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PLUMBING-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDEB DELCARATION <br />t h.rcby rfiirm undd pcnalry ol Friury th,l I cr.npr fmm llE Conlnclfi Lkds Lrs for rhe following lmn (Sc{.?011.5 <br />ausincas i Pmfcsio. Cod.): Any Chy or Coonty which eqlircs a tEmir ro @6lrucr. 3lle. improvc, dctulish or Epon uy <br />srtuduE, prior to irs h$!ne. llro rcquier rhc appli.er fo. euch p.mjt b nh a siSmd sIat m lhll he or sla ir liccm.d ,rlrMl <br />ro rlE tmvisions ofdE Conrabls Lic.nsd Law (Chafler 9. Commemi.g qlh Scclioo 7000 of Division 3 of lhe Busi..ss and <br />PBLsiom C.dc) or lhlr lE or shc is crcq,l rhcrcfroh utrd rhc b6si$ for rhc alh8cn cxcmplion. Any liolationofSelion 7011,5 by Nny <br />apdiclnr fo! s Fmil subiEk rh. appli.a.t ro . cival le.rlly of mr mr. lhs 6vc nun<lr.d dollss ($$O). <br />-1. <br />6 owBr of rh. pilFny. n my cnploJrts enh wag.s &1 rlrn $b onp.Mrb.. wi[.h lh. *ori en 0E nriEi! mt <br />inrcrded or offer.t for sk (Sc.7044. BuilE$ ed ProL$ions C6dq Tnc Contnclor's LixnF Ll* do.s nor tppl, lo .n oeM of <br />rh. Frpdiy wlb buiu! m i,proG tlEra sld *ho d6 skn eri hi@lf or heslf or thmu8n nis or hcr o*n ctDk'rtB. <br />pmvid.d rh,r slch impovmnts 4 ml i"l.n&d tr ofeld for sk. If. lD*cwr. tlE boildiiS or itrqrcEr ix mh withii .m ,* <br />ofsIpkrb( rh. O*d Blitkr eill lEr d! h!dc. oflreviiB $d lr o, llE dn d hoild d iryroE tlE PotEly for tlE pEpos of <br />-t, <br />as owmr ofrh. tmpcny. M cx.lusit.ly .o.hlin8 wilh lian*d conlrrclos ro onslo.r llt lolrr (se 7044. Busirc$ <br />!d PrDf.sh. tu : Tnc Conrmror\ Liccne ti* dds er lrnly ro m own.r of rropcny wlF builds or inpovcs ln4.er. <br />rnd aho conrdcls for such pmFts wilh a ConlEdo(s) lkcnsd luBunl lo llt Conrador's Licens t w). <br />-l <br />u6crcnpt undcr Sccr B & P.C.lorrhh rcaso!. <br />woR(Ells' con'TPFNSAT(rN <br />DECI.AEAIION <br />I hcrcby alfim unds ,Enrly or psrury onc of th. following &.I!olions: <br />thrv.u trilltruiNrinrCcnlncalcolConscnrn'scllli{rcfrtr*.rkcnoNli$sllion.tspovitlcdlrbys..rnr]ToOoirhc <br />trb(tr Cod.. ntrrhc pcrtu niNc olrhc trolk ntr whi.hlheI,ennir is h\ucd <br />-l havc and will mainrain wortc^ cohp..sdtion nsrancc, ns rcquncd try Sd ion ITOO 6f rh. Labor codc. ror thc ncrlbrroncc of <br />rhc qo& lor which fiis lcmir is iscd My ' .onFnerbn insumre cdis 341lblky nrnher dcl <br />I Lrnirt th,r ir rhc l).rformmc of lhc wort lor which lhh pcrmi! is irsucd.l shall nor cn?loy lny lcson in an, n!.nd <br />$ as ro bcrom suhject to th. @,1c6 .5n{Enselion lNwr of C.lir.mia. und rEN that it I sholld lt@m sub}st b ltE <br />No*ol compcnstion rmvixi6.. of Scdion l7l)o ol lhc bhor Codc, t shlll. fonhwith .omply qnh rh.c povisions.. <br />i{ARNN(; F,ilurc b s.urc w(nkcn compcnsnrn'n rcEsc is unlu$tu|. and shrll subrccl M cmplorcr lo dinn.al FElrax dft] <br />.ivit nncs ut ro oe hundr.d lhousa.d douau ($l 100). io (ldirion ro $c .o( of sn{ENlion. dlmgcs ds p&*lcd fo, {he <br />DECIIIEAIIIIN <br />I hdrcby afii,nxndcr !).nrlryoifclury rhd I om liensd undq rreri\ionofChapr( 9 (cor,ftncins *irh Sr..lion 7000) otDilhion:l <br />ol rhc Bulirc$ lnd Pofcs\ionr Codc. aJr! nry li..nsc G i6 rnll foa crG(l <br />(lJISrnI]!rcNlJll2INCrlgEI(} <br />i\\ucn rs.d 1r)r)7 ('iv ( l <br /> PPI.!(]ANT DF(II AR,\TIoN <br />I hcrohy dlinn undrr pcnrlly.tperjury oi. or rhc rolk,\ i'rt dc.ldari,,n!: <br />D.nhlirn Pcrmir(.,^\h.nosNolilic$n,n kd.rrl RcBu[tionsllnlc10. Pxn6) <br />Rcqun.d Lorr.rof Noriiolitrr <br />_l cenify ttut rhe fcdcra! rcgnhiio.s rcgarding dstBror rcmval m mt ,oplicahlc lo tht t'oj.{. <br />I.dify!h l hNc r.ld rht aprltation and sr.te lhal thc rbtr infomrio. h.ond I agu lo 6mply vnh i[ Ciry lnd Couniy <br />odin0N.s .nd strlc t *s Ebring ro hlildins .oosrtudion. ud hcEh, authoriz EpEsnt{rivcs ol lhh Cily and Colnrr l. .ntc. upon rh. <br />rh.\r .r nl ion.d ,n,p.dy for <br />Apnli.bnl or r\Aenl Si(n l <br />I tw?1/\) <br />/4tt <br />UNDER GROUND 1\ <br />Waste & Vent g'79-lK h.\+7b <br />Water-Under lloor <br />Gas-Underfloor <br />Buildinq Sewer <br />Area/Storm Drain <br />lnterceptori Clarif ier <br />TOP OUT <br />Waste & Vent <br />Water Pipinq <br />Gas Piping <br />Rool Drain <br />Tub/Shower Test <br />Rouoh Water Heater <br />POOL/SPA <br />P-trap/Drain Line <br />Ivlain Drain/Pool Pipino <br />Fill Line/Back Flow <br />Pool Heater/Gas Line <br />Miscellaneous <br />Gas Service <br />Water Service <br />Lawn Sprinkler <br />Sanitary Sewer/Cap <br />Rouqh Plumbing y-zslV <br />Final Gas Test K'zt-lY <br />FINAL 1-t7-ls <br />Notes, Remarks, Etc. <br />Back Flow Device <br />Meler Release <br />'tv\t