REMOVAL_1995 - Laserfiche WebLink

Home Browse Search

CITY OF STOCKTON 0 M -COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION, CITY HALL PHONE:(209)937-8561 STOCKTON, CALIFORNIA 95202 24 Hr. Inspection Request 937-8560 PERMIT Application Number 95 00001223 LICENSED CONTRACTORS DECLARATION I hereby affirm put I am licensed under provisions of Chapter 9 (commencing q with d my IMM§ of fDIMMDIDRI hl�y CenO Job Addrec3 _ Prolaasipnr Code,and my II IMM§iiT I'fdY28YN3Yffkct.' Issue Date CONTRACTOR 30S S EL DORADO ST 4:18/95 LICENSE NO. LICENSE TYPE DATE Permit Type . : GRADING PERMIT--------------2L STOCKTON BUS.LIC.NO. Parcel Nbr . : 149 063 01 OWNER-BUILDER DECLARATION Geo Code : 0100 06 04 04 0 1 hereby affirm that I em exempt from the Contractors License Owner Name . . UEDA DEN 6 BETTY Law for the following reason(Sec.7031.5.Business and Professions Code: Address 626E 6ALIN RD Any city or county which requires a Permit to construct, alter. improv:. demolish, or repair any structure. prior to Its Issuance, also requires the applicant for such permit to file a signed statement that he is licensed FRENCH CAMP CA 95231 pursuant to the provisions of the Contractor's License Lew (Chapter 9 A I Ty a . . . SITE IMPROVEMENTS commencing with Section 7000) of Division 3 of the Business and.Pro- PP P sessions Code)or that he is exempt therefrom and the basis for the alleged Desc of Work NON RESIDENTIAL exemption Any violation of Section 7031.5 by any applicant for a Permit subjects the applicant to a civil penalty of not more leen five hundred MISCELLANEOUS dollen(f30o.1: ❑ I,as owner of the property,or my employees with wages a.their SITE MORK role compensation, will do the work, and the structure is not intended valuation . . . 4000 or offered for sale (Sec. 7044), Business and Professions Code: Th: Contractors License Law does not apply to an owner of Square property who S -ft . . 321 Zoning . . . C3 builds or improves thereon,and who does such work himself or through R 9 9 his uwn employees, provided that such improvements are not intended Occup Group . . Const Type . or offered for sale.If, however,the building or Improvement is sold within ' on:year of completion,the owner-builder will have the burden of proving that he did not build or improve for the Purpose of sale.) ❑ I. as owner of the property. am exclusively contracting with Special Notes and Conditions licensed contractors to construct the project (Sec. 70". Business and BACK FILL TANK REMOVAL TO LOCATIONS ON Professions Code: The Contractor• License Lew does not apply to an mo: of property who builds or improves thereon, and who contracts SITE 1-24 CU.YDS,1-293 CU.YDB for mse projects with a contractor(s) licensee pursuant to tneContractora VALLEY ENVIRONMENTAL SOLUTIONS ❑ I am exempt under Sec. ,B.A P.C.for this CSLI 695643 EXP 9/30/96 '°aeon WC STATE FUND 7125/95 Data Owner CITY LICE 95-46541 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(Sec.3097,Civ.C.). - - - - - - - - - - - - - - FEES - - - - - - - - - - - - - - - Lender.Name PERMIT FEE 33.00 PLAN CHECK FEE 22,50 Landers Address A20-SPNI (.00IEVAL)----KK 4.00 WORK ERS'COMPENSATION DECLARATION A15-SHIP-STRON6 MOTION-N9 .84 I hereby affirm that I have s certificate of consent to sell-insure.or a certificate of WorkersCompensation Insurance, or a certified copy A35-LAND UPDATE--------NN 2.50 thereof(Sec.3800.Lab.C.)Policy No. Company A10-MICROFILM FEE------LO 10.15 ❑ Certified copy Is hereby furnished.Expires A30-PERMIT TRACKING----MM 10.00 13 Certified cop,Is filed city bug n ei •"hent. A25-SPAS (.0005aVAL)---LL 2.00 1' DDot. -1 V .Applican CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE This section need not be completed if the permit is for one hundred PERMIT TOTAL 84.99 dollars($100)or lose. I certity that in the performance of the work for which this permit I$Issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. Data Applicant f NOTICE should APPLICANT: IL after marker this Certificate a of Exemption of you should ode. you must r the Workers comply Compensation such provisions is the Labor Cods. you must forthwith comply with filen provisions at this permit shall be deemed revoked. I pthat I neve read this application and stats that the above informationn is la correct.I agree ocomply with all pity and county ncee and seta relating to building ro atction authorize.and hereby autnoriza ,sores. ative of this City u the • ve mentioned property for in` ech urpIGNE1/10 ADDRESS JOB ADDRESS APPLICATION APPROVAL THIS PERMIT DOES NOT BECOME VALID UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS DEPUTY AND FEES ARE PAID. SIGNATURE: � - /5�