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APPROVALS DATE tD/stG.COMMENTS OM$.Boild.i D.chrdri@ <br />I idcby .fim u&i p6dry of pdjury fial I d .x6p fm 6c CdE .16' Li6* Llw lo. thc followinB rc6on (5.c ,0r L5 Businat <br />ed Prcf*ie C.dc): Asy Ciry d C@ty *hi.I Equi6 r p.mn to c6!Eucr. .lrd. ihprov., dBnolish or r.p.ir ey sEuctw, pnor b iB <br />iss@e, ,lco tquir th. .9?li@t for !u.h p.rhi1Io fil. . !i8r.d slncrialt 6n hc tr !h. ir li6cd puEusr ro $. Foviti s olth. <br />cor&iof5 Liq6&d Lrw (Cltaplr 9, Cmmacinawi$ Selion 7000ofDvition 3 oltn!Bqir6i d ftofsio.s Cod.) or that he o <br />sh. i5 .xopt thfttw dd ilt. tdrh lc $G .ll.tcd dmBio Aiy violrtio of Se-tio. ?01I 5 by d, applidr fo ! p.mn slbjccrs lh. <br />lppliclnr ro . civil Fdry ot hor. tu fiv. hud..d &llss (3500). <br />_1, d oqd ollhc prop.fiy, d m, 6ploy6 {iih *!96 a thct rclc @nF6!rid, rill do $. wort ed rh. stDctu. is not inrcndld <br />or olfdrd ld sd. ( S€.704t, BGin6 &d Pbf6i6 Cod.: Ttc Cnlr&toal Liffi. t w tlc nor spply ro r offi( oifi. propqr, <br />who builds or improv6 6.l@, ed sho d6 such wdt hin.lf or h@lf d $rcu8h hic q hd oM mdoy?4 ,rcvid.d rhlr r8h <br />imprcvmott @ .ot imodd o o,Idcd for sal.. lf. howed, th. buildiry d ihpro!.hdt n sold wi6in onc ycu of cofrplcrim. !h. <br />Omd'Build{ wil! h3v. $. bu.da of provinr lhll h. o shc nor build 6 imFov. for $. purD@c of salc) <br />I, E oMq of O. Drcp.ny, a cxclBivcly @Eatim vith li..ns.d 6trer6 ro @sr*r lhc prcjar ( SE 70a4, BsinB dd <br />Prcr..sio Cod.: Tlrc Conr.cs'5 Lidr. Lrw dc ior eply ro e ow.d ofprcpciy *ho boil& d imFoy6 lh.16 , dd who <br />coir&r for such PtojeL wirh , c6r.Eror(s) li@!d prsur ro th. coretql Li6e L.w ) <br />I d cxcmpt und{Sdion <br />UqEAIBI.qAI{IENIAflON.PDCI.AIAION <br />I hd.hy aflim und.r po.lry of pdjury @. of $. loU@in8 d.clmti6s: <br />_l hav. &d *ill mintah . Cerifi.{. of Cdsr io s.lf-ln!!E l* odt6' c@pci3.rioi. 6 Fovid.d ld by S.ciion 3?00 or dr <br />Labor Cod., ld lt. p.rfroe ol$. eo* fd which tho pdthn ii isr.d <br />_lhalcddeillruj .b ydt6 ffiFsatid iNlfuG, E r.qunld hy S&rim 3?0o ofth. L.bq Codc, forfi. p.rfomuc. of$. <br />wod( lor which $ir pnn is isucd M, wort .s' @mpas.ri6 i.sutue 6id aid policy nunb.r sr: <br />Poli., NMb6_Erynlr: <br />(rh7(rbn nc.d <br />F.-.*U*ro <br />rcr b. .mrl.r.d ir $. prmit i3 for Onc hundr.d dolla {l I m} d I*) <br />ol lhc porL fo. which lhis p.mn ir i$ucd I <br />h* of Califni.. ed 6ere thir <br />o"ah <br />e cmploy.r to oimin.l p.n.lri6 an vll <br />&l16 (l I0o.0o0),in ddirion dan aB a prcvidcd fd tn. S.clio 10?6 of <br />inr{6t od !nm.y! lB. <br />LICENSTD CONTTI"\CTORS DECLr\fu\TION <br />I nq.b, .ltim udlr Fndlty of p6iuy th.t I D licqs.d lidn provitio ofch.p!6 9 <br />rhc Burin6r ed PrcadiN Co&, ed is in fill l6c. Md.fl<' <br />pdjury rh 6@ i! ! cdlrl'crid rh. F fom€. of lh! wok io which thi! plmn is <br />Civ <br />APPLICANT'S DECL\RATION <br />Dcmolitio. Pmil.-Albdi6 Notificrion rcd.ial Rcill.lior (Tirl.40, P.n 6) <br />_ Rc4uiEd Ldtlr of Notific.lio <br />r .r,it$o ,r,o fod-.I ,"sut.rioI, Esl'dins <br />-:11 Ftiry tu I h.E ad lri! splic.d6 sd !88 !o @nply with .ll Ciry dd Counry <br />odined ud Su& t *r rcl.dn8 to <br />.nov. m.rti6cd Flraly f6 iNp€rid <br />UNOER 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-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 b;i i"itiLiu <br />FEU.| (u rJ <br />FINAL saMC 8-43 290, 556, 6 <br />Notes, Remarks, Etc. <br />PLUMBING.INSPECTOR RECORD <br />POOUSPA <br />Meter Release <br />D.-omd- <br />lad.r,t A.Lh., _ <br />I <br />- <br />=