SU0007523 - Laserfiche WebLink

Home Browse Search

JOB ADDRESS: PERMIT B: LICENSED CONTRACTORS DECLARATION 1 hereby affirm own I am IicemW under me previsions aa(CMper 9 kamm ucinand my liner".is in full force and eflccn, s wilh Seen.lot of Ulvision 1 of tie gations.and PrIssWuwa Call, IJ«me M Earr:Dae Dale Canl(artw OWNER-IIUII.UER DECLARATION I lamby.firm.mar I am tuce"l fano the Conu«tor'.Linen.Law for the following rtwon(Sec.70.11.5.Ruiinrss uNl RMexiaa Cade; Any rilY or County which requires a permit to comma.alar,)nr to he,um,icd.h,ornit_nr Any suuemrt.Prior tests isno«e.clan requim.the aplabean for mch pemul to file a signed t a Business that he u licensed pwnam to the pmvisiom of (ASV«Per's Lia:nse Law(Chuptet 9(commencing with Smian 7")a( Divisions a of the Bumoua mk est thepmfesaffliom ction Idiom he i.by ,,,Iwref,,in Aad the basis for Ne allegal eaemption. Any linchnlun M Seaton 7031.5 by anY aPPhcant!w a pemdt subl«ts the applicam ro a civil penally or nal men than f we hundred dol lam owner of the property,or my omplaynes With wages as then sole Compensates,will do the wwk,and the gnawrt u nn intended w o(fcretl fou xlc (S«.7Ma.Bananas and Prene"I'ma Cadc:The Cadin.a.a Licnx Law it,.na apply rte on ownero!properly whom,ala m intended Ulermn,end wan does such work Cold within hi through his own empbyw,provided that arch�mpmvenanls arc sloe I.led n offered for sale. If,Iewever,the building w i improvement is xW wilM1in one year o(<omplaiou,CM uwnobuiker wilthlashe burden or proving that le didpq build nrimProve forncC purpose n( sale.) O L as owner of the Property,em ucWsn"'y Conciliating With IiCalssr4 enntsaeers b construct IIrc pmjan(Sm.7044,Business sal Pmrnsiun Code:The I"'C'.Lkcnx Law duo am apply m an ownas or properly wlso builds or inflow"Ihcrcnn.ark who contracts no such proq«is with a cmtrnush) icmnxd pursuum a the Contractor's LscCdn Law.) O 1 am can."under Sec. O R P.C.(w m:s rcann Dole Owner WORKERS'COMPENSATION DECLARATION 1 hereby Wfum Phu a eert I have ifaate of canaenl to self-Imam, Lab. by ora certificate or Workers'Compensation Insurance or a Calcined copy thermal Sm.3800, Eap.Dison Continuity 13 Qnlfie.l Copy Is frveay fam'ah til 0 Certified easily is finds With the County Building Inspection Division CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE j( Mass section need not be Completed if the Permit is fou one hurkmd dollars(S Ion)or Icss) 1 certify than in the petf"mance Of the woh ter which this per em,is issued.I shall ret employ any person in any manner n an he bma o suhj«I an Ila Walken'Compensmlon Low.of California. Dace Applies NOTICETO APPLICANT:If.an.making this Candies.of Baempllan.you should baseem ubjca lC the Workers'C .,..,Ion Labs,Cork,you soca f nthwitheomply with such Prasrisl M Ill..Perms shall M dCarrN revoked oma PaW isiam of tae CONSTRUCTION LENDING AGENCY 1 hemby affirm that thue is a construction lending agency W on,pnrfommrce of the went for which this permit is issuW(See 3(W.Civ.Cl, Lando',Nome Lerker'a Address DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑1 herby sandy that a0 C nu va ion fiva(5)M more f4J In depth Into Whwh es PC.Is equired n,4mmod.will bit,makC In.Vnrrertiml WNh Walk ngiv(Cl by the permit and tan on building S.C.A.C.) arodding.fal.awaik,w demolition or dismantling mean[Will he ewe than rainy-sic,(36)feel i high.(l]eP.].1,Grp],ern Z,Sec 341,Tilk S.C.A.C.). 0 As Owner-builder 1 will wt employ anyone to do Work which would require a PcrmU from tine Division of Industrial Safety,as aced above,unleu such Person MI A perms'to do such work from the dsvuion. ❑Divlsiuu of htluurin Permit No. I Calcify the I hove read Nis appllcaion red wale Phu Ue above infammiun is coacd. 1 age«to comPlY with all Gill ark county ordinances aM mme laws strelucilYrelmiegmwellc�cP�.orxwage syaemronas«tian,and herchy amhoriae nmcscnmtivea oflhis mildly m enter upon the above-nimliancd "",lion's tion u Dace APpheanl 1