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APPROVALS COMMENTS <br />UNDER GROUND <br />Waste & Vent <br />Water-Underfloor <br />Gas-Underfloor <br />Building Sewer <br />Area/Storm Drain <br />lnterceptor/ Clarifier <br />Waste & Vent <br />Water Plpi <br />Gas Pipeing <br />Roof Drain <br />Tub/Shower Test <br />Rou h Water Heater <br />POOUSPA <br />Ptra rain Line <br />Main DrainiPool Pipi <br />Fill Line/Back Flow <br />Pool Heater/Gas Line <br />Misc <br />Water Service <br />Lawn Sprinkler <br />Back Flow Device <br />Final Gas Test <br />Meter Release <br />FINAL <br />Notes, Remarks, Etc. <br />Omq-Blilds Del.r.ri@ <br />I hftby .fiim u..hr po.lry of pajlry filr I M Gxdpt fdh $. C@r&1d' Li6s. trw fo. thc totlowin8 B6 (G.?O! L, BGinB <br />ed Prcfeiotr Cod.) Any City or C@nty *hich rcquiB . p.mi !o coEtrlc! alrcr. ihprcvq dcmolilh or rcplir ey sEu€turq prio !o ir! <br />ie@@, .lio Eq!i6 tho qppliot rdiu.n Fmn m flc ! 6i9.d.llrdMr thr h! n 5h. ir li@.d p6@r b ln. Foviri@r orrtc <br />Cdaalort Ucal9.d riw (Ch!/.r q Cdmaciu ,iO sedon 7o0o of Dviri@ , of tnc Bsiie ud Prcfdi@ Cod.) d rtar tu d <br />lhc i. .xnPl rhEtfron Dd ilE tarir fa lh. dl.grd cicrnprio .Ary viotllio ofsc.rio 7o3l 5 by Dy .ppti6r fa . p.mir iubjccB ln. <br />applior lo a civil p6.lty of Id t!@ $E fivc hui&cd doll.6 (1500) <br />_1, a ohd of d. F.pary, d m, oployd virh v.ar. s Od. sl. c@pora!6, eill do th. wdt od otc <br />'l.ucr@ <br />i! iol inLnd.d <br />d ofi6.d f6 s.l. ( Sa ?044. Buina sd Profei@ Co&: It. Coa..rd.r Lic4G tlw do6 not .pply to s oMcr of thc proFny <br />vho buil.lr 6 ihFDvq! thoq, ad,ho <h.. 3uch wo't ni@.lf d h@lf d $6rd' nn a 116 own oploy6. provid.d th{ suchimproyffil! s! nor intold.d or olT@d fn id.. Il hw.6. tt. b{ildilg cinlrbvdi.Dt i$old wi$h onc r@ of onplaion, ii. <br />Om6-B!il.Lr will nrv. I'c burdq of provii8 rhll h. o( rh. iol build 6 imFov. fd th. puryd. of !.lc) <br />_1, a Md of tlt. prop.ity,6.rclui!.,y @r&tin8 wi$ licdrcd 6E&@ 10 c@E!d lhe prcjd ( Sa ,o44, BNin6 edkofsio Cod.: Th. C@Eiqd'r Li.c@ hw <to€ not rpply ro & o*i6 ofFoFrty vno blild! 6 in!.ov6 d!a@, , sd *ho <br />cdll&r. for luch prcjcr eirh . cdr'rdo(, lialcd p6@r ro 6c csE&torr Li..e Lrv ). <br />_l o danfl ud!' S6ri@ <br />-B <br />& P C. fd $ie rGrs.n. <br />WORKERS COMIENSArION DICI.AR,{'IION <br />I hr?t, .mm @da p63lty 6f Fiury c of i!. foll*ir8 d.dsd@: <br />_l h.v. ed *ill n.int in . C.flili@L of Corlc ro SGIf-lM fd wdt6'cohpcnlraon, B Fovid.d fd by s!4ie lToo of $. <br />L5bc C!d., fd $. pcrfmu@ of tlE qdt for which rh. Fmir i3 iB!.d. <br />_l talc dd will m.inl.in {dI6' @mpadion iNlm*. 6 aquir.d by Slclion 37oo ofrhc Labd Codc, for th. p.rfomscc oith.sort lorwhict lhi! p@n ii i$ucd My wor*6' oohpcBsdd insuMc. csia d !6licy numbcr dc <br />Ao^,^ <br />nor b. @npla.d if 0!. Frnir is fd on. hu.d'.d dolls {l t oo} d 16, <br />dt pdfomu@ of lh. vorr for which this pmir is i$ocd, I <br />b*qc.!bj.cr to dc wst6 ' @opa3!i6 l.w of Crlifmi( Md.gre <br />comp.nr{ioo prolirid! of S6ri6 !of th. L.bor Cod., I sh.,lj.--6 <br />Fdlur.lo r?c@ wdt6' 6hF$dim @r6!gc <br />fin6 up to d. hedrcd $ou$d dolle (tloo,ooo),ii .rtdlrio <br />thc Llbor Cod., inrGr ud anom.yt f6 <br />&maa6 d proeidcd tdficS.cion 3076of <br />LICENSED CONTRACTORS DECLARATTOl\ <br />I hq.by amm un.ld !...lty of Fjury lnar I u lidscd undd prcvi5ior ofci.pr6 9 ()of Oi <br />rh. Busin$ od Profesioro Cod., od ny li@sc is in full ftrc. dd cffet <br />Li@nlccls L&.sc Numb.r <br />I hdcby alfim und.. p6a1ry ofFrjury d O6c t a @sEudi@ lodiry a86cy <br />issu.d (scc 109?, Ci!. C ) <br />6. pdfoD'lrcc of tlE wdL 16 *hich dris Fmn i3 <br />ATILICANT'S DECL f, AIION <br />Dnolirio Pmir-A!b6t6 Norili6ri6 rqddt RcSxl.aon! (Tid. .0, p.n 6) <br />_Rcquircd t rd ofNodfcrior <br />ro conply wi0' dlCi9 dd County <br />lbovc tutim.d Flpaty fd i Fctio <br />rhi! Ciry ud Cooty lo 6ta upon lir. <br />oo- <br />PLUMBING{NSPECTOR RECORD <br />tD/stG. <br />TOP OUT <br />Gas Service <br />I Sanitary Sewer/Cap <br />Rough Plumbing EXF IRED <br />F E,E :. | (utu <br />SAtvlC 8-di ,q6 l{a ar 7 <br />I DATE <br />Ii-