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LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapter -9 (commencing with Section 7000) of Division 3 of the Business and
Professi�n;
$� INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
OX to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL
APPROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Sewer Connection
Gas Piping
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Pool Cover
Encapsulation
Gas Test
Appliances
Final
COMMENTS:
Final
r�
Utility Notice (Gas) (F�/
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
TOTAL $ / f �`•� ,'�
k. Remarks: !^CCtf(a %-C "Tl f!A
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'NI Copy to: b ` — 314(fir..
Cash Water Service
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Money ' Cashier
Order "' :yV CVWD-438(11189)
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COACHELLA VALLEY WATER DISTRICT
1
CASH RECEIPT DETAIL 4K:
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Received From: >�1��
Date.
Address:116A
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Account No. �/ (� � -�
Lot(s) Tract
Service Address
G.A. Code
❑ Meter(s)
$
❑ Service(s)
❑ Backflow(s)
❑ House Lateral(s)
❑ DetectorCheck(s)
• ❑ Meter Surcharge
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Sanitation Capacity Charge
1`1
❑ W.S.B.F.C.
❑ Temporary Construction Meter
❑ Turn on Charge
y
❑ Uncollected Account - Name
❑ InspectionFee'- Tract -
~
' Fee -
❑ Pian Check Fees Water / Sewer -
Tract -
❑ Bond Payment - A.D. - Bond
' Assmt.
❑ Customer Deposit
❑ Other
TOTAL $ / f �`•� ,'�
k. Remarks: !^CCtf(a %-C "Tl f!A
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'NI Copy to: b ` — 314(fir..
Cash Water Service
'.
Check ✓ �i rc w
Money ' Cashier
Order "' :yV CVWD-438(11189)
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