Laserfiche WebLink
PLUMB! NG.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS <br />UNDER GROUND <br />Waste & Vent <br />Water-Under floor <br />Gas-Underfloor <br />Building Sewer <br />ArealStorm Drain <br />I nterceptor/ Cla rifier <br />TOP OUT <br />Waste & Vent <br />Water Pipinq <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 Piping <br />Fill Line/Back FIow <br />Pool Heater/Gas Line <br />Miscellaneous <br />Gas Service <br />Water Service <br />Lawn Sprinkler <br />Sanitary SewerlCap <br />Back FIow Device <br />Roush Plumbins <br />Final Gas Test <br />Meter Release -,/ /lt /2aMoFINAL5fi4/N (Wa <br />Notes, Remarks, Etc.I <br />OWNER BUTLI'ER DELCANATTON g <br />t hacby affm undo pcnalty of pojury thal I m qmpt tom thr ContractoB' Licm t:w for thc following tq$n (Sc.7031.5 <br />Bsin6s atd Prcfeion Codc): Any City or County which rcquim a pcmil to @rdruct. alts, imFovq (bnolist or Epair m/ <br />structurq Fior to its isureq slso rcquiG thc spplkmt br such Fmit to filc s signcd std@ot tha hc or drc ir licqucd plmarn <br />to thc FovisioB of thc Contr8ctor's Licmscd t w (C-h8pt6 9, Comacbg with Sction 7000 of Division 3 of thc BNitrs md <br />Prcfasioro Codc) or that he or shc b qcmpt ths.from ud thc basis for thc allcgcd qmption. Any violation of Setion 7031.5 by uy <br />applican for a pcmit subjtrts thc applicot to a civil pcnalty of not morc thu fivc hun&cd dollus ($500). <br />_1. 0s owner of the property, or my employccs with wages as their sole compensation, will do the work and the structwe is not <br />intended or offered for sale (Sec.7M4. Business and hofessions Code: The Contractor's Liccnse [^aw does not apply to an owner of <br />thc propcrty who builds or imp,rove thereon, and who docs such work himself or herself or through his or her own cmployces, <br />provided that such improvanents are not intended or offcned for sale. I(, howel/er. the building or improvcment is soH within one ),tar <br />of compleion, the Orvner Builder will have the hrden of poving ttra he or she did not build or improve the propcrty for the purposeof <br />sah). <br />-1. <br />as o$mer of the prop€rty. am exclusively contracting with licensed contraclors to construct the project (Sec. 7044. Buiness <br />and Pr,oftssbn Code: The Contraclor's License Law does not apply to an owner of property who builds or improvcs thereon, <br />and who contracls for such pnojecrs with a Contracto(s) licaued pursuant to the Contractor's Liccnsc l-aw). <br />-l <br />am exempt under Section-. B. & P.C. for this reason. <br />O*ner' <br />WORIGRS' COM'ENSAT <br />DECLARATION <br />I h@by affm under pcnalty of po'jury onc of thc following dcluatioro: <br />-l <br />havc md will rointain 8 Ccrtificatc of CoMt to SclfJEurc for workc'compqsation, c povidcd for bySetion 3700 of thc <br />tabor Codc for thc pcforocc of thc wo* for shich thc psmit b issucd. <br />y'A t mrc ua *itt maintain work6' compcmation i6uracc, I rcquircd by Sction 37OO of thc lrbor Codq for thc psbmecc of <br />th. srk for which thb pcrrnit is issucd. My workc' compcnsaion immcc mia ad policy numbo rc: <br />z q <br />s,1, <br />poricy *"^*,UlCUb 6 9O9€ctl Expires:ZI <br />drcertiff that in the performance of the work for which this permit is issued. I shall not employ any person in any manner <br />so as to become subject to the worlccrs' compensation laws of California, and agree that if I should become subject lo the <br />workers' compensation provisions of Section 3700 of the Labor Code, I shall, forthwith comply with those provisions.. <br />WARNING: Failure to sccure workers' compensation coverage is unlawful. and shall subject an ernploy€r to criminal pcnahies <br />civil fines up to one hundred thousand dollars (3100.000), in addition to the cost of compensation, damages as provided for <br />Section 3076 of the tabor Code intercst and attorney's fees. <br />o*", tt 19(ZoZO <br />DEC'I ^ RATION <br />I hereby affirm under pcnalty of perjury that I am licensed under provision of Chapter 9 (commencing rvith Scction 7000) of Division 3 <br />of the Business and Professions Code, and my license is in full force and effect. <br />?TtoctC <br />and <br />the <br />(hf,. <br />Liccnse Nurnbcr: <br />ort", t I (9lZsl-o contrecto t Fw/t furlravtcrfr **fr ilavi nt <br />W <br />I hcby affirn unda paalty of pqjury thd th@ b I @ostructbr lcodirg agacy for thc psfomc of thc mrL br which this pqnit ir <br />isucd (Se. 3097. Civ. C.). <br />lrnder's Name: <br />lcnder's Address: <br />APPLICAIIT DEC LARATION <br />I herebyatrnn undcr penalty of pcrjury one of the following declarations: <br />Dcmolition Permils-Asbcstos Notification Fodcral Regulations (Tille 40. Part6) <br />- <br />Required lrtter o f Notifi cation <br />-l <br />csrify rhar thc ftdgal ruaulatioro rqrding ubctos moval rc not eplicablc to this projEl. <br />ktt cariry tmr t Urc rad this rpplication ,td ststc thd thc abovc infomdion is coner. I agre to @mply with all chy ud coury <br />ordimcB and Statc Law Glaritrg to building corgruction md hftby authorizc rcprsmrivc of this City ed County to atc ulDn thc <br />above mentioned property for inspeclion purposes. <br />,,r", n(i(ZtlsApplicnnt or Agent <br />Permitee nRme <br />Drte:_