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PLUMBING-INSPECTOR RECORD <br />COMMENTSAPPROVALSDATEID/SIG. <br />UNDER GROUND <br />Waste & Vent <br />Water-Under floor <br />Gas-Underfloor <br />Buildinq Sewer <br />Area./Storm Drain <br />lnterceptor/ Clarif ier <br />TOP OUT <br />Waste & Vent <br />Water Pipinq <br />Gas Pipino <br />Roof Drain <br />Rouoh Water Heater <br />POOL/SPA <br />P-trap/Drain Line <br />Main 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 />Back Flow Device <br />Rouqh Plumbinq <br />Final Gas Test <br />Meter Release <br />e-4-/8 -UJila,-rfi\FINAL <br />Notes, Remarks, Etc. <br />OWNER BUILDER DELCARATION <br />I hcrchy .frm u.dd !.mlly of lEiury lhal I d cr.nfl ftnn lhc Contraclos Laur Llw for thc lollowirg E3$n (Scc.7031 .5 <br />Busincsr and P,or.ssh, Codc): Any Cily or Counry vnich Enrncs a Fnni, lo onsrucl. !16. inD.ove .Lmli\fi or qen {v <br />.rructurc. prn. ro irs issuaN. ale rcluiEs lh. lpplicanl for s!.h Fmlt b 6h a si8lEd sla|ce lhtrl lE or slE is lieri.d plNml <br />ro rhc Dmvhio$ of dE Conketols Lhcn$d Llw (Ctupln 9, Comfttuing wiri Scclion ?000 ol Divi.ion 3 of lhc Bulincsq ed <br />Prcfcsiio.s Codc) or thll h.orstE n cxcmB Eenon{d lnc bast forllE dL8.d crctrglion Anv viohlion of SNlioo 703I 5 bv ov <br />,ppli.ant for a pennir sobirF rh. aplli..nl lo a ciril lcnsll, oa nor mE rhq firc huldcd doli*s {1500). <br />La{.trmroirMprcp.nr-,ornUchfl(iyc.\si,Isr!.\r\rhrnv,h.m|ttr$rion.*Jldorltsork!ft1rhcitur!(nmt <br />iflrcndcd oroilcrcd fff {lc (sc..7(}rl.llusi'rc\\ od fi(,ri\iodi C.dc lhcConrrcnr'\ Li..n\c l-nq nocs nol rnllv tu an o*nc! of <br />rhc FTcny *ho l{illl{ or irllrrns rhcrdrt. klsho&.sn(hqod(hinxcltorhcr{llorrhnn'3hhnorhcr.*trcn{!'vcc\. <br />rror cd rl,,r tu.n i'll|rtuvoEnk m 'xn inrcnddl or ofltul tur *'h. ll ho\rc\.., rlf, tnriklnlg or rnFov.nrnr is c'kl *irhin om ]t:n <br />oicotrDbri{,n. rh. Oskr ltuiklcr villhn{ rhc htrd.tr of lrnrihg rhd hc q \hc did ftn build or n\norc rhc rn)F-dy f(n rh: purlxE ol <br />t.i\.McrollhcIn)pcny,atcx.lu\ivclycoolr.rir,S*irIliccd\rd.oki.ld\n).onntu.rrhctn']ccrrScc7ur48tri"'* <br />{kl h.f.si Cddc lhcConrrocroi\l-ic.trsc l-r*d.cr tror unrilykr snoRn.r olpii,Dcnywho builJ\ or nnPnrvcs rlrr.oi <br />prcj.ch rith u Conlr{ck(r) liccn*d puisuanl lo thc Conr!.r.t <br />D &P <br />I hceby nrrm undcr p.mltyol <br />-l <br />h,E .rd will mi.rai! a C.ni6c0l. ol Con*nl to S.lalns@ ftr sort6C onpcnlllion rc l,6vii.d for <br />trhor Codc for tlrc pcrflJmm of llE mrt for *nich llE pdhil ir isucd. <br />-l <br />hsE lnd will mainlti. *.rt6 coqrcnsdion iBuEtc. 6 t.quiEd by Selion 1700 of lh. t bot Corle. for llE p.rf'mnm of <br />rtE wort fo. whi.h rh,! Fmil is LssEd. M, *0116 @mp.ndio. insumc @i* .ri potiy nunbd @: <br />P,'liN Nr $.i <br />-ExPncr <br />-l <br />ccnity rhat in tl' Frfo.nEmc ofthc *orl for which thh Pdmit is isslcd. I rhru mr e.ploy any pc6on in inv mnrcr <br />$ ar ro b.ro@ subt{l lo llr worters ompen$lhn lres oaclliaomia. od ,88 tnd if t should lE om subFl lo rlt <br />worlc6'comFnstionpmvisionsolScctionlro0ofth.LihorCode,lilull.lonhunhcomplyenhlhospmltions.. <br />WARNING fiilurc t *!r. workcrs coml[nsrt mvcrlrc n u lduful. ond shlll subit.r ofl cnrtlo)s ro oin]in0l lEmhts <br />onc hundrcJ rhusrnd dollus in addnion lo thc cosl of on{Enrarion.x <br />I hcEb, afaun und.r pcnully of pcrjury M li!f,scd undd po$ion ofch.pl6 9 {comdeinB wi,h Selion <br />of thc Blsitusr and Pofc$ions Codc. ,td my lkctr{ k in tull fore ud crccr <br />CONSTRIICTloN I ENDING AEFN(]Y <br />I hceb, imrn uod( r.nnnyorF_tjury rhBl rht,c ir I c.trerudiotr Lndins arcey lor rhc pcrlonun.c ofrh. *ork ior ltlich'hi\ p'rmil is <br />issucd (Scc. :1097. Civ C ). <br />L "lc' <br />1 Arl'h-'- <br />APPI ICANT DECLAqATION <br />I nolbystrmhdd lenshy ofp.rjuryonc ofthc folbeing d.cla ions: <br />D.mlilion Pcrmik Arbcsrd Noriicarior Fcdctul Rc8ulari.N (Tirlc 40. Parr6) <br />-Rcquircd <br />Lcrrf of Noriucar0n <br />a/L-b <br />Tub/Shower Test <br />t|, <br />Nunb.ri <br />- <br />lri,l., .\'ii' <br />-