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PLUMBING.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS <br />UNDER GROUND <br />Waste & Vent <br />?- z< - /f JJ*<s *r,Water-Under floor <br />Gas-Underfloor <br />Buildinq Sewer <br />Area/Storm Drain <br />lnterceptor/ Clarifier <br />TOP OUT <br />Waste & Vent <br />Water Piping <br />Gas Piping <br />Roof Drain <br />Tub/Shower Test <br />Rough Water Heater <br />POOL/SPA <br />t ?/ty'OPtrap/Drain Line <br />Main Drain/Pool Pipinq I qil. <br />Fill Line/Back Flow tt \v@9()Pool Heater/Gas Line Y <br />Miscellaneous <br />Gas Service <br />Water Service <br />Lawn Sprinkler <br />Sanitarv Sewer/Cap <br />Back Flow Device <br />4 <br />Rouqh Plumbinq 9Jo- /Q ,l^b[trl D <br />Final Gas Test <br />Meter Release _41 <br />Notes Remarks Etc. <br />FINAL <br />owNuR BUil.l)t:R DEt.( ARA',ilON <br />lo I he pro\ isioils o f thc ('onlractor's Licensed l-as ( ( hapler 9. ( irmnlenc in! ftit S(Ntu jO(x) of Ditision J of the Busincss and <br />al)plicanlforapermilsubiectstllc applicflflltoaci!ilpcnaltyofnotmorelhnnfivchurdreddollars($5(xl) <br />_1. m orwr ofthc popcry. or my mplole wilh rvag6 6 lhcir ple com[mution. rtill do thc wott and thc $nrtuc k rct <br />intodcd oroffqcdforslc(56,T044.BusinsmdhofsioNCodqThcContrac'tor'sLicoscLawdoBnotapplytoiloMoof <br />thc propsty who tuil& or imprcvc thqon md who doe such uort himself or hmclf or through his or ho oun cmploycc. <br />providcdlhatsuch improlsE|lsrcrctintadcdoroffucdforsb. lf,houao.th€hilildingorimprcl'ffitis$Hsilhinone)@ <br />ofcompl:tion. thc Omo Builds will havc thc hrdan ofproring tha he or shc did rcl tuild or improvc the propqty for thc purpoeof <br />slc). <br />_1. rorwa of the Jrcpei'ty. m cxclusivcly contmcting rvith licmscd conl.acloE lo construd the prejecl (Sd. 7044. B6ins <br />and ProfushnCodc:ThcContractor'sLicsseLawdo6notapplytoanotrntrofpropcrtywhobuildsorimprovesth(sn. <br />and sho contmcts for such prcjets with a Contmcto(s) licenscd pursuant to the Contractor's Licqsc kw). <br />_l an crenlpl undtr S@tion . B. & P.('. for lhis reason. <br />()lrncr' <br />\\ ottKElts' ( out'1,,\s,\ I l()N <br />l)t.:( l.,Ul,\ I loN <br />I hereby aflirm under penalty ofpojury one ofthe follorvirrg declarations: <br />lharemdsill nrairlainaCcnificateof('onsmlloSelf-lnsurcforrrrrkcrs composalion.as proridedforbyS(lion-1700oflhc <br />t-ahor Codc. for the pofomance of lhe *trk for thich the pmnil is issued- <br />_l havc and will maintain workos' compcnsation irourancc. as rcquired by Sction -1700 of thc t bor Code. for thc pcforocc of <br />thc work for rvhich this pcmit is isucd. My workm' compeution insurmcc cmio and policy numba rc: <br />( rrric| <br />lblicr Nunthcr:l rlircs <br />I cstify that in lhc p€rformancc of thc work for which this ponit is issued. I shall not mploy any pcmon in aoy mmnr <br />$ B to b6ome subj(l to thc rvork6' comfEnsaion larvs of Califomia. ud agrc lhat if I should bccomc subj(t to lhc <br />wor*m' conrpnsation provisioro of Seaion -1700 of thc Labor Codc I shall, fonhrvith comply rvilh tho* prcvisiom., <br />WARNING: Failurc to sure $ork6' compcnsation colqagc is unlas'ful. and shall subjat and <br />civil fines up to one hundrcd lhousnd dollsB ($in acldition lo the cost of lhe <br />Setion Codc. intersl and <br />I hocby affim unda pcnalty ofperjury that I m liccBcd unds fovision ofChaptq 9 (commmcing uith Scction 7000) of Division 3 <br />of the Busins ild Prefesions md nry licose is irt full force and cffet. <br />Numbcr: <br />qt <br />I hereby aflirm unde ;rcnally ofpsjury thal <br />issued (Sa. 1097. ('iY. ('.). <br />l.endr's Name: <br />rsa lmding agocy for the pqfomancc of thc work for which this psmit is <br />Lmds's Addrs: <br />APPLICAN'T DI](]LARAl'ION <br />I rrwry* aflinn under pcnalty of pcrjury onc of the [ollo\ intr declaralions: <br />l)trnolition Permits-Ashcslos Nolification Federal ReSulalions ( I ille {0. Parl6) <br />Requited l-elter of Nolilicatior <br />-l <br />cqtify that thc fcdml rcgulatiom rcgoding ubetos rmoval are not applicablc to this prejcct. <br />lcmifr I ud stale lhat lhe atnve in is co[crl. I agreto comply lvith all City and County <br />ordinancs reprffitativG of thb City <br />atrevc <br />Apllicent or <br />l'(r nrilro <br />this <br />ion. od hqcby <br />m.,1 <br />to f,16 upon the <br />'o-/{ -/?J/n9"*'(,r1 <br />Liccce Clas <br />,"," '? I <br />13 <br />II <br />I l l <br />--ll <br />T-