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Joe DRESS l] Vl_J t�. I tr�Jr�Y� �� PERMIT!: LICENSED CONTRACTDRs f)ECLARATioN I hereby affirm that 1 am ficensed under the provisions orchapter9(commencing with section 7000)of Olvision 3 of the Business and Prolbaslons Code and my license is in full force and effect License# ! �yiv Expiration Date 10/31/14 Date 7— b''—QUI Contractor/Z//}/-Z"44(�'� Q MMER-sUILDEt DECLARATION 1 hereby aft'irm that 1 am exempt from the Conlraclor s License Law far the fcpowfrna reason(Sectlwr 7051.5,Business and Professions Code: Any city or county which requires a permit to construct,attar,improve,demolish•or neper-v any structure,prlor to its issuance, aIso requires the applicant forsmh permit to file a signed statement that he is ricensed pursuant to Oto provisions of the Contractofs Licerae Lam(Chapter 9(commencing wkh Section 7000)of D'nrWM 3 of the Business and Professions Code)or that he is exempt herarrom and the iasis fru the alleged exemplar. Any vioiatiion of Section 7031.5 by any applicant For a permit subtects the applicant to a"penalty or not more than fire hundred"lm($500)): 13 1,as owner of the property,at my omployees vrah wages as Uww sale cornpensatbn,wilt do Ere work and fire structure Is not intended or tittered for sate(Section 7044,SuSbUM and Professions Code:The mnlractofs License Law does not apply to an owner of property who bunds or improves thereon.and rrho does such work himself or through his oem employees,provided that such irprovernerits are not intended or o6ered for sate. It.however, the building or improvement is sold viAhin one year of comptetwn,the owner-builder will have the burden of proving Etat he did not build or improve for the purpose of sale.) 13 i,as owner of the property,an ezdusively contrnc ft wlih licensed contractors to eonstmet lb,project(Section 71144,Business and Professiorms Code(B&PCk The Carmtraetofs License Law dors not apply to an ovnw of Property who builds or improves hereon, and who constructs for such projeeia mvith a asntractor(s)licensed pursuant to the Contractor's Lttxsue Law.) LI 1 am uemmpt under Section , Btt.PC for this reason Owner: WORiCMS't;7AAPg3,t-,A'7M DECLARA3iDN 1 hereby affirm DMI I have a certifuate of c ortse:rl2 to self ire a a cerUfirate of Workers C�rrPensataon Insurance.or a cB,tw,Opti i wmd(section 3ew.Labor Gude). x/15/14 compalry Zui1C�7i etican Instir�rr•P L-xpiradtott Date,],,,�,.,,�..— 0 Certified copy is hereby ftmtished El CelgW copy is tried with ftte En*0nrtteat1t t11,111,Deiarlffleni Chili!KATE(W exewnoW FROM VVOMMW COWENSA-noN INSURANCE AS rfhis sechon need not ,Ile eomnleted if the permit is for one hurtded rr's iswed.l shat!cwt temPln Y any person to any manner so t ce,*trtat in Uta performance of the work for%ftc t utas p as to becom-Mesa to the wwbeie C-Mensdfion taws of Cafifwrtia. Appiicardt atnuld)>ecoree subyKt to the Mfarkers'CamPornsation HpTrGE I Aft"UGJLr '>t,after makrnfl this Cef12ivb afi£xe+nP�n. nX�.e r»dovMed.rooked. prv.rf:ions of the Labor Cada.you rtastnminsatr oamr(ty wtmh a.`t'Prrwssi COM-MUCnon Ltr3dUNG AGENCY I hereby affk-that there is a construction k'W4V agency far the pesformatice of Ruta worts for which Ihts permit is issued (section 3097,0A Code). Lendees Name LLendee Address DIVISION OF INDUMMAi-SAMY PERidBT CERTIHCA71O2e1 El 1 herby cery7t,that mo excavation rive(5)or mere feet in depth spa vlhkb a person is required to descend.wit be made in correction tffYwith work auriortted try Ute tx and that no bu6di[rp structure. trt2 hrtlGe 2.scaliS¢dWn 31�1 Tait 8.CCgi'lomia Admi e thereof vaHl be more that►I1mtft six 135)feet high.(C 3.2.Group Codb) r e a parnit from the Division of industrial Safely,as noted t3 As amer-builder.I w�not employ anyone to do work Which v+orrid regti above,unless such person has a pertnit tet do such work from rhe division. 13 oivlsiom of Industrial Safety Permit# rieh an city and county L r agree to a mpRsentatNes of this I eer6fy that 1 have read line application and stale that the above ird6errr �� end��, ordinanrts and state faros l9ve-ug ri were construdi forindor sewaV speclion Purposes, courttY to enter upon the above-mentioned proper►F _. Applicant Date tUICENSM COWMCfoiR DeCLARA" ERR 4"T �orso�