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APPROVALS DATE tD/srG.COMMENTS Om6-B{il.!d Delarlim <br />I h6.by.ffim ud.r p.nrlry of pdjury lhdI66x@pt fm d. C6t &16'Li6k trw for tt. followin8 r$m Gcc,o3l.5 Bsines <br />ed Prcr*id C.d.): <br />^ny <br />Ciry c C@ry *hich rcquiB ! p<rnt to cdlltucl .lld, iEprov., d@olish o rcp.ir ey ritucn!!, pnd to iri <br />i$@@, dro EquiB thc appli@t frilch F t to fil.. dsnrd r..r.!qr lnllh. d lhc i.lic4cd puRuor ro th. p.ovi3i@5 ol$. <br />C@l'!ddt Li.tu.d r4w (Ch+tr 9, CooDacing eirh Sdior 7000 of Uvbion 3 of lh. Bsin6 and P@f6io3 Cod!) d fiar h! or <br />3h. is qdnF fi.rcfr@ Dd rt. baii fd ihc dl.8cd d6Fi6 .^ry violdion of S.crjon 7011 5 by d, applimr fd 0 Fmn subjc.ls thc <br />.ppli6r to a civil p6.19 of tut noE 0!e live hu&d doue (1500). <br />_1,6 ow.s of thc pr!p6ry, d hy dployc6 wirh w!86 E U.t sol. @mpaBali{, {ill do thc worl ud rhc rt lcrffi is .or incndld <br />d offq.d ftr 5.1. ( sa.70a4, Buinq$ ud Prcf6r@ Cod.r I1l! ConrEtd't Lic@! tlr dc no! apply b 6 oMs of lhc prop.rry <br />who buildi or inlry6 $..w, ad who .tG iucn qo.t hi@lf a hdr.lf ( rhoah hi! d hr N. .mplorc6. Fovi&d rhar Nch <br />ihprovmrn6 @ nor inrdd.d or offncd fd s.l. If, hrye6, th. buildi.s d impovmdr is sold sithin on. y.d of @mpldio., rhc <br />o*id-Buil.l6 will h.v. Oc h!d.i ol prclin8 $ar h. d lhc nor build 6 ihFov. fd rh. pup6c of 3ald <br />_1, a M6 of $. proFity. e cxcluiv.ly @tr.tin8 wth licorld @n-lds ro .mrc rh. prcj.d ( 34. 7044, 86in6l ed <br />Prof6ion C.d.: Th. C@E!dq'3 U.4G lrr .106 mr .p?ly ro M oMq of Fop6q Dho blild. q imFovq rhctw . sd whoqrE t3 fM sch proj4l! qi$ ! coirrctd(t) li6Ed p6ost ro rh. conn dort Li@& L.w.). <br />_l u qmpt u.lcr Sedo .B. & P.C td $i! r.ard <br />WORI(iXS COMPENSATION DECLIRATION <br />I hocby afiim udd pcnalty of pfjury @. of tt. follopir8 d.cl@rio{E <br />_l hav. ed will minuin r Carific{& of CG6l !o S.lf-lNe fd *dl.'!' c!np6'!.tion, B providcd fd by Sc.ljon t?oo oirfi. <br />L!b6 Cod., f6 lhc Ff.in rcc of rh. q6l fd *hich th. rffn k i$ucd. <br />_l nav. xd will n.irllir w6t6' cdFrrci@ iNlme, s rcquird by Sali6 37oo Dftn. kbo cod., for ln. pcrtomdcc ofrhc <br />wort fc wtid Ob pqmir ir brucd. My wntd cmFE io isl@e Mid od policy numbo u. <br />Policy Nmb.i Expir6l <br />(Ttit t.cri@ ncd not b. .dplacd if $. Fmn i! tc Onc h6.b.d dollr! {3 | oo} d 16r) <br />ud" ^n^^.*^.r o.$. sdr ror <br />)4.s. iubjqr b rl. vdrd mp@.r,@ l.B <br />,hich lhis pqrr i! isu.d, t rnri <br />conp.ns.rion Fovirim! ofSaio l70O of$c Labe Cod.,l sh.ll, <br />?- €-,>L <br />WARNING: F.i,@ ro @ur wdt6' !diFn5.i6 <br />fii6 up to @. hu<tld 0bued &llc (ti00,000).in <br />th. t lor Codc intc.d Md snm!y'! f..'. <br />th.ll ruud $ mdoyd ro dimin.l Fn.lrj6 ud civil <br />.mpcE.rio., drn.B6 s provid.d fd dc Selion 30?6 of <br />IICENSED COITTRACIOTS DECI,AXATION <br />I h@by 6fiim und.r pa'dry of Frju.y rhc I D lim.d u.t r Plo"iii@ of Chrpld 9 (edmcid <br />tnc BBinB ed Prcfsionr Cod.. ed h, licas. is i, full amc dd.fL.r <br />-o <br />!flim undd pa.lry of pajury $d th@ ir . @.nucrioi l..ding aaa.y f6 of thc wdk for shich thir Fmit it <br />issucd (Sc. 1097, Civ C) <br />AIIIIJCANTIS DgCLA&{TIOII <br />Doolidoi PlmiB-A5hdt6 Nodlicdion Fcdaal R.8ut.tdr (T c ao. rrn 6) <br />_ RlquiEd t"ctcr of Nodficrlid <br />to comply with rll City sd Couir, <br />dov. n6ri6.d phFrry ad iniperio <br />&d Couniy to al.r upd th. <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 />P{rap/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/Ca <br />Back Flow Device <br />FT <br />Rough Plumbing Er\r r.\L <br />Final Gas Test rrDnl 013 <br />Meter Release <br />FINAL <br />SP ,MC 843, 2S0,t!o, co/ <br />Notes, Remarks, Etc. <br />PLUMBING.INSPECTOR RECORD <br />POOUSPA <br />--T-------+- <br />t <br />I <br />=