SR0071764 - Laserfiche WebLink

Home Browse Search

Joe ADI?Rfss: PERMIT#: I i LICENSED CONTRACTORS D6 LARATION 1 hereby affirm Mat I am licensed under the provisions of Chapter 9 1com 5noing�yidl 6ection 7000)of Division 3 of the Business and Professions Code and my license is in full force and 1 r License# C�7#484288 Expiiation Date 12-31-15 Date 3-1 1-15 Contractor E%plor4tio Moservices Inc OWNER-BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason'Section 7031.5,Business and Professions Code Any city or county which requires a permit to construct.atter. improve,demolish,or repeir any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is iicensed pursuant to the provisions of the Contractors License Law iChapter 9 tcommencing with Section 7000)of Division 3 of the Business and Professions Code)or that he is exempt herefrom and the basis for the alleged exemption. Any violation of Section 7031 5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars;3500)): 1771 I, 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 (Section 7044, Business and Professions Code: The contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however. the building or improvement is sold within one year of completion.the owner-builder will have the burden of proving that he did not build or mprove for the purpose of sale.j O I,as owner of the property,am exclusively corm-acting with iicensed contractors to ccnstn:ct the project(Section 7044,Business and Professions Code(B&PC): The Contractor's License Law does not apply to an owner of property who builds or improves hereon, and who constructs for such projects with a contractors)licensed pursuant to the Contractor's License Law 1 ❑1 am exempt under Section B&PC for tt is reason Date: Owner: WORKERS'COMPENSATION DECLARATION I hereby affirm that I hape a Pri of consent to self-insure or a certificate of Workers'Compensation Insurance.or a certified cony thereof{recti n 3800, Labor Code) Expiration Date y Z Company mortified copy 5 hereby furnished 0 Certified copy is filed with the Environmental Hearth Department CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100)or less) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of California. Date: Applicant NOTICE TO APPLICANT. If, after malang this Certificate of Exemption, you should become subject to the Vkorkers' Compensation provisions of the Labor Code,you must forthwith complywith such provisions or this permitshall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097.Civil Code). Lender's Name j Lender'Address JI DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION I hereby certify that no excavation five (5) or more feet in depth into which a person s required to descend. will be made in connection with work authorized by the permit, and that no building structure, scaffolding.. faisework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high. (Chapter 3.2, Group 2,Article 2, Section 341, Title 8, California .Administrative Code). O As owner-builder. I will not employ anyone to do work which would require a permit from the Division of Industrial Sat" as noted I above,unless such person has a permit to do such work from the division. C Division of Industrial Safety Permit# _._.___.._........_.__...._......._.._.. I certify that I have read this application and state that the above information is res to comply with all city and county ordinances and to If"relating to well construction and or sewage system n, d hergby authorize representatives of this county to enter ufon tile above-mentioned property for inspection purposes Date �t .�i�j� Applicant Dr EHC C,X L;CENSE[),'ONTRAC'CR OECt.ARAT;CN