc suh wqt hirelf q hoclf u thmgh his tr h6 m mployccs, Fovidld fiar such <br />imFovf,@E e not intcndrd tr offsrcd fG salc. It howwo, thc building or imprcvmt is sold within 6c yo of omplaio4 thc <br />Ownq-Builds will havc thc hrdfi of Foving fur hc q shc nor build a imprcvc fc rhc purposc of sslc). <br />_L a omq of thc popaty, o acluivcly mtrcting rith liord mtretG to coltruct thc Foj@r ( S4. 7044, Buine ud <br />PrcfBim Codar Thc C6tr8.ttr'i Licffi Lr* dc not spply !o u ma of popaqr who buil& r imFova thow , ed who <br />cotreE fc ruh proj€ls wilh a Cotrtrrcto(s) limcd pmwt lo thc C6tr&ts'5 Liqs€ Law.). <br />-lm <br />u&r Sation & P.C. fq this so. <br />Datc: <br />1- <br />I hcby affim u&r pcnalty of pqjury @c <br />_l havc md will mint8in a Cqtilicate of Coroot to SclfJuw fq uqtm' ompcnstion, c prcvidcd fw by Setio 3700 of thc <br />Labq Codc, fq thc pafme of thc wqk fo which thc pcrmit is isucd. <br />_l havc md will mintain wqtm' mposatio irouac, s rcquircd by Satim 3700 of thc labq Codc, fqthc pcrfme of thc <br />wq* fq which thic pamit ir isucd. My wor*m' mpa8atim irolme cuia ud policy numba m: <br />Policy <br />(Thit grd-nccd not bc mplctcd if thc pqmit is ftr otrc hu&cd dollm ltlool q l6s) <br />l2!t *lty tlai"tc Ffme of tlrc wak fa which thir pamit i! isuc4 t shall oot arploy uy paso io my mns s a robce $bj6r !o thc wat6 ' cdnp?Grtim lm of Califmi!, ud agre th.t if I rhurld beom sbjd to thc wqto' <br />provisiw ofScctio 3700 lrba Codc, I fcthwith cmply with thcc Fovisios.. <br />t <br />Failurc b sccw wtrk6' @mpcndion <br />6nc up to oc hu&cd thmd dollm ($ I 00,000),in <br />thc labq Codr, intsur qd anmcy't f6. <br />additim to thc c6t <br />LICENSED CONTRACTORSi DECI,ANATION <br />I hely rffm uds paulty of pcrjury thrt I m limcd udfi provisim of Chsptq 9 (ffiacing with Scrim 70Oo) of Divisim 3 of <br />thc Buineud Prcfeim Codc, md my lirc is ir full f@ad cffc(t <br />LiwOs,_LifficNmbq <br />Dd.: Coffiaate <br />CONSTRUCTION LENDING AGEN'CY <br />I hqcby gffm udsr pct dty of pqjtry thd lh@ it E mtutio lading agocy fc thc pafm of thr wqt fc whictr thir pcrmit ir <br />isncd (Sc. 3097, Civ. C.). <br />landa's Nmc; <br />landq'r Addrs: <br />APPLICANT'S DECI./\RATION <br />Dsnolitio Pmilt-Alb6tq Notificatim Fcdaal Rcgulsriw (Tidc,f0, P.rt 6) <br />_ Rcquircd lrtr6 ofNotificaio <br />with 8ll City sd Couty <br />sd CMty !o 6tq upo0 thc <br />Applimt c rgot rig. <br />Pmittellsm(prini): <br />G7 / z@e <br />UNDER GROUND <br />Waste & Vent <br />Water-Underfloor <br />Gas-Underfloor <br />Building Sewer <br />Area/Storm Drain <br />lnterceptor/ Clarifier <br />TOP OUT <br />Waste & Vent <br />Water Piping <br />Gas Pipeing <br />Roof Drain <br />Tub/Shower Test <br />Rough Water Heater <br />POOUSPA <br />P-trap/Drain Line <br />Main Drain/Pool Piping <br />Fill Line/Back Flow <br />Pool Heater/Gas Line <br />Misc <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 <br />Notes, Remarks, Etc.