Laserfiche WebLink
PLUMBING.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWilER BUILDER DEI,CARATION <br />I hmby affm undo parahy of pojury thar t m qmpt &om thc Contraclon' Licry [:w for tbc followhg ren (Sc.7031.5 <br />Buinas ed Profesion Corlc): Any City or County which rcquiro a pcmit to ooltruct, altc, imprcvc danolish or rcpair uy <br />structurgprbrtoits issmcc,alsorcquiuthcqplimtforsuchFrmiltofilcssigncdstatmat thallEorshcblicascd pumat <br />to thc prcvbioa of thc Contnctor's Liccnsod Lrw (Chapta 9. Comming with Sctiotr 7000 of Divisba 3 of thc BBire ud <br />Profsiom Co&) or that hc or shc b qmF thsc&om ud thc bais for thc .llcgcd qadion. Any violaioa of Sctbo 703 I .5 b,y ey <br />applicut for a pamit subjct thc appli@t to 8 civil pcodty of mt mrc the fivc hudrod dolln (3500). <br />-1, <br />I om6 of thc prcpaty, or my mplole with wsg6 I thch $lc @mpcnsarion. wil do thc wort ed 0E stnElrc i! rct <br />inrsdcd or offcrcd for sle (Sc.7044. Buire md Pr.ofeiou Codei Thc Conllelor's Licre lrw doq mt eply to I om6 of <br />thc propqty who buil& or iryroE thspn ad who dos uclr mrt hiruclf or helf or thrcugh hi! fi h6 om mplo)€rc <br />ppvidcd tlul $ch imprcvcncas rc rct intodod q oftrd br sk lf, how, thc hrildiry or inprowmt ic old withir m )6 <br />of onplebn, th. OlvE Buikta vill harc tli hdo of poviog dra hc or shc dil not hrib or irryorc thc popqty br thc prpqc of <br />sh). <br />-1, <br />ns owner of the prop€rty. arn exclusively contracting with licensed to construct the projcct (Sec. 7044. Buiness <br />builds or improvcs ther@n.and Pnofession Codc: The Contraclor's License Law docs not of proffiy who <br />and who contracts for such projects with a Contracto(s)to the Contractor's License l-aw). <br />_l am exempt undcr B.reason. <br />\ <br />I hereby affrm undcr penalty of pcrjury one <br />-l <br />have and will maintain a Centificate of Consent r for workers' compcosdion, as providod for by Soction 3700 of the <br />b issued.Labor Code, for the pcrformancc of thc work for which the <br />_l have and will maintain workeni' compcruiation insurance, as requircd by Section 3700 of the Labor Code. for the pcrformance of <br />the work for which this permit is issued My workcrs' compensation insurancc carrier and policy numh are: <br />Policy Number: Expires: <br />-l <br />certi& that in the performance of the work for which this permit is issued, I shaff not ernploy any person in any manner <br />if I should become subject to the <br />comply wilh those provisions.. . <br />U <br />a <br />so asto become subject to the workers'comp€nsation laws of California, and <br />workers' compcnsation provisions of Seclion 3700 of the l-abor Code <br />WARNING: Failure to secure workers' <br />civil frnes up to one hundred thousand <br />and shall subject an cmployer to crirninal panalties and <br />to the cost of compensation, damages as provided for the <br />I hereby affinn under penalty of perjury that I am of Chapter 9 (commencing with Section 7000) of Division 3 <br />of the Business and Professions Code, and my license is in and effect. <br />License Class: Liceuse Numbcr: <br />l)oto' <br />I <br />W <br />I hwby affm uda pdBlty of pGjury thar th@ b s mnstrucriotr lcoding agocy for thc pqfomcc of thc mrl fur which this Fmit b <br />isucd (Sc. 3097. Civ. C.). <br />Lender's Name: <br />[.cndcr's Address: <br />APPLIqdNT DECLARATION <br />I herl*,yaffirm undcr pcnalty of perjury one of the following declarations: <br />Dcmo lit ion Permits- Asbcstos Noti licat ion Federal Regulat ions Part6) <br />-Required <br />lSter of Notification <br />-her,iry <br />that the fcderal regulations are not applicable to this project. <br />thc <br />above mentioned property for <br />Applicant or Agent <br />Permitee name <br />to <br />*,", dTfll <br />UNDER GROUND <br />Waste & Vent <br />Water-Under floor <br />Gas-Underfloor <br />Buildinq Sewer <br />ArealStorm Drain <br />I nterceptor/ Clarifier <br />TOP OUT <br />Waste & Vent <br />Water Pipins <br />Gas Piping <br />Roof Drain <br />Tub/Shower Test <br />Rough Water Heater <br />POOL/SPA <br />P-trap/Drain Line <br />Main Drain/Pool Pipinq <br />Fill Line/Back Flow <br />Pool Heater/Gas Line <br />Miscellaneous <br />Gas Service <br />Water Service <br />Lawn Sprinkler <br />Sanitary SewerlCap <br />Back FIow Device <br />Rough Plumbing <br />Fina! Gas Test ,A-tl q <br />Meter Release - llr4 ,?A WD * <br />F!NAL 7r -I,/Tt tT C ,1 dL/ <br />NotBs,, Remarks, Etq.I I <br />^,1 ?./rrKlzt(il-f-D*>x /lr I <br />Carrier:- <br />Section 3076 Labor Code intercst and <br />-t