|
APPROVALS DATE COMMENTS
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Underfloor
<br />Gas-Underfloor
<br />Buildin 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 />POOUSPA
<br />Ptrap/Drain Line
<br />Main Drain/Pool Piping
<br />Fill Line/Back Flow
<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
<br />Meter Release
<br />/lzlZzFINAL{/tt lrv
<br />Notes, Remarks, Etc 7
<br />OMa-Buildq DdLarion
<br />I hs.by lftm uadd p. lty ot psjuy th.t I M q.opt forD th. CoMclB' Li..nr. t { for lt followins r.&n (s 7031 , Bqi.6r
<br />!4d Prof..io. Codc): Aly Cny ot Cou,ny *,iiicn .Gqoi6 . pdnir ro @tg@.{ rh.i, inprovq .Lmlilh or r.p.i. uy strucruc pnor ;
<br />i$urne,.bo r.qrt6 0'c tpplh.nr fo, ru.l psh to6Lrsigr.drnt@ rhIh.o.5h. i! li..6.d pc6at ro rll. ploviliod of de
<br />Conmdof' Lietu d Lru (ch|plq 9, Coilltll@ils *irh Serion 7000 of Divbion I of $. BqiGs.nd ProresbE Cod.) o! l!.r hc or
<br />3h. ir q.apr thqctoo lnd dE b!!i! for lII. !ll.g.d qcsption Aly vioLtion ofs6r6n 7O3l.5 by hy.pplidnt for I p.@iGubl!.r5 Uc
<br />.ppli..nr ro . cilit p.Ehy of nor mr! du nv. h!.drod dolL6 (I5OO).
<br />_.1.soMdol|hcpopsry,ormy.nploy6wirhM86$.ncir.ol.tud!.Mdon,w'lldoth.wo..drlEtrldu.nmtinrc.d.d
<br />or otr Ed lor !rl. ( S€ 70.14, Bul6 lrd Prof.srbnr Codq Tn Corhdoli Lr@M tlw.loa nol rpply to uoqM ofrhc Eop.ly
<br />stF brild! or ihprovq Oa6q &d wlD do6 ru.ll eo,k hi@lf o. bssllor drouSl h! or h.r oM 6ployG, providcd fiI sEh
<br />mp.oEnmrs.r. nd i.cnn.d or otrd.d for qla If, howola, U! b{ildii8 ot inproEn l3old witrn on. yd of@hplexo4 rhc
<br />O*M-Build6 sill n E rh. bud.n of provi.g rhrl h. or !h. nor build o. inprcv. for rh. purpoF of$|.)
<br />co r.ct for luch pojeE *!th . conhcto(, licn.d puEu ro fi.
<br />_l m.x.mpt u.dq Satbn-B
<br />7-1 -br7 o*.
<br />I h.r.by !fiirm lndcr p.rhy of poj!ry ooc ofrh. lollo*its delrdioE
<br />_l hrv. .id will dinlin . Carifiol oI Coent r. S.lf-lBur. for rcrk4s' @op.uiio\ s provB.d for by S..l6n 1700 oflh.
<br />Llbor Cod., for $. p€foo@ ot dtc wo 60. *,lichdB Dcnh n &u.d
<br />_I h.vc&d will mi.r.in wort.6' oipcMrion in !rnc. u r.qun.d by Sdton lro0 ofdE L.bor C.d., lor rh. Frfom.@ of rlE
<br />wodi for which thn p.m i3 ilsud My worl.6' compctu.rion iGrrna qris ud policy numbo &
<br />qL13'?-t3 t-l-tq
<br />(Th,s sdbn n..d not b.6mpl.t d rfrh.pdmn E iorOru hundr.ddolhs (1100| or le$)
<br />I cdr& thl rn th. p.rrormne orrh. sort for vn'.h $B pdm't E
<br />'sucd,
<br />I rh.ll .or mDloy iny p.6on rn lDy manns so.i to
<br />b.emc llbjel ro th. e.kd! @6p.eron hw. ofc.lifor.n, &d u,e thlr
<br />co6*.s!i6n .rovB,6B ofS.drn l70o ollh.
<br />*.,. z<'z.z
<br />W RNING Frilur. !o 3aur. wod6, @op.etioi coldg. i! uhwtul, hd !h!ll 3ubjdt u dploy.r ro dihinrl p.Mhi$ .nd civil
<br />fin6 !p to oe hud.cd rhoud dolLr. (iloo,om),ii .ddnion lo rnc 6n of @hp.erill\ dttugB a provd.d for fi. Sdion 30?6 of
<br />thc L.bor CorL, inr.r6r .nd .nom.y s ia
<br />LICENSf,D CONTf,AC'IORS DECLARATION
<br />I b.t ny lffm lndd pdlty of pajuy rllr I h lienk! uns pmvirioD ofctuFs I (6mn .citrg eirh Sction ,0oo) ol Divi5io. I ol
<br />$c Bsin6! lnd ProfdsioN Cod., .nd oy liccG. i! in tull for@ &d !f,et
<br />CONSTRT'CTION I,ENDIN(i AGENCY
<br />I hEeby nrm unds pcBhy of pc4ury that !hs. is r os.rudioi hndiig rBdcy for th. p.rfo@n& of rhe work lor vhoh th6 pcrmn it
<br />issu.d(S.c 3097, Crv C )
<br />APPLICANT'S DECI-AI TION
<br />D.hohion Pdnilr-Alt4ror Notifiqtion F.dol R.Sulrtiolr Onb aO, P.n 6)
<br />R.qun d l-.ns oa Notifioliotr
<br />I c.nify d6l lh. f.n.rl r.sul.tioN ,.8.rdin8 ..b6ro, r6oEl Ar. @t .ppli..bl. lo di! prorcr
<br />_ I 6try th.r I h.vc rqd thi5 lpplic.tion ed rt!r. thtr ln. !to* iafomrion is cotrd I .gra ro @mpry wnh rll Cny rnil Cou.ty
<br />ordinrncd.trd SLl. t ws rchdnS to bui iol\ lnd h...b, luhorE. reprB.nllliv.s of $is Cny rnd Couly ro ener upoo tlr
<br />!bov. m.nrioo.d prop.ny
<br />CJV
<br />PLUMBINIS.INSPECTOR RECORD I
<br />l'4
<br />ID/SIG.
<br />Pool Heater/Gas Line
<br />I, 6 ohd of rh. prop.ny, .h dclusiv.ly orhding wnn lie6.d @.t .dos ro @Bll!(t rlE p(oj{r ( S.c 7044. Bsinds .nd r
<br />PofBor Cod.: T6. Confidolt Li@ns. tiw .loq n6! apply to a og@ of popory ,ho build or ihDroc thscon , ..d uho
<br />l'"*..'.,' BA- - Lan,.,\umbd- 2o?flo
<br />h,,. z'-? zpts- c*,-.- ?Lrlnlzorc co"r sr|.r.:4icxr-..,
<br />""" 7:9:291<
|