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T4TA�kPFE I 4 1 2 i,�0 � 'Rlan chnc6 uBP�W7A1� .. .--. . � ... . . ...��U r � swGte fa�u�k • : 1 , . . i� HQME ONMER$LILOE ECIABAffQN� Nome - - � � ���••.e6y afflrro�Y�at I�n ealmpKK9m et�ma�a/t tiroaae . .- .._ .. --- - � . — � . . . �o.iha fatlowi�ry repypn(Ssoion b.@uatne��d '0`d�°�_ i �;.i�� -�'`: y suion�Cqde): 'Ciry 8. _ . I ❑ I�as�a�ener o4'�hn pmPerrV,wit}d��he wak aod�1�e - . . .. - _ . . � sTwcture is not iM sd-ar a�ar�.f ta.wte(Sea�� � j �oat 6usime�+and�Eeu�t�code3. 60NStRIUC9'Iqt1:tENU�t9Q RGEIvCr I he.p(ry a[t�Rm nc�tr�hsrs ia�4<oi4BRia��endFrl�°apsrrcY ior ' . . �he perFarmp qce N rh,e.xmrk foe WFte1r�rHit pe[�iir-is 4soed i (Sec.30➢T,Ci�t.k , � le�ler'sNao�n . _ . . . _. . � i lender:A.�Qre�. j� i eeq�tq�doF+�iwa�ead�li�40?ileptlAn 4Pd uMe� �i rY.e � . abors�inParmqHon it�correa�Or�� v eylPoalk orrb ddtt 6tais xawt�09�����At1 h�aebY G R� mt��a'e�m�t�es�ihia Catreiy.�P ��_TyC��tre� � �YaandnWnl�tlrIIpkdY foc�FAs+ipn�lh x7lf.[R� ,����������¢��fj►�'f����[1�.�A�.� S+qnature of�mmne�S elil�+�•l� Date � _- -- _ . _ _ . - - - ___ ._ . - -. ._ _ . _ .. �_ _ _ _ __. __ APPROVALS DniE �t�CfOxS510NAiURE � �NSP€CTOR'SNOTES OWf�ER-BUILD`eRDECLAEATIOU ��i UNDER SLAB WORK � � � � I hereoy af(irm thut I a mpt f•om tho Contractcr's ��, ROUGH MUMBING , License Low for the followine7 reason (S•.;cfian 703L5, j GAS FIPING � � � - Bos/ness and Professfor.s Code):Any dfy or covnfy which GAS VENT requires o permll�o cons6vcf,olfer,Improve,demo7�sh. � � � ar repair ony sfrucWrm prior fo Its /ssuonce, also rr � HOT WA7ER FIEqiER � ' res tAe a 1 canl fo�soch �mit�o file o sl ned s}afm I - �4�' PP' P-� 9 PWMBING FIXTt1RE5 ' ' • monl fhvt ha Is licensed pursucnf lo the prevfsions of 1he I GASTE57 ��]— Confracfori Llcense Law(Chapter 9(commencing wilh I � Sedion 7000)ol�ivision 3 a/�he Rusiness and Pro7es� I UTILITYCO.hk7TIFlED• • � � , ._ sions Code)or Ihc�he ls exempl Iherelrom and fhe bvsls � P c'J (or Ihe alleged eremp�ion. Any viofafian of Secfion � FINAC � ' (r��nr on yronl � � . � 7031.5 by ony appliconf Ior o permit svbjecfs!hc appli- canf fo o clvff per.alty ol nof ,norc fhon/ivc hundred . doflars(5500).: '�. MDUSTRiAI ' � � _ ' .� . ❑1,as owner of the propmry wlll do the work,and WASTE APF�OVFL Iha shuct�rc is not intend�d or offcrcd for scic. (Sec 7014,Business nnd Professions Cade� 7he('�`ao � � . �� - . tor's Llcenso Law daes not opply lo en owner of p ,�fy wFo bu(fds or Improves fherecn, and who does'such � . . . . , work hfmsell provldad Ihal suc6 Improvemenfs ore nof � � � fntended or offered lor sole.If,however,!he 6ullding or � � . , � � fmprovement is sold wifhln one yror of compfc'ion,Ihe � ' � � � '� ownerbvilder w(If hove/he bu�den of proving fnol he did i � , . . na!bolld or fmprove for fho�purpvsc ol svle.) I �. . I am exempt under Sec. , � �e�`' 6&P.C.for ihis reason i i j Dotc iOwner I , INSPECTQR'S NOT€5 ' .