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APPROVALS DATE ID/SIG.COMMENTS Oms-Build6 Dchdion
<br />I hdcbyrfli.E unda p. hy ol Fjury thtt I !m d.hpr fom $. Conrr.ao6' LieM L* fo, tlE lollowing raon (16 ,o! L5 BuinBt
<br />rnd lroa<tDn Cod.). tuy Cny o, county *h'ch ,.qutr6 r F6i ro @sttud. .lra. imr.ovc, dceli.h or r.F rny rtrucluc. prior lo iu*u.rcq rlo rcquiB th..ppliq fo, such psnil 1o ,11. ! 3i8n.d rrrtd.nr tut h. or fi. i. tic.N.d puiuut 10 th. prcvirio ofrhc
<br />Co.tl.clor! LieEcd tls (Cttp6 q coBn@ins whh Socrion Tooo otDivirion I ofrh! Buin6i md Plofdioc Codc) or rhr h. or
<br />sh. is .x.mpr lhdc&oo .nd th. b€lir for rh! rucg.d ddplion A.y viotnion of Saion ?ol I i by .n, ippliont for . p.mt rubj.d! th.
<br />rpplionr lo r civil p. lty of nor oorc th.n fiv. hu r.d doll& (l5m).
<br />_ . l, 6 oMd ol th. pop.fly, or my .nplot6 wit M86 as rh.t .ole omlEnelron, wrtl do rhc wort ud thc smcrur. s iollildded
<br />dr of.r.d fo, s]. ( s.c ?o44, Bsin6s !.d P.otcarionr Code Th. Conui.rof! Lc.Nc Lr* do6 nor .ppty ro d oM.r ol rhc Fop.ny
<br />who boild! o, inrro!6 lh.rdn, .nd *ho dos ruch work him$tfor teclror tuoush nis., hd om.mployc6, provd.d thrr such
<br />inp,ovcbc ! .r. not htnd.n or olta.d lor sk li how.ve,. d. blildins or improwncnr k old ,i$m oe yar ot @mpl.tion, rhc
<br />Omq'Build.r *ill hrv.(llc bud.. ofprovins Lh{ hcor ih! not build or inp,ov.lo, th. purpo..ol$tc)
<br />I,sownsol$. propdy, !m qclusiv.ly co.ridinEwnh lic.dcd conrrcrors to mBru.t th. proj.cr ( Ss. ro44, Busin6!dd
<br />Prcf.$ion Cod. Th. Contrdor's LieB. llw do6 not .pply ro M oqa of propdy eho buitd! or iiprovB .h.ron , lnd who
<br />conlrcB for 6u.h proi.cB *hh ! Connrcro(, li..m.d pusunr ro rh. Cohrldor! Lic.cc trw )
<br />l.m.xenpi undcrS&tion __,
<br />-B
<br />& P C aor thir rason
<br />WORKf, RS COMPENSATION Df, CLARATTON
<br />I her.by rrnh undc. pcMlty olp.rtury one ofrnc followins d.chrlri.ns
<br />I h.v. a.d sill mrinl.ii ! C.nifiot. of CoMnr ro S.lfj6urc fo, wrt.ri @mp.Mrirn, B provdcrt tor by Salion,7oo oadj.
<br />lrb.r cod., for rh. p.rformnE oIrh.*.'l ro' whrch rh.pdmir ts is(u.d
<br />I
<br />]tr,. -a *' tr *.n"- *-Lc,r' onp.ns.r
<br />'on
<br />rmuon*. a! ,cquncd by S4tion r?oo ot fic hbor Cod., tor ftr p.,for neoarhe,ort for \hrh,htr r.re R trru.d Mv *ork.o . cory<nehon h!ur!... ank' .nd po I'cy numb.r rr.
<br />.",,- (k<".I( P-v^d
<br />"r,, n,.* O QIOZ Ztt ---*p;{O--ot-tz
<br />(Thiss.clion rccd not b..omplel.d ifth.permn ir aor Orc hondr.d dolhB l$lo0|or hs)
<br />__l.difr lhl i, c p.rforru.e of rh. mrl for vlrh ttn pdnn is isu.d, I itltll .ol dptoy .oy pcron in.ny m..nc. !o .3 to
<br />bcrhc slbjd lo E worr.G ' @hp.nsrion lsw! of ctlirorni!. ..d .src rhlr il I should b..om subjd io rhc eork s'
<br />omp.nntion Fovi.ions olScdion3T00ofrhcl,bor Cod..l rh!U. fonhwith comply vit rholc p,ovisiotu.
<br />*,"5t2c.1y2 { ?-c: c cql ".r-}6W RNING: Iddur. lo Eur. wortar' .ompcslrion
<br />fin6 u0 to one hund..d tlbumd doll.B (510o,000),i.
<br />ih.Iib.rCod.. irrd6l rnd.n m.y r fB
<br />md 6h!ll 3ubjccl !n .hploy.r ro cihi.rl p. lli6 lnd .ivil
<br />comp..erion, dr B6 a Eovid.d a.r the Sarion 1076 of
<br />LICf, NSEN CONI NACTOiS DDCT,AI TION
<br />I lE.by .{f!n lrdd FEIty of pqjury ihx I .o lietu.d undd proviion of Ctrptd 9 (@m.ndng wnh S.crion TooO) of Divkion 3 of
<br />$. Buircs.id Prof4liou Codq Dd ny liee it h tull fore.rd ctr cr
<br />r.ieeNuhha s-?t osRz(
<br />." -gl Lc,.tr"-) l(o
<br />t h.,.by .llirn uda p.Mlt, of Frjury rh.r rh6c ir r oEnudion Erdin8 .B.Ny for rh. pstomre ol rh. wo* tor whhh rhir panit is
<br />i,es!.! (Se 1097, Crv C )
<br />AI'PLICANT'S DECI AI]{TION
<br />D9rol on Pdmil!-Arb.rtos Nouf'qhon F.dd,l R.Bdl ion!{T hao,Plrl6)
<br />l!_l.cun.d kr., or Nonfioror
<br />_ I enify thrt th. Ld.nl rcguhrioB r.BrdinS ab6ro3 r.moEl u. not ryDliobl. lo ftir rrole1
<br />I diry rur I hrvc rad 0ti! .pplic.lion hd sltL th{ rh. rbovc inform io. ir otrd I !8rc 6 comply *irh .lt Cny r l Coomy
<br />ilding @aIrucriorl $d hq.by iulnori& rc9r6.ntlriE of rhn Chy snd Coury ro d.r !!on fi.
<br />1-c: 7 o.)/^
<br />UNDER GROUND
<br />Waste & Vent
<br />Gas-Underfloor
<br />Building Sewer
<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 />Meter Release
<br />FINAL ln rr[z /llt/n h 71
<br />Notes, Remarks, Etc.
<br />PLUMBING-INSPECTOR RECORD
<br />MlwP5'l\P6rmrl-hsp€cton Forms\Plumbino,l.sp€ctor Rocord doc 03 31 06
<br />Water-Underfloor
<br />Area/Storm Drain
<br />Final Gas Test
<br />*,"SLrs"!z-
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