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PLUM BING.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS <br />UNDER GROUND I <br />Waste & Vent 7/lzzz/4 <br />Water-Under floor I (v -v <br />Gas-Underfloor <br />Building Sewer <br />Area/Storm Drain <br />I nterceptor/ Cla rifier <br />TOP OUT <br />Waste & Vent <br />Water Piping <br />Gas Piping <br />Roof Drain <br />Tub/Shower Test <br />Rough Water Heater <br />POOUSPA <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 Flow Device <br />Rough Plumbing <br />Final Gas Test <br />Meter Release <br />xfl#(FINAL 1,0*q'-A \ <br />Remarks Etc. <br />Io <br />I hcrcby allirm undcr pmlty of pajury thrt I m qcmpt frcm thc Coilr.ctoE' LicGre Law for thc followinS Een (SG.7031.5 <br />Busincss and Pmfcssion Code): Any City or Couny which rcluircs r Fmit to @ndruct. slt6, impmrc, &mlbh or quL sy <br />stnrcluc. Irbr to il3 issreq sho EquiG thc applicmt for sch Jrmit to filc 8 signEd statclmt that h. or shc h lictrsd puMot <br />to thc prcvisioB of th. Coilretc'3 Licn3cd Lrw (Chsptr 9, Comrcing wilh Sation 7fi)0 of Divhion I of thc Burincs and <br />PmfcsionsCodc)orthathcorrhchcxcmptthtrcfrom8rdthcb6qisforthccllc8f,dcxctrrption. Anyvioloiionofs6{ion703l.5by8ny <br />applicant for a pcmit sbjcts thc .pplient to I civil peEltyof mt mE thao fivc hudrr{ rlollm ($5(x)). <br />-1, <br />rs owner of the propeny, or my emplolrces with wages as their sole compensation, willdo the work and the structure lq rnt <br />intended oroffered for sale (Sec.7(X4, Business and Pmfessions Code: 'l'he Contractor's License Law does not apply to an owner of <br />the progrerty who builds or improves thermn, and wtrl does ruch work himself or herself or through his or her own employees, <br />provided that such impmvements are not intended oroffered for sale. l[, tnwever, the building or inprovement is sold within one ]€ar <br />of completion, the Owner Builder will have the burden of proving that he or she did ncrt build or improrr the property for the purynse of <br />sale). <br />-1, <br />as owner of the property, am exclusively contracting with licensed contraclors to construct the pmject (Sec. 7M4, Business <br />and Professbn Code: 'l'he Contractor's License Law does not apply to an owner of property who builds or imprnves thereron, <br />and who crntracts for such pmjects with a pursuant to lhe Contractor's License Law). <br />_l am exempt under .C. for this reason. <br />s s\- <br />I hereby affirm under penalty of perjury one of the following <br />-l <br />have and will maintain a Certificate of Consent to Self-lnsure for workers' conrpensation, as <br />Labor Code, for the performance of the work for which the permit ls issued. <br />Scctiorr .17(X) o l' tlre <br />-l <br />have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the perfornrance of <br />the work for which this permit is issued. My workers' compensation insurance canier and plicy number are: <br />Policy Number: Expires: <br />-l <br />certi& that in the performance of the work for which this Jrcrmit is issued, I shall not employ any penion in any manner <br />so as to become subject to the workers'compensation laws of California, and agree that if I should become subject to the <br />workers' compensation pmvisions of Section 37fi) of the Latnr Code, I shall, forthwith comply with ttnse pmvisions.. <br />WARNIN(I: l;ailure lo secure workers' <br />civil fines up to one hundred thousand <br />and shall subject an to criminal Jrenalties and <br />to the cost of as provided the <br />Section 3076 of the Labor Code, interest and <br />,",_ -r+_\\ <br />I hereby aflirm under penalty of perjury that I am licensed under of Chapter 9 (commencing with of Division 3 <br />of the Business and Profcssions Code, and my license is in full force and effect. <br />Liccnse Clasc: Licenqe Number: <br />('ontractor: <br />CONSTRUCT!(IN LENDING AGENCY <br />I hcrcby allirm undcr pcnahy of pcrjury that therc is a omtruction lcnding agffy for lhc pcfomarce of the work ftrr which this pcmit is <br />issued (Sec. 1097, Civ. C.). <br />Lender's Name: <br />Lender's Address: <br />NTPL|CANT nrct ARATTON <br />I hcrebyaffnnrunder penalty of perjury one of the following declarations: <br />Demolition Permits-Asbestos Notification Federal Regulations ('l'itle 40, Part6) <br />-Required <br />Letter of Notification <br />-l <br />certify that the Heral regulations regarding asbestos removal are not applicable to this project. <br />-l <br />certi$ that I have read this and state that the atnve inftlnnation is correct. I agree to comply with all City and County <br />representatives of this City and Counly to enter uJrrn theordinances and State Laws <br />above mentioned property for <br />Applicarrt or Agerrt <br />Pernritee nanle <br />constructior\ ald hereby <br />, <br />JJ <br />IA <br />Date: <br />-=,6Fq.,{el