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PLUMB!NG.INSPECTOR REGORD APPROVALS DATE ID/SIG.COMMENTS UNDER GROUND Waste & Vent 711-?t brrof {z Water-Under floor ?-lq e ll Wdlu Gas-Underfloor '?-14-Ll offil 4> Buildinq Sewer Area/Storm Drain I nterceptor/ Clarifier TOP OUT Waste & Vent 1 -l'l -?l rxcrlY {v Water Piping )- lrl -2r ,Dderf .la Gas Piping 7- l"l -U rrrtf?W Roof Drain Tub/Shower Test Rouqh Water Heater POOL/SPA P-trap/Drain Line Main Drain/Pool Pipinq Fill Line/Back FIow Pool Heater/Gas Line Miscellaneous Gas Service Water Service Lawn Sprinkler Sanitary SewerlCao Back FIow Device Rough Plumbing Final Gas Test Meter Release FINAL io- l.l-1-l lur@i) Notes, Remarks, Etc. It o\!'NItR lluIl,l)liR t hmby alfim undc paalty of pdjury thd I m qmpt ftom thc CootretoE' Licw Law for thc foloving r@n (5â‚¬.7031.5 Buias and hofcssion Codc): Aoy City or County which roquic a pcmit to onstruci. alts, improvc dcoolish or rcpah my suucluc, prior to its issuecc also rcquiB $c eplicet for such pcmit to filc a sigtrcd stdffit thd hc or shc b licâ‚¬rBcd pwattr to thc prcvisioB of the Contretor'3 Liccnscd kw (Chapt6 9, Comocing with Setiotr 7000 of Divisbn 3 of thc Buine md Profsions Codc) or that hc or shc is dmpt thft&om ed thc b6sis for thc allcgcd cxmption. Ary violatior of Sctbn ?03 L5 by uy ' applimt for a pamit subjGrs thc 8pplicut to ! civil pculty of rct mrc thu ,ivc hundrcd doll6 (3500). -1, as owner of the property, or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec.7044, Business and hofessions Code: The Contraclor's License Law does not apply to an owncr of thc propcrty who hilds or improvcs thcroru and who docs such work himself or hcrself or through his or her own cmployees, provided that such improvonorts arc not intended orofftrcd for salc. I( howqrcr. the building or impr,ovonent is sold wilhin one )er of complaion, the Orrner Builder will have thc hrdcn of pnoving tha he or she did not build or irnprove thc p,roperty for the purposc of sale). _1, 8s owner of the Fopâ‚¬rty, am exclusively contracling with licersed contractors to construct the project (Sec. 7044, Btsincss ard Pr,ofcssion Code: Thc Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projccts with a Contractor(s) licemcd pursuant to the Contractor's Liccnsc Law). -l am exempt undcr B. & P.C. for this ,n",f,b^ LY- 2 | I hereby affrrm under pcnalty of pcrjury one of the following -I have ard will maintain a Certificatc of Conscnt to Self-lnsure for workcrs' compcnsation, as povided for by Section 3700 of the Labor Codc, forthe performance ofthe work for which the permit is issued. -I have and will maintain workers' compensation insurance, as required by Secrion 3700 of the labor Codc, for the pcrformance of the work for which this pcrmil is issuod" My workcrs' compensation insurancc carrier and policy numbcr are: Policy Numbcr: Expires: -l certi& that in the performance of the work for which this permit is issued, I shall not cmploy any pcrson in any manner so as to bccome subject to the wortetrs' compensation laws of California, and agree that if I should bocome subject to thc workers' compensation provisions of Section 3700 of the kbor Code I shall, forthwith comply with thosc provisions.. c WARNING: Failure to sccure workers' compensation is unlawful, and shall subject an anployer to criminal penalties and civil frnes up to one hundred thousand dollan addition to the cost of damages as provided for the altorney's I hereby affrm under pcnalty of perjury that I am licenscd 9 (commcncing with Scc-tion 7000) of Division 3 of the Business and Professions Code, and my licensc is in full forcc and effect. License Class: Liccnse Numbcr: I)rr t o' CONSTRUCTION LENDING AGENCY I hmby affm under Fmlty of pgjury thd th@ b 8 @nstNciion kodiry agacy for thc pcfomcc of rhc mrk 6r which thir Fmit b issued (Sc. 3097, Civ. C.). knd6's Nme: - l,cnder's Address: APPLICANT DECLAIIATION I hoeb,y affirm under penalty of pcrjury one of the following declarations: Demolition Permits-Asbcstos Notification Federal Regulations (Title 40, Parr6) -Rcquired Letter of Notification _l ccrti& that the fcderal regulatioru rcgarding asbestos removal are not applicable to this project. _l certi& that I have read this application and state that the information is correct. I agroe to City and County ordinances and State laws relating enter the above mentioned propcrty for tApplicant or Agent Permitee authorize representat ivcs to upon d t /