INSTALL_2013 - Laserfiche WebLink

Home Browse Search

JOB ADDRESS: 2680 REYNOLDS RANCH PARKWAY, WDI, CA 95240 PERMITU: LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under the provisions of Chapter 9(commencing with Secton 7000)of DMslon 3 of the Business and Professions Code and my Hcense is In full force and effect. License# 804431 Expiration Date 8/31/2013 Date 12/14/2012 Contractor—JONES COVEY GROUP, INC. OWNER-BUILDER DECLARATION I he hirrr that I em exempt from Ne Contmdors License Lawlor the following reason(Section 7031.5,Business and Professions Code: Any ' or county which requires a permit to construct alter,Improve,demolish,or repair any structure,prior to its issuance, also requires the t for such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contractors License Lew(Chapter encing with Section 7000)of Division 3 of the Business and Professions Code)or that he is exempt herefram and the basis for the ed 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 red dollars(5500)): O I,as owner of the propery,or rry employe 'th wages as their sole compensation,will do the work,and the sWcWre Is not Intended or offered for sale(Section 7044,Buslne d Professions Code:The contractors License Law does not appy to an owner of property who builds or Improves thereon,and w oes such work himself or through his am employees,provided that such Improvements are not intended or offered for sale. If, ver,the building or Improvement is add within one year of completion,the owner-builder will have the burden of proving that he d build or Improve for the purpose of sate.) O I,as owner of the property,am exclusivey contracting with licensed contractors to butt the project(Section 7044,Business and Professions Code(B&PC): The Contractors License taw does not apply to an owner M who builds or Improves hereon, -- and who wristn cts for such projects with a contractors)licensed pursuant to the Contractors ae Law.) 01 am exempt under Section , S&PC for this reason _ Data: Owner. WORKERS'COMPENSATION DECLARATION I hereby affirm that i have a certificate of consent to self-insure or a certificate of Workers'Compensatton Insurance,or a certified copy thereof(Section 3800,Labor Code). Explration Date 2/1/2013 Company GRANITE STATE INC. CO. _ Certified copy Is hereby furnished Certified copy is filed*Ih the Environmental Health Department CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE hl sscti0 n ed Ifthe e i for one hundreddollars 0 r l s I certify that in the performance of the 1Ch this permit Is Issued,I shall not employ any person In any manner so as to become subject to the Workers'Compensa on alffomia. Date: Applicant NOTICE TO APPLICANT:If,after making this Certificete Of Exemption,you stould become subjec ens'Compensation provisions of the Labor Code,you must forthwith campy with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby effirm that there S lending agendy for the performance of the work for which this permit Is Issued (SBCtion 3097,CIN[Code). Lenders Name Lender Address DIVISION OF INDUSTRIAL SAFETY PERMITCERTIFICATION O I hereby certify that no excavation five(5)or more feet in depth Into which a person is required to descend,will be made In connection with work authorized by the permit,and that no building structure,scaffolding,felsewvrk,or demolition or dismantling — thereof,will be more than thirty-six(36)feel high.(Chapter 3.2,Group 2,Article 2,Section 341,Title 8,California Administrative Code). ❑As owner-builder,I wID not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless Such person has a permit to�wdo such work from the dMalon. {.Division of Industrial Safety Perrdta l� ' o 0 l T�q I certify that I have read Ws application and state that the above Information Is correct I agree to comply with all city and county ordinances and state have relating to wall construction and or sew age system m sWdbn,and hereby authorize representatives of this county to enter upon the above-mentioned property for Inspection purposes. Date 12/12/2012 Appl168 am No 4301 DCENSEDCONMCTOROEC MON rwa'07